[Congressional Record (Bound Edition), Volume 156 (2010), Part 8]
[Senate]
[Pages 11273-11275]
[From the U.S. Government Publishing Office, www.gpo.gov]




                               HEALTHCARE

  Mr. McCAIN. Mr. President, as I understand it, it is about 90 days 
since the President signed the legislation known to some as ObamaCare 
and to others as the Medicare reform bill. But there have been some 
interesting developments in the intervening 90 days.
  To quote the Speaker of the House, she said at the time, ``We have to 
pass the bill so that you can find out what's in it.'' We are finding 
out what is in it. Remarkable events have taken place, ranging from the 
implementation that means that more than half--51 percent--of all 
employees in 2013 will be in plans that aren't grandfathered, despite 
the President's comment that if you like your insurance policy, you can 
keep it. Nearly 7 in 10--69 percent employees, 80 percent of workers, 
and small businesses--would lose their current plan within 3 short 
years.
  Mr. President, I would like for my friend, Dr. Barrasso, to explain 
exactly how that happens. First, I would like to mention the issue du 
jour which, of course, is headlined on Politico this morning: 
``Medicare Tussle Stymies Hill. Rift between Pelosi and Reid stands in 
the way of funding compromise.''
  I think it is important to recognize the reason we did not do the so-
called doc fix is because the majority did not want to do the doc fix, 
which means not implementing the 21-percent cut in reimbursement for 
doctors who treat Medicare patients. The reason we did not was because 
they had cooked the books on the cost of ObamaCare.
  The fact is, they kept counting into the cost--in order to keep their 
commitment that it would cost less than $1 trillion--they kept counting 
in that there would be the 21-percent cut, a $281 billion difference 
over 10 years.
  The AMA and all of those people who signed up with this bill are now 
saying: Why are you not doing the doc fix? We did the doc fix on 
Friday, I believe. It is now in the House, and we will probably do the 
doc fix. But why the delay? The delay is simply because they did not 
want to. On the floor of this Senate, they did not want to do the doc 
fix because of the budgetary impact on how they were selling this 
proposal to the American people.
  I ask my colleague, Dr. Barrasso, to comment on that point and also 
what we are finding out as to how many Americans are actually going to 
lose the insurance policy they have. By the way, there is also an 
article this morning in USA TODAY entitled ``Doctors limit new Medicare 
patients,'' which was also predicted by some of us.
  One thing my friends on the other side of the aisle might have 
forgotten is we cannot force doctors--they have not enacted a law yet 
that forces doctors to see Medicare patients. Therefore, a number of 
doctors are voting with their fee in the respect that they are not 
enrolling new Medicare patients they would treat.
  I ask my colleague, Dr. Barrasso, if he would comment on the doc fix 
and also maybe a better explanation than I have been able to give as to 
why so many people face the loss of their health insurance policy 
between now and 2013.
  Mr. BARRASSO. Mr. President, my colleague from Arizona is absolutely 
right. There is a front-page story in USA TODAY. I was reading it as I 
was coming back from Wyoming yesterday. In Wyoming over the weekend, I 
visited with a number of seniors on Medicare. I visited with some 
family physicians who take care of families in Wyoming. I practiced 
medicine for 25 years in Wyoming taking care of families and have lived 
under the Medicare rules and regulations.
  Here it is: ``Doctors limit new Medicare patients. Surveys point to 
payment concerns.'' Doctors will tell you the biggest deadbeat when it 
comes to paying for health care is the Federal Government. It is 
Washington. More and more of my colleagues are opting out, as the 
Senator from Arizona said, from taking care of Medicare patients 
because what they get reimbursed is so limited that it does not keep up 
with the growing cost of liability insurance, the mandates on them in 
terms of the expenses of running a business, and they try to provide 
health care for all their employees.
  Item after item, those costs go up. But what the government continues 
to pay for taking care of patients on Medicare, which is an expanding 
group of people, is shrinking.
  Think about how Washington works and does not get it. Patients around 
the country on Medicare understand they are having a hard time finding 
a doctor. The Center for Medicare and Medicaid Services was quoted in 
yesterday's USA TODAY saying 97 percent of doctors accept Medicare. 
What is the reality? In North Carolina, since January 1, this article 
says 117 doctors have opted out of Medicare. In New York, since the 
beginning of the year, about 1,100 doctors have left Medicare. The 
president of the State of New York Medical Society is not taking new 
Medicare patients.
  Mr. McCAIN. As well as the Mayo Clinic.
  Mr. BARRASSO. Mayo Clinic said: We cannot afford to keep our doors

[[Page 11274]]

open if we are taking Medicare patients. Specifically in Arizona, where 
they have a wonderful clinic, the best care in the world in many ways 
in the sense that early on in the health care debate, President Obama 
said we should use the Mayo Clinic as a model of what works, they do 
not want to take Medicare patients. They do not want to take Medicaid 
patients. But this health care law is cramming 16 million more 
Americans on to Medicaid. What the President is proposing for the 
American people is something less than what he has previously said is 
the best in care.
  One of the other promises the President made is, if you like the 
health care you have, you can keep it. As a matter of fact, he gave a 
speech about a year ago at the American Medical Association meeting:

       If you like your health care plan, you will be able to keep 
     your health care plan. Period.

  He went on to say:

       No one will take it away. Period. No matter what. Period.

  Now the White House has come out with new rules and regulations about 
who really will be able to keep their health care plans. In the 
analysis that has come out from the administration, over 100 pages--I 
had it on the Senate floor last week--what they have shown is, over the 
next few years more and more Americans who have health care right now 
through their jobs that they like, they understand, they know how to 
use--and as a doctor I have worked with these patients. I know what it 
means to them to have a health care plan they are comfortable with, 
that they understand, that they use, that all of the work has been done 
with the doctor's office, hospital, and the patient, they understand 
the whole thing. To have that change is very distressing for people. It 
is unsettling. But yet this government report out from the 
administration says within the next couple of years, for people who 
have their insurance through small business plans, almost four out of 
five of them may lose the coverage they have.
  Mr. McCAIN. May I ask, is that because of a minor change in the 
insurance policy they now have that then forces them out of the policy, 
even though there is a minor change? Maybe Dr. Barrasso can give us 
some of those examples of how minor they are, how they basically force 
them out of the policy they have into the ``exchanges.'' Is that what 
happens?
  Mr. BARRASSO. I agree with my colleague completely. What is happening 
is any sort of a change to a policy, whether they change the 
deductible, change the copay or any of those things, then that policy 
is disallowed as something you can keep.
  Mr. McCAIN. Some of those changes would simply be driven by pure 
economics and the escalating cost of health care on which clearly this 
legislation has no effect.
  Mr. BARRASSO. Let's say you change your job. Let's say you move from 
one employment situation to another. You may change your insurance. 
Most people do because most people get their insurance through their 
work. We will have a situation where over the next couple of years, a 
promise that the President made to the American people--another promise 
that the President made to the American people will be broken.
  We have not just seen it with regular insurance. My colleague from 
Arizona is in a State with many people who are seniors, a number of 
them on Medicare Advantage, a special program that speaks specifically 
to preventive care, coordinated care. People signed up for Medicare 
Advantage because there are advantages to being on Medicare Advantage. 
Yet this health care law that was crammed through this Senate is going 
to cut massively from Medicare Advantage.
  One out of four people on Medicare is on Medicare Advantage, and they 
know why they have signed up for it. It is because of the advantages to 
them.
  Mr. McCAIN. May I ask one more question of my friend? This is kind of 
a hometown issue, but 330,000 Arizona citizens who are enrolled in 
Medicare, who paid into Medicare all their working lives and have 
enrolled in this Medicare Advantage program which gives them choices 
are now going to have that severely impaired or eliminated. How does 
that happen? How is it when a program is offered to people who have 
paid into the system all their lives and they have chosen that Medicare 
Advantage program, and now it is going to be taken away from them. How 
does that work?
  Mr. BARRASSO. It works when a Senate and a House of Representatives 
and a President think they know more than the American people. They 
say: We know what is best for you. We don't care what you think. That 
is what has happened.
  Mr. McCAIN. They have pledged basically to dismantle the Medicare 
Advantage program?
  Mr. BARRASSO. Cut the funding so people on Medicare Advantage--who 
like it, who like the preventive medicine activities of it--are going 
to lose those opportunities.
  Just since 2003, the number of seniors on Medicare Advantage grew 
from a little over 4 million to 11 million. That is because the seniors 
talk to one another, and they know what the best deal is for them, for 
their money, and for their health.
  The seniors I know in Wyoming who signed up for this program said 
they want to make sure they have a number of these preventive services. 
Once they lose this, they are going to lose preventive services. They 
will have to pay more. The cost for people will go up, in spite of the 
promise made by the President that he was going to get down the cost of 
care.
  Experts who have looked at this said: No, I am sorry, it is not going 
to work that way.
  Mr. McCAIN. May I ask the Senator one more question. Did he have a 
chance to examine the $14 million--I believe it was $14 million, $18 
million----
  Mr. BARRASSO. The mailer.
  Mr. McCAIN. The mailer. I was trying to find a polite word--the 
mailer that was sent out to all Medicare enrollees and what conclusions 
he drew from that infomercial?
  Mr. BARRASSO. To my colleague from Arizona, I did. I had a chance to 
look at that mailer sent out by the Secretary of Health and Human 
Services. I found it very misleading. Some have described it even as 
being a piece of propaganda.
  The sad part is, it was paid for by the American taxpayers. The 
estimates for the cost have been $16 to $20 million of taxpayers' money 
to send out this piece of mail that essentially misleads, or tries to 
mislead--as my colleague from Arizona knows, the American people are 
too smart to be misled by this--it tries to mislead them into saying 
that this whole health care law is actually going to strengthen 
Medicare.
  The seniors of this country clearly understand, as I know they do in 
Wyoming and Arizona, if you cut $500 billion--a $\1/2\ trillion--out of 
Medicare, not to save Medicare, not to save the program that is there 
for our seniors but to start a whole new government program, that is 
not going to improve Medicare. That is money seniors planned for, know 
it is in their system, and it is being taken from Medicare to start a 
whole new government program. It is not for them. It is not going to 
improve Medicare. It is not going to strengthen Medicare.
  That is why from the beginning, to my colleague from Arizona, I said 
this bill, now the law for 90 days, is bad for patients, bad for 
payers--the American taxpayers who are going to end up stuck with the 
bill--and bad for the providers--the nurses and doctors who are trying 
to take care of these people.
  Mr. McCAIN. Mr. President, I thank Dr. Barrasso for his leadership on 
this issue. Those who are interested in his Web site, which is titled 
``Second Opinion,'' might be interested in gaining more information 
from that Web site. My colleagues might be interested in that.
  I thank Dr. Barrasso for his leadership on this issue, for his in 
depth knowledge of it. I noted the luncheon we had with the President 
of the United States. I applaud Dr. Barrasso's attempts to inform the 
President on this issue. I am not sure how receptive the audience was 
to it, but

[[Page 11275]]

what he had to say made a lot of sense to me.
  I know Dr. Barrasso shares my view that we are not going to quit on 
this issue. We are not going to quit on this issue. It is going to be 
repealed and replaced because we are not going to do this to the 
American people.
  Still the overwhelming majority of the American people disapprove of 
this proposal. As the Speaker of the House said, we have to pass the 
bill so we can find out what is in it. As they are finding out what is 
in it, more and more Americans dislike it.
  Mr. President, I yield the floor. I suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. McCAIN. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. McCAIN. Mr. President, I ask unanimous consent that I be allowed 
to engage in a colloquy with my colleague from Arizona.
  The PRESIDING OFFICER. Without objection, it is so ordered.

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