[Congressional Record (Bound Edition), Volume 155 (2009), Part 21]
[Senate]
[Pages 28908-28910]
[From the U.S. Government Publishing Office, www.gpo.gov]




                           HEALTH CARE REFORM

  Mr. ENZI. Mr. President, after the speech by the Senator from 
Illinois, I feel compelled to make a few comments. One, he challenged 
us a little bit to do a bill in 2,000 pages or less. I am one of those 
people who do not think it can be done in less. I do not think there 
are nearly enough pages there to solve the biggest problem in the 
United States for every American.
  People are not comprehending how big health care is. The bill we are 
doing will affect 100 percent of the people in America. I do not know 
if we have ever had a bill before that affected 100 percent of the 
people--100 percent of the people, 100 percent of the professions, 100 
percent of the businesses. This is big. Everybody has a role in health 
care, and we are trying to condense it into 2,000 pages and make it 
seem a lot simpler than it is.
  The reason our side has been saying you need to take this a step at a 
time and get it right is because that gives up some of the right. There 
are over 200 references in the 2,000 pages that say the Secretary of 
Health and Human Services will solve that particular problem; in other 
words, put in the details. We do not have nearly the details in there 
to actually run health care for America. Without the details, we do not 
know what the devil is, and that is the difficulty. So we really ought 
to break it down a step at a time.
  One step I really think would calm America down is if we did Medicare 
as a separate step. That way we could assure seniors that Medicare was 
going to be for Medicare. Yes, there are savings in Medicare. Yes, 
Medicare is going broke. Use the savings for Medicare. It seems pretty 
simple to me.
  One of the things they are complaining about is the doc fix we have. 
We are not paying doctors adequately to be willing to take Medicare 
patients. Of course, we are not paying them adequately to take Medicaid 
patients either. But we are not paying them right. It would cost about 
$250 billion to fix that.
  Well, if we are talking about $464 billion worth of savings in 
Medicare, why

[[Page 28909]]

not use that $250 billion to fix that problem so we have doctors. I do 
not care what kind of insurance you have, I do not care how much you 
pay for the insurance, if you cannot see a doctor, you really do not 
have insurance. That is what seniors are being faced with. That is what 
Medicaid people are being faced with.
  Medicaid--well, that is another piece that ought to be maybe a step 
because 40 percent of the doctors will not take a Medicaid patient 
because they are not being paid adequately for it. If you are not paid 
adequately, you go broke. They are small businesses. They are affected 
by this bill in more than one way. They have to provide what we are 
saying is a government requirement for the minimum insurance they have, 
and they also have to live with whatever rules we put in there and 
whatever pay fixes we put in there.
  On the government option, one of the things CBO said was, the only 
way that would ever bring down costs is if the government fixes prices 
for the doctors, for the hospitals. Well, we are kind of doing that in 
this bill for Medicare because we are telling nursing homes they are 
going to take a big cut. Nursing homes do not have a lot of margin, and 
if nursing homes go broke, people have to go a long ways, sometimes--in 
Wyoming, anyway, and Colorado, wherever we have rural populations--they 
may have to go a long way to see their loved one. They may not even be 
able to do it. So we have to keep those small nursing homes in business 
as well.
  So we ought to do this in steps and get it right. That is one of the 
problems that the Group of 6 ran into. We were not given the time. We 
allocated about 13 different areas to go through. I think we made it 
through 5 completely and probably 3 fairly completely, and the rest we 
were just asking basic questions. With any business, it looks pretty 
easy until you scratch the surface a little bit, and when you scratch 
the surface, you find out that every job out there is fairly 
complicated. If you have never done it before, and you are trying to 
come up with 2,000 pages worth of laws to govern that, you are probably 
going to get it wrong.
  That is what the doctors are telling us. That is what the other 
providers are telling us. This bill has it wrong, in a lot of places, 
enough places that it is going to cause a crisis in America if this 
bill passes the way it is.
  We have never passed a major bill in this body with just one side 
voting for it. If that were to happen, the other side would take 
potshots at anything that turned out to be something that had not been 
comprehended when the bill was written. And there will be plenty of 
that in here.
  But just as important, the American people will not have confidence 
in it. They do not have confidence in us now--either side. I think that 
is what the elections in Virginia and New Jersey said. That is what the 
tea parties are saying. They are saying: We don't trust any of you. 
Throw the whole bunch out. Start over.
  Well, we need to stop and get their confidence. Just steamrolling 
from one side, even if they have the 60 votes, is not going to do that. 
I have been saying that since we started. It is something so important 
that we have to get it right, and we do not have it right in this bill 
because there are a whole bunch of things, over 200, where we said to 
the Secretary of Health and Human Services: You figure that one out. 
Well, that is going to be thousands of pages, and it is going to be 
done by an unelected bureaucrat. It is not going to be approved by this 
body.
  We ought to take the responsibility for getting those things right. 
And we can. Yes, it takes time. Yes, we have a lot of things to do. But 
I am in agreement that health care is the most important thing we have 
to do. But we ought to take the time to get it right.
  There are a lot of ideas out there that would--in fact, one of the 
things that always upsets me when they say: So where is the Republican 
version? Well, I have been working on this thing for about 4 years. I 
have been working on it, actually--health care--ever since I got on the 
committee over 13 years ago, but for the last 4 years pretty 
intensively.
  Senator Kennedy and I sat down and worked out principles we wanted to 
have. The principles are still the principles we are talking about 
around here. We want to make sure people are covered in catastrophic 
situations. We want to make sure preexisting conditions are taken care 
of. We want to make sure they have portability when they go from one 
job to another. The list goes on and on. We reached agreement. He was 
busy working on the Higher Education Act because it was way past due 
for being reauthorized, so I was kind of released to go talk to 
everybody on health care. I worked that. I worked both sides of the 
aisle, finding out ideas they had, and boiled it down to a 10-step 
plan.
  I did a tour with my 10-step plan to see what kind of problems there 
were with it and was really pleased with the reception. Yes, I learned 
some things that needed to be done differently than what I thought. But 
if you will check my Web site, there is a 10-step plan that is a bill 
that covers the things we have been promising people they would have. I 
would not suggest doing it in one package. I would suggest doing it in 
several steps, not necessarily 10 steps, which are what are in there. 
But it would bring down the cost of health care insurance. That is the 
biggest thing I hear from people out there: Bring down my cost.
  Now, everybody has been real pleased with this CBO clarification that 
came out that said the costs were not going to rise. They did not say: 
Don't let them rise. They said: Bring them down. Bring them down. They 
said: We don't mind covering a whole bunch of other people, but don't 
increase my costs as a result. This bill increases their costs as a 
result.
  There is a way to do it. There are four different bills on the 
Republican side. And then there is a really bipartisan bill that 
Senator Wyden and Senator Bennett worked out, and I think there are 
about 15 cosponsors on both sides of the aisle. Those are all ways that 
this could be solved. But they are not in the bill. Since Senator Wyden 
was left out of that part of the process, I am not even sure it could 
be considered partisan because you have to include all from one party.
  But, at any rate, there are alternates out there. When we did the 
health care bill, which took weeks of doing the amendments, because it 
is very hard to do something in an amendment process and get it right--
it is easier in the committee than it is here on the floor--but in the 
committee, we put up one of those as an alternative. We only took one 
vote to vote the whole thing down. They only had to criticize about 3 
parts of 20 to get enough enthusiasm against it to be able to win. All 
the votes were 13 to 10, pretty much.
  So we said: Wait a minute. That is not a good idea for us. They 
should have to take a look at these germs of ideas that are in all 
these different sections. So we started putting them up one at a time. 
We still lost most of them 13 to 10. There were a couple of them that 
did finally pass.
  But we need to get into a mode of working across the aisle, like 
Senator Kennedy and I did on so many bills. In fact, I think we set 
some records, probably, not just when I was chairman of the committee 
but when he was chairman of the committee. We were on our way to 
getting a bunch done.
  Anyway, deficit reduction. I heard Senator Durbin talk about deficit 
reduction, and if this bill reduces the deficit. You have to be honest. 
If you use phony accounting, you can show huge deficits being reduced. 
That means leaving out some things that aren't in the bill, but they 
are going to be costs we have to cover. For instance, the doc fix, $250 
billion. It is not in there. They say we will fix it for 1 year and 
then we will hold them hostage again for another year so we can get 
them to join us on something else. That is not the right way to do 
business. We ought to fix the thing and if we have all of this extra 
money in Medicare, that would solve some problems for Medicare.
  On Medicaid, we are about to dump a whole bunch more people onto the 
Medicaid system. It is nice we are going to be able to do that, but 
there are some

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other ways we can take care of those same people and make sure they 
have insurance, and they would have insurance that didn't have the same 
stigma as Medicaid. One of the stigmas I am talking about is the 
doctors not willing to take them. If you can't see a doctor, you don't 
have insurance. If we dump all of these people on a system that already 
won't take the patients, how many of them are going to be able to see a 
doctor? So we could eliminate that stigma. In fact, that is what we did 
in the SCHIP in Wyoming. We made a provision so that it could go 
through the private market. When they go through the private market--or 
when they don't go through the private market, a problem a kid has if 
their dad is working, they have insurance; if he is not working, they 
don't have insurance, or if it is mom. Under the Wyoming one, when they 
go through the private market they know they have it for a year. That 
is the way it ought to be. That is the way Medicaid should be. Of 
course, you have to sign up for it. Right now you don't have to sign 
up. You go to the hospital, you get your fix, and we pay for it, or the 
State pays their share. We are dumping a huge liability on the States, 
so it is a real problem.
  The States are very concerned. Right now they are having budget 
problems almost across the entire United States. They are saying, so 
what are you going to dump on us? Well, our Gang of 6 asked that 
question and we got this overall CBO score on how much it was going to 
cost the States as a whole, but we didn't want to know how much it was 
going to cost as a whole. Every one of us has to answer to our State, 
so we asked for it to be broken down and they broke it down. It was 
kind of interesting. I had to call my Governor and explain to him how 
much he was going to have to come up with, even under the extra 
protection we were trying to build in for States. But the next day we 
got another breakdown. I said, so did CBO change their score? No, they 
didn't, but we manipulated the numbers a little bit differently. Well, 
they manipulated the numbers for Nevada and New York, and I think that 
is in the bill too. Their excuse for it was that Nevada and New York 
are particularly hard hit by the recession. Well, one of our 
complaints--and part of the phony accounting--is that this doesn't even 
go into effect for 4 more years, so how would we know that in 4 more 
years Nevada and New York would be the hardest hit? How do we know it 
won't be Wyoming and Colorado? So the formulas ought to be formulas 
that are going to work for everybody all of the time, not just for some 
of the leadership.
  There are some flaws in here we need to take a look at and we need to 
clear up. I am not going to keep everybody much longer because I want 
to go hear the President speak too and I apologize for the time I have 
taken. But once in a while a speech gets me kind of concerned and I 
have to expound a little bit on it and I think the people of America 
need to know. Actually, I think the people of America have figured this 
out. I think that is why there were problems in August and I think that 
is why we are not going home on the weekends, because we don't want 
people to hear what the people at home are saying. I was home over the 
Thanksgiving weekend and I got an earful, and I like what I am doing. I 
don't think I like what is happening in the bill.
  So with that, I yield the floor and thank the President, so the 
Senator from Oklahoma can speak.
  The PRESIDING OFFICER. The Senator from Oklahoma.
  Mr. INHOFE. I thank the Senator from Wyoming.
  Mr. President, the Senator from Wyoming made some references to the 
August recess and what happened during that time. I admire the Senator 
from Wyoming so much for the time he has spent on this issue. I, 
frankly, have not spent much time on this issue. We are kind of a 
product of our own committees in the Senate, but I do remember--and 
some people have forgotten--that during the August recess it was not 
just health care, it was also the cap-and-trade bill, because these are 
the bills that were passed right down party lines.
  I have to disagree with the Senator from Wyoming in one respect and 
that is the people during the August recess were not upset with the 
Republicans. They were upset with the Democrats because the one bill in 
my State of Oklahoma is referred to as socialized medicine. They have a 
hard time believing that the government is going to be able to run 
anything better than what we have today. I know those in this Chamber 
who represent States up in the far north recognize that the hospitals, 
the Mayo Clinics, and some of those in the northern tier, are filled 
with people from Canada. They have come down to America because they 
can't get what they wanted in Canada. So I kind of looked around and 
the people in Oklahoma seem to understand that if it doesn't work in 
Denmark, if it doesn't work in the United Kingdom, and if it doesn't 
work in Canada, why would it work in the United States? The answer is 
clearly that it wouldn't.
  The other issue that was prominent at that time was the issue of 
global warming. Six years ago I made the statement that the notion that 
manmade gases, anthropogenic gases, CO2, cause global 
warming is probably the greatest hoax ever perpetrated on the American 
people. I know that more and more people are using the hoax statement 
now. The reason that was such a big issue was it passed again in the 
House, right down party lines--this was the Waxman-Markey bill--that 
would have been a tax increase on the American people of well over $300 
billion a year. That translates in my State of Oklahoma to about $3,000 
a family, a tax-paying family. It is something we were not going to let 
happen and we still are not, but that is a reality. I wish to remind my 
fellow Senators: You may think that August is a long time ago. You may 
think that since we have been in the shelter of these halls here in the 
Senate that people have forgotten about those two issues, and they 
haven't forgotten. However, I have to say that is not why I am here 
tonight.

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