[Congressional Record (Bound Edition), Volume 157 (2011), Part 8]
[House]
[Pages 11824-11825]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  1130
                         THE FUTURE OF MEDICARE

  The SPEAKER pro tempore (Ms. Buerkle). Under the Speaker's announced 
policy of January 5, 2011, the gentleman from Arizona (Mr. Schweikert) 
is recognized for 60 minutes as the designee of the majority leader.
  Mr. SCHWEIKERT. Thank you, Madam Speaker.
  I promise I will not take the whole 60 minutes, because I know many 
folks have flights to get to.
  Madam Speaker, one of the reasons I'm here--and we are also working 
on some additional, shall we say, display items for maybe next week. 
Maybe I'm out of my mind, but this last couple of weeks I've been 
actually reading from top to bottom, beginning to end, the Medicare 
trustees' Federal hospital insurance and Federal supplemental medical 
insurance trust fund actuarial report for 2011. It's actually more 
interesting than you would think, because you go through about 270 
pages, lots of great information, not that hard to read, so anyone 
that's actually watching this, I strongly suggest, if you have the 
stomach for it and you really need a little help in falling asleep, 
this might be the occasion. Google it, take it off the Internet, but do 
this for me: This is one of those occasions I'm going to ask you to go 
to the very end of the report and start with the last three pages, 
because that's what I'm standing here to talk about is you have a 
report that basically gives a window of a dozen-some years of actuarial 
soundness, but when you get to the last three pages, it basically says 
something like Roseannadanna, that character from Saturday Night Live 
from 20 years ago: ``Never mind.''
  I brought a couple of the boards we already had printed up to sort of 
demonstrate what's going on, and then I wanted to talk about this.
  Day after day after day after day in the political theater of this 
Congress, I see Members walk up to the floor, walk up to the press, 
send out press releases saying, ``We don't want to change Medicare as 
it is in law today.'' How many times have we heard the attacks on the 
Republicans saying, ``They're trying to change Medicare as we know 
it''? I need you to think about that comment, because what's in this 
report is Medicare as it is in law today. You need to understand what 
the left is defending and the crash that is just a few years away; and 
I'm standing here today to defend the fact that, as Republicans, we're 
saving the program. We are actually trying to find a way to make 
Medicare actuarially sound so that you and I can have it but also our 
kids and our grandkids can have it.
  So let's actually first walk through the numbers, and then I'm going 
to read parts of these last three pages. I promise it's more 
interesting than it sounds, and it's more depressing than you can ever 
imagine, and this is the current law.
  All right. A couple of primers on some spending out there.
  2010, how much of our spending is mandatory?
  2016, you'll start to notice mandatory spending is consuming 
everything we are.
  Another point of reference. Today, when we borrow, we're actually 
having to borrow to cover all the discretionary. That's defense. That's 
all the alphabet agencies. We even have to borrow today to cover a 
portion of the mandatory spending. Think of that. The Medicares, the 
Social Securities, the Medicaids, the VA benefits, interest on the debt 
are actually living on borrowed money. I would think that would set off 
an alarm bell in someone's head that there's something horribly wrong 
out there.
  So let's actually bounce on to this graph and just sort of give you a 
concept of how fast these numbers are eroding and why things like the 
battle over cut, cap, and balance are going on in this body, because 
there seems a willingness here by many Members--and I've got to be very 
careful how I phrase this--that I believe telling the public the truth 
of how difficult these numbers are and how dangerous they are to our 
Republic may mean they don't get reelected, may mean they have to stand 
up in front of an audience that for years and years and years they've 
said, ``Don't worry. It's fine.'' How do you go back in front of that 
same audience and now tell them, well, maybe the numbers weren't fine, 
because the truth is in front of us right now.
  Here is the 2010 sort of breakdown. Department of Defense, Military, 
Other Discretionary. We use this one, because this is last year's 
numbers. It's all done. We know what it was.
  Do you see this? That's probably about 62, 63 percent of all spending 
was in the mandatory category. Think of this. This here, from the 
President's

[[Page 11825]]

own numbers, is the 2016 projection, which is four budget cycles away, 
because, remember, right now we're working on the 2012. This is the 
2016.
  Do you see the difference in these two boards? Do you see that growth 
in that blue area? We go from something in the low sixties to 72, and I 
have one person who keeps telling me it's 73 percent of all spending.
  But think of this. In about 13\1/2\ years, every dime of this pie 
chart, every dime of spending, will be consumed by the mandatory 
portion of our spending. So 13\1/2\ years. There's nothing left in 
defense. There's nothing left in the alphabet agencies. Mandatory 
spending, the entitlements, consume everything we are. And, remember, 
this is as the law is written today. So every time you see a Member 
walk up and say, ``I don't want to make changes; I want to keep 
everything as it is in law today,'' they're basically saying your 
future is a crash. Everything will be consumed in these mandatory 
numbers.
  Now let's actually walk through a couple of things that are in these 
last three pages of the 2011 Medicare actuarial report. Once again, 
please, I ask you, if you don't believe me, if you're someone who has 
trouble believing these statements that I come here to the floor and 
try to walk through, go take it off the Internet yourself and read 
these last three pages.
  Part of the premise here is, to his credit--and I believe he is 
actually the chief actuary for Medicare, actually wrote a little 
Statement of Actuarial Opinion, the last three pages, and he puts it in 
perspective. He basically says, yeah, the numbers in here are fine if 
you live in a fantasy world and assume Congress will never make certain 
changes. And understand, baked into these numbers, you'll love this 
one. I'll read it, and then I'll explain what this means. This is in 
the second paragraph. I'm going to read the second half of this 
paragraph:
  ``They are not reasonable as an indication of actuarial future costs. 
Current law would require a physician fee reduction of an estimated 
29.4 percent on January 1, 2012--an implausible expectation.''
  Did you hear that? Built into these numbers, January 1--what is that? 
Five months from now? January 1, doctors are to get a 29.4 percent cut 
in their compensation, and that's built into these numbers because 
these numbers don't work without taking that type of hit to the 
doctors.
  How many doctors are going to see Medicare patients come January 2 
when they've taken a 29.4 percent cut? So what traditionally happens 
around here is the Members of this body sometime in November, December, 
we're going to run to the floor, we're going to say that's not fair, we 
want to make sure Medicare recipients can actually see their doctor, 
and we're going to go back and raise up that compensation and keep it 
flat. We're going to get rid of that 29.4 percent cut that's already 
built into the law. The next day we should have a new actuarial report 
saying, oh, by the way, the dozen-some years that we said Medicare was 
fine is crashing, because it's built on premises that don't have 
reality.
  I'm trying to find nice ways to phrase this. When you read an 
actuarial report, it's based on current law. What happens if built into 
that current law is absolute fantasy, and that 29.4 percent cut, which 
I will be one of the people who will walk onto this floor and do my 
best to stop that because that's not fair. It's not fair to the 
doctors. It's not fair to the people in the program. But you've got to 
understand. Then when Members of this body walk up here and say, ``We 
want no changes to Medicare,'' when they say they want no changes, are 
they saying they want the law as it is today? They want doctors in 
January to get a 29.4 percent cut? You can't have it both ways. You 
can't walk up here and say, ``We want to keep the law exactly as it is, 
no protection, no changes.''
  ``Oh, by the way, you're never going to see your doctor again after 
January 2.''
  You have to actually go through more of these last three pages, this 
statement of opinion. It's devastating. And you start to realize the 
political theater around here hasn't been telling our public the truth. 
They're more concerned about winning political points than helping the 
American people understand we have a huge, important program here 
that's about to collapse under its own weight. We have the documents. 
We have the data. We're trying to step up and be responsible. But by 
being responsible, you get demagogued, you get attacked, you have 
people going out and holding up little protest signs. And then you talk 
to them and say, ``Hey, read this,'' and they read it, and they look at 
you with these eyes saying, ``I can't believe my own side's been lying 
to me. Why didn't they fess up and tell us this was coming?''

                              {time}  1140

  There are a couple of other things in here. Medicare prices for 
hospitals, skilled nursing facilities, home health, hospice, ambulatory 
surgery centers, diagnostic laboratories, and many other services would 
be less than half of their levels under prior law. That is built into 
this Medicare actuary report. Think that through. Built into the 
formulas today, those groupings are going to be receiving half the 
compensation? How many of them are ever going to treat, take care, 
diagnose, or provide hospice care for Medicare recipients? That's what 
the Republicans are trying to save. We're trying to fix it. We're 
trying not to let that happen.
  Anyone that says they do not want changes to Medicare, they are 
actually supporting the downfall of the program. And that is actually 
why I stand here. I will be back next week with a series of slides that 
actually break out a number of segments from this Medicare actuary 
report, because it's time we start having Members come to this floor 
and tell the truth.
  One last little thing here. For these reasons, the financial 
projections shown in this report for Medicare do not represent a 
reasonable expectation for actual program operations. What the Medicare 
actuary is basically saying is, What we've based much of the rhetoric 
on around here, if you dig into the numbers, this program has already 
changed as people know it. It was changed last year when they did the 
health care takeover vote. It's already built into the law.
  As a Republican, we're trying to find ways to save this program, make 
it actuarially sound so it is there for the folks who are on it, for 
our children, for ourselves, and for the next generation. We are here 
to do the right thing. And if you don't believe me, go pull the report, 
and read through it yourself.
  Madam Speaker, I yield back the balance of my time.

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