[Congressional Record (Bound Edition), Volume 157 (2011), Part 7]
[House]
[Pages 9293-9294]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                MEDICARE

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Louisiana (Mr. Boustany) for 5 minutes.
  Mr. BOUSTANY. Mr. Speaker, over 14 years in private practice in 
medicine, I had the great privilege to treat many, many Medicare 
patients, thousands of Medicare patients. I did open heart surgery, 
complex open heart surgery, lung cancer surgery, in times of great 
need, great difficulty for these seniors who had paid many years of 
their payroll taxes into the Medicare program with the hope and the 
recognition that this program would be there for them, for their health 
care needs in their later years.
  And I'll tell you, in the nineties, when I was in the midst, at the 
peak of my practice, it was not unusual, and in fact quite often 
patients would come into the emergency room with a very difficult 
situation, without a primary care physician because they had not had 
previous health problems. And then what would happen is we would have 
to do emergency heart surgery on them, and once they got through all of 
this and got through the hospital stay, we could not find a primary 
care physician to take them on, to treat their everyday problems with 
hypertension, high blood pressure, diabetes, gout and things of that 
nature.
  I would get on the phone time and time again and I would call family 
doctors and internal medicine physicians and plead with them, Why can't 
you take this one more patient into your practice? And it's because the 
reimbursement situation for Medicare was so bad even back then in the 
nineties that if a physician took on too many Medicare patients, they 
couldn't meet their costs. That situation has gotten much worse today, 
in 2011.
  I could tell you that I have grave concerns about the future of the 
Medicare program and what's going to happen. And I'm not speaking as a 
Member of Congress, I'm speaking as a physician, as somebody who cared 
for many, many patients, who valued that doctor-patient relationship. 
This situation whereby families who have a loved one on Medicare cannot 
find a primary care doctor, this is a very serious situation today and 
getting worse by the week.
  The bottom line is Medicare is in trouble. I saw this as a doctor, 
and I see it now as a Member of Congress.
  Just a couple of facts. Over 10,000 baby boomers are reaching 
retirement age every day, leaving fewer workers to support them. We 
have an aging population. This is putting tremendous cost pressure on 
this Medicare program. In fact, the Medicare program, according to the 
Medicare actuaries, the trust fund that provides the money for the 
hospital program, is going to be out of money by 2024, and now, in 
fact, starting last year, more money was being paid out than taken in 
to support this program. The Medicare actuary predicts that without 
changes to the current law, something that was basically not looked at 
when the health care law was passed, in fact, it was assumed that these 
certain cuts to physicians would occur in the law. In fact, what we 
know is that without any changes to the law, physician reimbursements 
will fall from 80 percent of private rates to 57 percent of private 
rates in 2012.
  What does that mean? That means that the situation for physician 
practices will get even worse, whereby they can't even meet the costs 
of their practice. Therefore, they're going to continue to limit their 
exposure to taking on new Medicare patients. That means access 
problems. That means Medicare patients cannot get access to physicians.
  We need real solutions to this. We need fact-based solutions. We need 
answers to the problem and not political rhetoric. So far, that's all 
we've seen, largely coming from the other side and from the White House 
on this. In fact, we're on a path to see the bankruptcy of this 
Medicare program if we don't act.

[[Page 9294]]

  Now let's take a step back and look at what happened in the health 
care bill. This health care bill, which passed without Republican 
support, cut over $500 billion from this Medicare program to expand 
coverage into a new entitlement, an extension of the Medicaid program. 
We're digging a deeper hole for ourselves without a way to pay for 
this. And now the plan calls for immediate 17 percent cuts in benefits 
for our current seniors. Current seniors, not people who are going to 
go on to Medicare in the future. Seniors who depend on this important 
program today.
  Another thing that's in this bill, and it's not well-known, is a new 
bureaucratic entity that was created. There were many that were created 
in the health care bill, but there's one that really bothers me as a 
physician. It's called the Independent Payment Advisory Board. Okay. It 
sounds kind of innocuous, but what does it do? It's a 15-person board 
arbitrarily chosen that will make life-and-death decisions about what 
things will be paid for under the Medicare program.
  Now, what is the recourse in all this? This is an arbitrary decision-
making body, and you cannot dispute what this body is going to do. In 
fact, for Congress to override it, it would take three-fifths of the 
Senate to override it. This is going to damage the doctor-patient 
relationship. It's bad for Medicare patients.
  I could tell you that Republicans have an idea about how we're going 
to fix this. I can't get into it now, and I'll do it in a subsequent 
speech.

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