[Congressional Record (Bound Edition), Volume 157 (2011), Part 4]
[Senate]
[Pages 5811-5812]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                MEDICARE

  Mr. NELSON of Florida. Madam President, the Paul Ryan/tea party 
budget of the House of Representatives privatizes Medicare. Let me 
repeat that. Medicare, the program of medical care for senior citizens 
that our seniors have come to depend on--the Paul Ryan/tea party budget 
of the House of Representatives privatizes Medicare.
  This is not an empty threat. It is not this Senator's or any other 
Senator's political interpretation. The budget of the House Republican 
Budget Committee chairman would end Medicare as we know it. It ends 
Medicare. It hands seniors' health care over to insurance companies. It 
would break a sacred contract between workers who paid into the system 
thinking it would be there for them when they retired. But under this 
new scheme, senior citizens will not have a Medicare Program anymore. 
They would have to pick an insurance plan, and a voucher would be given 
directly to the insurance company.
  Under the proposal--I am not making this up--a voucher, paid for by 
the Federal Government, would be given not to the senior citizen to go 
shopping, it would be given to the insurance company that they chose. 
Medicare for senior citizens would be turned over to insurance 
companies. If this sounds incredible, it is, because under that plan 
insurers would decide what doctors seniors get to see and what health 
benefits get covered.
  Now, why do I say that? That is an HMO. An HMO is a health 
maintenance organization. That is an insurance company. They have a 
panel of doctors, they have a panel of hospitals, and they determine 
what is in the coverage that a senior citizen gets.
  Contrast that to Medicare now, that Medicare fee-for-service. The 
senior citizen makes the choice of their doctor, of what are the things 
they look for in their total medical care, paid for because they are 
senior citizens and are eligible for Medicare, of which they have been 
paying in all of their lives through a Medicare tax.
  So now this proposal is to privatize Medicare, take it out of being a 
government fee-for-service plan, and, instead, insert it into a 
privatized insurance company.
  Do senior citizens want to change their Medicare and turn it over to 
insurance companies? I do not think so. If insurance plans raise their 
costs, which we know they do, seniors then would have to pick up the 
bill. Seniors would have to pay more out of their pocket for this 
voucher program.
  According to the Congressional Budget Office, out-of-pocket costs--
this is according to CBO, the nonpartisan actuarial accounting 
organization--according to CBO, out-of-pocket costs would more than 
double for seniors.
  This voucher program proposed by the chairman of the Budget Committee 
in the House, Congressman Ryan, is not like Medicare Advantage. 
Medicare Advantage has been a great program for senior citizens, and in 
our State of Florida we have more signed up for Medicare Advantage than 
any other State because of what it does. It provides benefits at low 
cost to senior citizens because the Federal Government directly 
negotiates with the insurance companies' plans. That is different from 
what Congressman Ryan and the tea party are proposing. So insurance 
companies, under Medicare Advantage, have to provide guaranteed health 
benefits at a low price that is negotiated. As a result of the new 
health care reform law, Medicare Advantage premiums have actually gone 
down. These are the premiums that are paid by senior citizens.
  So do not let folks confuse you between what is proposed by the 
Budget chairman in the House and the existing Medicare Advantage 
Program. The Ryan/tea party budget leaves these decisions up to the 
insurance plan. In other words, insurance companies will be in charge 
of seniors' health care. I do not think that is what our senior 
citizens intend to have happen.
  The tea party wants to end Medicare. That is the bottom line. Yet the 
House budget does little--interestingly, little--if anything to 
actually reduce the Federal deficit, which is what they say their 
budget is for, to reduce the Federal deficit.
  Well, look at it. The House Budget chairman claims his budget 
includes $5.8 trillion in spending cuts, but when we look at it closer 
we learn this claim was an accounting gimmick. We have seen these 
gimmicks over and over in budgeting in the Federal Government.
  For example, first, we learned that his staff had made a $200 billion 
mathematical calculating error in calculating interest savings. Then, 
second, we learned that $1.3 trillion of the savings is artificially 
derived from a misleading assumption that the wars in Iraq and 
Afghanistan would continue indefinitely. Third, and most importantly, 
of his savings, $4.2 trillion of the savings come from the spending 
cuts that fly out the back door in the form of tax cuts for 
millionaires.
  At the end of the day, those $5.8 trillion in spending cuts in their 
budget translates into less than $200 billion in real deficit reduction 
over those years, or less than 1 percent of the total debt held by the 
public.
  So the Congressman Ryan/tea party budget does little to address the 
deficit while making every single senior citizen in this country get 
their health care from an insurance company.
  So that is why Senator Baucus, our chairman of the Finance Committee, 
and I have introduced a resolution. This Senate resolution calls on the 
Senate to oppose this radical voucher program. Medicare has been 
providing affordable health care for seniors and disabled Floridians 
and Americans for

[[Page 5812]]

decades and decades. It is a very popular program with our seniors. 
Medicare should not be dismantled. It should not be turned over in a 
voucher program to insurance companies that will eliminate choices. It 
should not be turned over to insurance companies that will increase 
costs, and, certainly, seniors' health care should not be turned over 
to insurance companies.
  I yield the floor.
  The ACTING PRESIDENT pro tempore. The Senator from Iowa.

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