[Congressional Record (Bound Edition), Volume 155 (2009), Part 19]
[Senate]
[Pages 26240-26242]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. GREGG. Mr. President, I rise to speak again about the issue that 
is the topic of the day for us in the Congress--independent of the 
question of Afghanistan and Iraq, which is our No. 1 concern--and that 
is the question of health care.
  Today, the Speaker of the House and the Democratic leadership and 
membership of the House unveiled their plan. It is 2,000 pages long. 
They made the representation that, in some way, it wasn't going to 
increase the deficit. This is a bill that is going to cost between $1 
trillion and $2 trillion over 10 years. The idea that it is not going 
to increase the deficit is so unbelievable just on its face that it 
doesn't even pass the laugh test. If you believe that, then maybe the 
Speaker of the House should sell you a bridge in Brooklyn--or even in 
Oakland, for that matter. That one doesn't work, by the way. The simple 
fact is, when you increase the size of the government by $1 trillion or 
$2 trillion, as this bill proposes to do by massively creating a 
massive new entitlement called a government-forced insurance plan, 
there is no way you are going to be able to cut Medicare enough, as it 
is proposed in this bill, or raise taxes enough, as it is proposed in 
this bill, to meet the cost of that program. There is no way it is 
going to happen. So to claim that this won't add one dime to the 
deficit, as the President claimed he would not do when he spoke to the 
Congress, is just not believable.
  Under this administration, we have seen a massive expansion in the 
debt of this Nation. They represent constantly that they just inherited 
this from the Bush administration. Yes, a fair amount of it did come 
over from the prior administration, but the budget they sent here, 
which has a trillion-dollar deficit every year for the next 10 years, 
isn't the Bush budget, it is their budget. The budget they sent over 
here, which raises the debt in this country from 40 percent of GDP to 
80 percent, isn't the Bush budget, it is the Obama and Democratic 
budget.
  The representation was that we would go out and spend almost $1 
trillion--$800 billion--on a stimulus package, and that would create 
jobs. What it created was debt for our children.
  The numbers are starting to come in now. It was represented in New 
Hampshire specifically, this administration said there would be 16,000 
jobs created in New Hampshire by the stimulus package. Since the 
stimulus package has passed, we have lost 12,000 jobs in our State, and 
$400 million has been spent in New Hampshire. The administration argues 
$400 million created 3,000 jobs. They have to use some pretty creative 
accounting to get to those 3,000 jobs. Even if we give them the benefit 
of the doubt, that is over $130,000 that it has cost Americans per job.
  Did we have that money to spend? No. We sent the bill for that 
package to our children. We put it on their backs. In fact, almost 50 
percent of that stimulus package is going to be spent after this 
recession is long over. It is going to be spent after the year 2011.
  Chairman Bernanke, head of the Federal Reserve, said the recession 
was over. He said that about 2 weeks ago. Granted, the pain and 
suffering and the difficult economic times certainly are not over, and 
we do need to be concerned about that. But in 2012, 2013, 2014, 2015, 
even in 2019, there will still be money being spent under that stimulus 
package, and all of it will have been borrowed, borrowed from our 
children, and they will have to pay it back.
  Then we had the Cash for Clunkers Program which was allegedly going 
to be this great stimulus initiative. That has been looked at by an 
entirely independent group, edmunds.com, which is an automobile site on 
the Web. They tell you a car's value and give you an independent 
assessment of its qualities, pluses, and minuses. They took a look at 
that program. They said there were 690,000 vehicles sold during the 
Cash for Clunkers period. But they concluded--they are not 
conservative, they are not liberal, they are not moderate. They are 
just a professional group of people looking at what happens in the area 
of automobiles. They concluded that only 125,000 of those cars would 
not have actually been purchased or sold by the dealer were the Cash 
for Clunkers Program not in place. In other words, the vast majority of 
cars would have been sold; they would have been bought under Edmunds' 
estimates.
  So we spent about $3 billion to buy 125,000 cars. That works out to 
$24,000

[[Page 26241]]

per car. Who did that bill go to? That is going to our kids too.
  Just in the last 2 weeks--well, almost every week around here we hear 
proposals to spend money and not pay for it. A week ago, somebody 
suggested from the administration that we should spend $14.5 billion by 
sending $250 to every Social Security recipient. Why did that come 
about? That came about because people were starting to realize senior 
citizens were getting a little upset with the fact that under the 
health care proposals that have been coming forward from the Finance 
Committee, from the Labor Committee, now from the House, that under 
these proposals Medicare was going to be significantly reduced. Seniors 
were going to lose their Medicare benefits so that a brandnew 
entitlement could be created which had nothing to do with seniors and 
be partially paid for with these reductions in Medicare payments.
  In fact, if you are on Medicare Advantage, under the Finance 
Committee bill, you can forget it. That program is gone. There are a 
lot of seniors in this country who have Medicare Advantage. They like 
it. They think it is a good way to get health care. But the majority of 
the Medicare cuts come out of Medicare Advantage. Basically, they are 
wiping out that insurance benefit. Talk about losing your insurance. 
The President says nobody is going to lose their insurance today who 
has it; nobody is going to lose it.
  Right on the face of it, when Medicare Advantage gets wiped out, 
every senior who has that is going to lose it. They are going to be 
moved over to the standard Medicare. And for what? To pay for a new 
program, a new entitlement program that has nothing to do with seniors 
and has nothing to do with making the Medicare system more solvent.
  If we are going to reduce Medicare payments, and there are 
adjustments we need to make in the Medicare system, it should go toward 
making that system solvent. Why is that? Because the system is 
insolvent.
  It is inconceivable that the White House would suggest that we should 
add $14.5 billion of new spending to the Social Security Program, which 
is also going to be insolvent in a few years, because seniors were 
upset and they were realizing what was going to happen to them under 
Medicare. They wanted to sort of give them some walking-around money, 
the old Chicago way--walking-around money. If we give people money, 
maybe they will not be upset by things.
  I think most seniors understand that, sure, they would love $250, but 
how does that work? When we total that all up, that is $14.5 billion of 
debt which is going to be given to their children and their 
grandchildren to pay when those grandchildren and children already are 
getting a massive debt, almost $50 trillion of unfunded liability just 
in Social Security and Medicare alone.
  We have to ask ourselves: Should we put another $14.5 billion on 
their backs simply to make a political statement? Of course not. But 
that was proposed.
  Then a week ago, it was proposed that we should do a $250 billion fix 
to reimburse doctors fairly. Doctors are not reimbursed fairly under 
Medicare. They are not. That is an interesting fact because if we look 
at all these proposals that are being talked about from the other side 
of the aisle, they are saying: Oh, everybody in America will have 
Medicare. That is a great idea. The fact is, Medicare does not 
reimburse doctors for what the real costs are. So a lot of doctors 
don't want to do Medicare.
  The reflection of that fact is, they proposed the $250 billion doctor 
fix. They didn't want to pay for it. That is a $\1/4\ trillion. That is 
a lot of money. All that debt goes on our children's backs. Our 
children have to pay for that spending. That was the proposal that came 
from the other side of the aisle.
  Fortunately, some folks on the other side of the aisle--I 
congratulate them, 12 Members on the other side of the aisle in the 
Democratic Party and one Independent--said: Wait a minute. We are going 
to join the Republicans on this one. You can't do this. This is not 
right. You cannot spend $250 billion on fixing the doctors fix, which 
should be fixed, and then take that bill and give it to our kids and 
grandkids. You have to be more responsible.
  Over the years, every year we have fixed the doctors fix. We have 
fixed it now for 10 years, and we have paid for it. But this was not 
going to be paid for.
  These ideas for spending money and not paying for them have become 
fairly common around here. But the biggest item is clearly going to be 
this health care bill which is a brandnew entitlement representing $1 
trillion to $2 trillion of new spending.
  What is that money going to be used for? It is going to be used 
basically to create a new government-inspired insurance program to 
compete with the private sector in the area of supplying health care. 
That would be OK except for the fact that as the Speaker of the House 
has said, that government plan is going to be used to save money. There 
is only one way that a government insurance plan can save money; it has 
to underprice the private sector. How does it do that? It uses the 
authority of the government to set price controls. It uses the 
authority of the government to control procedures that people are able 
to get. It uses the authority of the government to limit innovation 
because innovation is costly.
  Inevitably because of that--price controls, controlling access to 
doctors and hospitals and procedures people can get, and controlling 
innovation--it inevitably deteriorates the quality of health care 
generally for the public.
  Equally important, of course, under the scheme that has been 
developed that we have seen so far--although we have not seen the 
specifics because they are being developed behind closed doors on the 
Senate side. We have seen the House bill, but we haven't had a chance 
to read the 2,000-page bill. But the scheme that came out of the 
Finance Committee, equally important, the practical effect would have 
been that employers would have been encouraged to basically drop 
employees from their private insurance plan and cause those employees 
to migrate over to the public plan--intentionally, of course--through a 
whole series of activities which would make it much more practical for 
an employer simply not to insure people but to pay a penalty instead 
and put employees on a public plan.
  There will be a natural contraction in the private insurance 
community because there would be a price-controlled government plan and 
a natural movement of people over to the government plan because the 
penalty for employers not insuring people is significantly less--at 
least in the HELP Committee bill--than the cost of insurance and, 
therefore, employers will look at it and say: It is cheaper to pay the 
penalty than insure the folks. So I will just pay the penalty and 
people can go over and get a public plan. They lose their insurance.
  Mr. President, 180 million, 190 million people in this country have 
private insurance. They are pretty happy with their doctor and their 
health care. They may not be happy with the insurance company--most of 
us are not--but they are pretty happy with their doctors and their 
health care. If they are forced on to a public plan, that is going to 
put this bureaucrat between you and your doctor. It will mean if you 
have a government plan, you may have to call Washington to see your 
doctor.
  It also means, as I said earlier, in order for the public plan to 
work and be cost effective in the sense of saving money, as the Speaker 
of the House says that is how she has to save money, it has to have 
price controls, it has to have control over access, it has to have 
control over innovation, all of which inevitably leads to delay and a 
lesser quality health care system.
  The goal on the other side of the aisle--we all understand this 
because they have been public about this; there is no subtlety about 
it--is to move to a single-payer system where there is one insurer in 
the country, and that is the government.
  The same group that is bringing us the swine flu vaccination program 
is going to bring us all our health care. Think about that. We don't 
have to go

[[Page 26242]]

too far for an example of how the government has a hard time managing 
fairly large issues of health care when it comes to the practical 
application of taking care of people who need assistance. All we have 
to do is look at what is happening in the swine flu program to 
recognize that the government may not necessarily, in all instances, do 
such a great job of delivering health care.
  For example, today you cannot get your swine flu vaccination in most 
places in this country because it is not available. Yet that is the 
system which a large percentage of members of the other party seem to 
desire, a single-payer system where government supplies it much along 
the lines of what we see in places such as Canada and England.
  I don't think it is healthy for you. I don't think it is healthy for 
patients. It is certainly not healthy for our children because it means 
they are not only going to get a lesser health care system, they are 
going to get this huge bill, this massive bill which is going to come 
out of this $1 trillion to $2 trillion increase in the cost of 
government.
  It is hard to understand--it has to be intuitive to people, and I 
know it is to most Americans--that if we increase the size of 
government by $1 trillion to $2 trillion, we inevitably end up passing 
on massive debt.
  The PRESIDING OFFICER. The Senator has used his 15 minutes.
  Mr. GREGG. I ask for an additional 1 minute.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. GREGG. As I said, it has to be intuitive, and I know it is 
intuitive for most Americans, that if we increase spending of the 
government by $1 trillion to $2 trillion--and our estimate is this 
program costs $2.2 trillion in fact--and we cut Medicare to try to pay 
for that, or we try to raise taxes to pay for that, we are like a dog 
chasing a tail. It never will happen. The two ends just don't meet. 
They just don't meet. And what happens to the part that doesn't meet? 
That is called debt, and it goes to our children. It is not appropriate 
to do that after we have already put so much debt on their backs, 
especially in the last few months.
  Mr. President, I yield the floor.
  The PRESIDING OFFICER (Mr. Merkley). The Senator from Iowa.

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