[Congressional Record (Bound Edition), Volume 157 (2011), Part 6]
[House]
[Pages 8609-8612]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  2010
                         THE FUTURE OF MEDICARE

  The SPEAKER pro tempore (Mr. Terry). Under the Speaker's announced 
policy of January 5, 2011, the gentleman from New York (Mr. Tonko) is 
recognized for 20 minutes as the designee of the minority leader.
  Mr. TONKO. Mr. Speaker, I look forward to the next 20 minutes where 
we can discuss the future of Medicare. It is being addressed in this 
House during this 112th session of Congress. We have seen many 
statements made about Medicare in the last weeks.
  I can tell you, a sign like this is greeting many colleagues as they 
return to their districts every weekend or during the recess that we 
have, the district work periods that we might have, signs such as this, 
``Hands off my Medicare,'' greeting us as we return to our districts, 
and rightfully so.
  Medicare has been a program that has served our senior population for 
quite some time. Seniors and those living with disabilities have really 
found life to be far more doable with Medicare assistance.
  It was in the sixties when the debate began, and it was President 
Lyndon Johnson who had been there to sign the measure into law. And at 
that point in time, our senior population, our senior community across 
these great United States, had a great concern. They were finding it 
unaffordable and inaccessible to search for health care insurance 
coverage.
  There was cherry-picking going on. There were those with the 
preexisting conditions that were denied any opportunity, and I think 
it's fair to state that the economic stability of those who had retired 
at that point of retirement, they usually found that that stability had 
dwindled, had gone south

[[Page 8610]]

simply because of the medical expenses that they required, and 
oftentimes with underinsurance or no insurance as a scenario, they were 
seeing their lifetime worth of savings dwindle because of that dynamic 
in their lives.
  Now, in this four-and-a-half decade stretch forward, many have 
suggested that their economic consequences have stayed fairly stable, 
that they have enjoyed a better retirement because of the addition of 
Medicare to their outcome.
  However, this Medicare program has been under attack. It's been under 
attack. There has been a Republican budget that has come forth and been 
produced in this House by the majority party, and they have voted on 
that measure to end Medicare, end the Medicare that would shift risk 
from government to the pockets of seniors in this country. It would 
take a given situation where they would be asked to shop, shop in the 
private sector. This could be a 70-year-old; it could be an 80-85-year-
old that might be asked to shop in that private sector market.
  Well, the egregious notion is that the value of that coupon they are 
given to go shop for new insurance holds a value of about 32 cents for 
every $1 of premium that would be paid on insurance costs. That means 
that they are tremendously drained economically. It means that 6,000 
more dollars would come out of the pockets of our senior citizens 
individually for the cost of this insurance coverage.
  Well, that is an unacceptable outcome. It's one that really makes it 
difficult for our senior community to be covered for health care 
purposes and to remain somewhat economically stable in their retirement 
years. And by the year 2030, it's suggested that the costs would triple 
for our seniors. By the year 2022, it would at least double.
  These are frightening statistics. These are unacceptable notions for 
our senior community, all of whom need to be responded to with respect 
and sensitivity and with the utmost compassion.
  This does not show compassion; this shows disinterest. It shows an 
insensitivity to the struggle that many would make and the correlation 
of the need for health care services.
  With age as a factor, it is an understandable partnership. It's one 
that would mimic and trace each other's curves, because as you grow 
older, the propensity to require services of health care delivery would 
naturally grow. And so we do not want to put at risk our senior 
population.
  Now, I think what is quite interesting is that, as we talk about the 
doubling and the tripling to seniors for this program, just recently a 
study came out that said that those who are age 55 today should have to 
save about 185, $182,000 additional for their medical expenses without 
the efforts made by Medicare as it exists today. And then the numbers 
simply escalate. I believe it's in the $400,000 realm if you are in 
your thirties. So this is going to put a huge hardship onto our 
American working families, onto our senior community of today and 
certainly of tomorrow.
  Now, what I found most generous is the statements made by seniors who 
are eligible for Medicare today, speaking in a way that is not self-
centered but really speaks to the future. They have said that they have 
enjoyed Medicare as a program. It has provided economic stability. It 
has provided health care quality of services, and they want that to be 
preserved for the next generation and the generation to follow. They 
want their children and grandchildren to enjoy the same order of 
benefits that they have enjoyed.
  So while there might have been this idea that if we safety net 
somehow a certain given population currently enjoying Medicare and 
suggest that most of that could maybe be kept intact, well, there was a 
far broader sense of concern expressed by our senior community. It was 
not a selfish order of self-centered reflection that some might have 
anticipated but, rather, the seniors showed that they are truly 
concerned about generations to come, which I think is a magnanimous 
statement for our senior population in this country.
  When it comes to messaging, it's important, I think, to know, to take 
lessons from the most recent congressional district election that was 
held just about a week ago. Last week the voters of the 26th 
Congressional District in the State of New York, in a rather Republican 
area, in fact, the ninth most difficult district in this Nation for a 
Democrat to win in--it was there that a Democrat by the name of Kathy 
Hochul was running. She was successful in that she was able to bring to 
the attention of the electorate in that district the facts as to the 
Republican plan, the Republican budget.
  And it was more than just Medicare. She talked about the end of 
Medicare but then related it to the dollars, the savings accrued from 
that elimination going toward other spending. Just what was and what is 
that other spending proposed? It would be handouts, mindless handouts 
to the oil industry sitting on a profit rich situation, perhaps the 
most profitable situation that they have known in their history. To 
date, this calendar year, the industry is sitting on a $36 billion 
profit margin, $36 billion.
  What they are asking here is that some $44 billion worth of handouts, 
mindless handouts that have continued through the decades, nearly a 
century now, be continued. And how do we pay for that but by ending 
Medicare, ending Medicare to take care of the profit rich oil industry. 
The same is true of millionaire, billionaire tax cuts. You see the 
savings that can accrue by ending Medicare would then be slid over to 
provide for millionaire and billionaire tax cuts.
  Well, middle-class America is not ready for that sort of assault. 
They are going to let their feelings be known. And it's why messages 
like this, ``Hands off my Medicare'' are greeting myself and colleagues 
across this country. They are concerned. They are concerned. They are 
letting their legislators know that this is not an acceptable thing to 
do.
  Now, look at the track record where, with Medicare, we have avoided 
administrative costs to the nth degree; we have avoided marketing 
budgets; we have avoided all sorts of external costs that don't go to 
the health care delivery of patients but, rather, are the externals.

                              {time}  2020

  Avoiding those dollars has kept down the price tag on Medicare.
  When we look at that same stretch from the beginning of Medicare to 
today, it's been an excess of a 5,000 percent increase in premiums that 
have risen from that point in 1965 to today. So it tells us one thing. 
It tells us that there is this tremendous growth from the private 
sector in comparison to what the Medicare track record has been.
  And we have spent time with the Affordable Care Act to strengthen 
Medicare. We have made certain that where there were overpayments to 
the insurance industry for certain services, those dollars were 
reduced. We made a major effort to go after fraud, abuse, and 
inefficiency. That strengthens the program. We provide for more dollars 
for primary care physicians who can be networked into the Medicare 
formula so that we can provide contact for administering the services. 
All of this has a growth factor so as to strengthen the Medicare 
concept as we know it.
  But people are concerned. Their health care situation has been 
addressed in very magnanimous terms by the Medicare program. People 
fought for years to get this developed, and they have maintained and 
strengthened it over the decades. And for people to come in and assume 
that they are going to end the Medicare program simply to pay for oil 
handouts and millionaire and billionaire tax cuts is just not going to 
be well received by America's working families, by her middle class 
that has seen this assault where it's their turn now to get better 
treatment, not worsened treatment, from the halls of government here in 
Washington.
  The Medicare situation is one that has really defined a stronger 
sense of quality of life for our senior community and has enabled them 
to have good coverage.
  What we also did in the Affordable Care Act is begin to close, and 
will

[[Page 8611]]

close completely by the year 2020, the doughnut hole that existed for 
pharmaceutical purposes for those on Medicare part D. Well, again, we 
saw what happened, that we needed to come forward with an improvement 
in a program that would assist people. And so we closed that doughnut 
hole eventually. I can tell you of so many seniors who have approached 
my office, who have seen me in the district, telling me of how 
difficult it is for them to absorb the doughnut hole concept. Within a 
few months within any given calendar year, they fall into the doughnut 
hole where they need to dig into their own pocket to pay for the cost 
of many pharmaceutical requirements that they have in their medical 
agenda to stay well or to be healed. So it is a very pricey situation 
for them, and we want to make certain that those improvements stay 
intact.
  We have also removed copayments and deductibles for the annual 
checkups and for various medical screenings that are available to our 
senior population. These are the source of responses that are 
compassionate, that are speaking to the quality of services and 
certainly to the dignity factor for our senior population. These are 
improvements. These are ways to stretch the budget and enable our 
senior community to be all the more intact and connected with community
  While we had worked with the Medicare issue in the Affordable Care 
Act, we want to make certain we also strengthen the trust fund. So 
there are things that have been done along the way. And now to just 
come in and say, look, this is more business for the private sector, 
this is a way to drive all the accounts of individuals who are enjoying 
a Medicare program, a concept that has worked well for four-and-a-half 
decades is now deemed to be ended simply now because of the desire of 
those who are in the majority in this House to pay for benefits to the 
oil industry and to continue millionaire and billionaire tax cuts.
  Just on the heels of this victory in a congressional district I 
mentioned earlier, in the 26th District of New York, we took yet 
another vote in this House to deem the Republican budget a budget from 
which we'll work. That includes the end to Medicare. So just this week, 
with another vote right in the shadows of that victorious Democratic 
win in the 26th Congressional District of New York, we are again at it, 
putting a close to the Medicare concept in this country. Unacceptable 
outcomes. People will not tolerate that outcome.
  In a CNN poll of recent measurement, there was a huge response in the 
negative to the Republican plan. Seventy-four percent of Americans are 
saying, leave the Medicare situation alone or improve it. Build upon 
it, strengthen it, prepare it to have even stronger values and 
concepts, and also provide for the trust fund that will be all the more 
secure to give it the stability, the underpinnings of support, not to 
end it. People have seen what it meant to them. They have seen what it 
meant to be able to enjoy the economic relief that is so important, 
especially as we age as a population.
  The life expectancy growing higher with time is an important factor 
that really underscores the need for Medicare as a model, as a concept 
in this Nation.
  There are many who have been speaking out against this proposal. 
There are many who understand that it's provided a great deal of 
stability. It has provided families, working families, with the relief 
of knowing that the senior members of their family are in good hands 
with a Medicare program that enables them to have more independence, to 
have more preventative services, to have more acute care delivery with 
an affordable outcome for their given family situation. This is an 
important measurement that needs to be kept in mind. It's an important 
effort to keep our economic situation in this country all the more 
doable and all the more viable.
  There's an opportunity for many seniors to be involved and invested 
in community. Medicare enables them to be that more vibrant citizen, to 
respond to the economy in positive contributory terms. And I think that 
that is very important.
  With the Medicare situation in this country, we have watched the 
quality of life of our senior population grow and grow exponentially. 
And for those forces to come here before this House to express this 
desire to end a concept for which people fought for many years, where 
there was a documented need for this sort of advice and this sort of 
concept, and now to watch it at risk where it could fold and not 
continue, where we could have a situation where the concept is ended, 
is unacceptable.
  There are those in selling this package that suggest that the 
legislators here in Washington have the same sort of opportunity. It's 
akin to what we're offering the senior community. Nothing could be 
farther from the truth. On average, the benefit for a congressional 
Representative is about 72 cents on the dollar, meaning that every 28 
cents worth of coverage would be absorbed by the individual legislator. 
For the senior population, we're looking at 32 cents, a 40-cent 
difference, meaning that the gross majority of that premium would be 
paid for by senior citizens.
  That is where the economic consequences become very, very real. That 
is where the shifting of risk from government to the senior citizen 
would be a real dynamic. It would be an unbelievably painful outcome 
for those who perhaps would struggle to find insurance. We would be 
asking people to shop in a marketplace, asking them to deal with a 
profit-rich industry, to deal with situations that might return cherry-
picking and that might return inaccessible, unaffordable notions when 
it comes to health care coverage.
  We've seen it repeatedly. We know that there were populations that 
were underserved as we began the debate on affordable care that was 
completed in the 111th session of Congress, and we certainly don't want 
that to come back and be the issue for the most senior elements in our 
society again. This was a victory that was hard fought. It's been a 
concept that has only been strengthened through the years. And like any 
good program, it gets adjusted as we move with time.
  Fix Medicare is the message. Strengthen Medicare is the appeal, not 
end it. And the advice for those who want to end it is very basic: 
Hands off my Medicare. It's the advice that's given, it's the chant 
that's repeated over and over again across this Nation. And it's been 
such for quite some time.

                              {time}  2030

  This is part of a plan that the Republican budget, introduced by the 
Budget Committee in this House, has dubbed itself as a Path to 
Prosperity.
  My friends, it is so obvious that this is the road to ruin, not the 
path to prosperity. You are taking the vulnerable and making them pay 
more. This is about tough choices. We have seen where people don't have 
insurance; they have to make tough choices.
  There is nothing tough--people have said, Oh, this is a tough choice 
that people have made. They have gone forward and taken a situation 
that they think is not affordable and they are going to make a tough 
choice and remove it. There is nothing tough about asking the weak or 
the poor to pay more so that oil as an industry can get more benefits 
and millionaires and billionaires can draw down a larger tax cut. There 
is nothing tough about that.
  What it is is insensitive. It is un-American. It is immoral to have 
such an outcome after so much success with a program that has proven 
itself time and time again to be a great friend to the senior 
community.
  There are those who have spent countless hours and effort to put 
together a plan that would respond to this Nation's seniors with 
respect and dignity. And we can simply not afford to walk away from 
this concept in the very calloused manner that we are asked to. I was 
proud when I saw so many people stand up and say ``no'' to this vote. 
Unfortunately, it passed in this House. If this budget had its way to 
the finish line, it would end Medicare at the expense of so many of our 
Nation's seniors.
  They have enjoyed this benefit. They have prospered from this 
benefit. They

[[Page 8612]]

have realized a great sense of dignity with this effort, and we must 
maintain it. We must continue the fight to preserve a program that has 
served this Nation very well.
  With that, Mr. Speaker, I yield back the balance of my time.

                          ____________________