[Congressional Record (Bound Edition), Volume 159 (2013), Part 3]
[House]
[Pages 4083-4088]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                MEDICARE

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
January 3, 2013, the gentleman from California (Mr. Bera) is recognized 
for 60 minutes as the designee of the minority leader.
  Mr. BERA of California. Mr. Speaker, over the past several weeks, 
I've been talking to my constituents and I've been talking to former 
patients about the importance of Medicare and how Medicare has impacted 
their lives, how they've relied on it.
  As a doctor, I've taken care of thousands of patients, patients who 
have worked their whole life paying into a system so that they could 
rest easy at a time when they needed their health care. They wouldn't 
have to worry about it.
  This is a value and a program that has served millions of Americans 
for decades. They've come to rely on Medicare. It is a program that 
works. It is a program that we've come to rely on as doctors.
  Let me make it even a little more personal than that. Let me tell you 
the story about my parents, who came here as immigrants over 50 years 
ago.
  My mom was a public school teacher and my dad was an engineer and a 
small business owner. They got up every day. They went to work. They 
paid into a system over a lifetime so that when they needed their 
health care, they could rest easy. They knew they had a Medicare 
system.
  Let me even make it more personal. Over these past few years, my dad 
is in his late seventies and he has needed knee replacements. He was 
able to get them. His doctor was able to order the care that was 
necessary to take care of him.
  A few months ago, my mom suffered a mild stroke. My dad didn't have 
to hesitate about whether she could get health care or not. My dad 
could pick up the phone, call 911 and get her to the hospital. She was 
able to get the care that was necessary that millions of Americans 
count on. Her doctor was able to come and see her. Her doctor was able 
to order the postoperative care that was necessary.

                              {time}  1730

  That is why millions of Americans rely on Medicare--so they can rest 
easy at a time when they need that security of health care. It is a 
system that works. It is a system that working men and women in America 
pay into over their lifetimes so that, when they're at their most 
vulnerable, they're able to get the care that they need. I've seen it 
time and time again as a doctor. Let me share a story with you.
  As a young intern in my training as a doctor in internal medicine, 
one of my first patients was a Roman Catholic priest, Father Mike. It 
was my first month working in a hospital and doing my rounds in the 
intensive care unit. Now, Father Mike was afflicted with ALS, more 
commonly known as Lou Gehrig's disease. Father Mike would be in and out 
of the hospital, and would be devastatingly sick. For those of you who 
know about Lou Gehrig's disease, it is a progressive illness that 
slowly deteriorates and eats away at your body. It takes away your 
muscles and

[[Page 4084]]

your ability to breathe. So, over the course of 2 years, I would see 
Father Mike repeatedly going in and out of the intensive care unit. He 
needed that care to keep him alive. Without Medicare, he wouldn't have 
been able to afford the care.
  Now, let's ask ourselves as Americans: What are our values?
  Our values are that we take care of our seniors, that we take care of 
our parents and grandparents, and we want to honor them after a 
lifetime of work. That is who we are. Those are our morals as 
Americans, and that is why I'm on the floor of the House of 
Representatives today to talk about how important Medicare is, not only 
for my parents but for parents throughout this country, for 
grandparents throughout this country, and also for that next generation 
that is currently paying into the system. I'm not alone. My fellow 
colleagues in medicine care about this deeply.
  With that, I would like to recognize my colleague, a fellow physician 
from California, Dr. Raul Ruiz.
  Mr. RUIZ. Thank you, Dr. Bera.
  This Congress has a responsibility and an opportunity to work 
together to grow our economy and to set this Nation on a fiscally 
responsible path. However, the Ryan budget is irresponsible, and it 
places the burden of the deficit on hardworking American families and 
seniors. This plan ends the guarantee of Medicare. As an ER doctor, I 
know that many of my senior patients are struggling financially and 
rely on Medicare in the moments of their lives when they need it the 
most.
  Our priority should be reducing health care costs in order to make 
Medicare stronger and more sustainable, but this budget transforms 
Medicare into a voucher program, shifting the costs of health care onto 
the shoulders of our seniors. We must, once again, work together to 
protect and preserve Medicare, reduce our deficit and decrease health 
care costs. I urge my colleagues to come together across party lines 
and put American families and our seniors first.
  Mr. BERA of California. Thank you, Dr. Ruiz.
  I urge Americans to share their stories. I urge them to share the 
importance of Medicare and how they rely on it. Share the stories about 
your parents and grandparents. I urge the Members of this body to share 
their stories. We all have parents and grandparents. We all care about 
this program, and we all have stories to tell.
  Just today, in my office, I had a colorectal cancer survivor come to 
visit. She talked about how her cancer was diagnosed early because she 
was able to go get a colonoscopy--because she was able to get the 
preventive care services that were necessary. She would not have been 
able to do that had she not had access to Medicare, had she not had 
access to basic cancer prevention.
  That is what's at stake here--making sure that our seniors, that our 
parents and grandparents, have access to that care when they need it 
the most. That's why I'm on the floor here today, because we have to 
protect Medicare--a program that has worked for decades. It is a 
program that we rely on, so I want to hear your stories about how we 
protect Medicare and make sure it's there for generations. This is a 
program that has worked time and time again. Let me even share another 
story of patients that I've taken care of.
  I've taken care of hundreds of men and women who do physical labor--
construction workers, folks who get up every morning and go to work. 
They don't make a lot of money, but they pay into a system. I'd 
encourage every American to pull out their paychecks and take a look at 
them, and you'll see right on there that you're paying into the 
Medicare system. Even those who are 25 or 30 years old are paying into 
the system.
  Why do we do that?
  We pay into the system so that, when we need our health care, we're 
able to get it. That's what we do as Americans. We know we're in this 
together, that we care for one another. That is the beauty of Medicare. 
As I'm working today, I am paying to make sure that my parents and 
grandparents have the health care they need so that, when I need that 
health care in retirement, when I'm a senior, I can get it, and so that 
I can rest easy and not have to worry about that.
  That's why we are encouraging you to share your stories. We want to 
hear your stories about how Medicare has impacted your life and why it 
is so vital that this body protect Medicare and strengthen Medicare. 
Share your stories with us on Facebook or Twitter.
  I would like to now recognize my colleague, the distinguished 
gentlelady from Florida (Ms. Frankel).
  Ms. FRANKEL of Florida. Thank you, Congressman.
  In listening to your talk, I've been inspired to share this personal 
story of my mom. I told this story a few minutes ago, but it's worth 
repeating.
  About 20 years ago, my mom had just reached Medicare age. She was a 
widow on a fixed income, and she was diagnosed with breast cancer. I 
had a young son at the time. He is grown now, but he was 13 years old. 
Our family was blessed as my mother had Medicare, and she was able to 
get the good health care that she needed, and she's still with me 
today. I didn't have to choose between helping my mother with her 
health care treatment or saving money to send my son to college.
  That's the kind of choice Americans are going to have to make under 
this Republican budget, because the Republican budget doesn't make 
seniors healthier, it just shifts the burden.
  My district is filled with people from all walks of life, from all 
different professions, whether they be teachers or nurses or 
accountants. They've worked hard their whole lives, and they've saved 
up their Medicare accounts and can live with the comfort now of knowing 
that, if they get sick or if they get injured, the health care that 
they've earned will be there for them. They will not be a burden on 
their children, and they will not take the savings that their children 
have for their grandkids' college educations and use it for their 
health care.
  But it's not enough, Congressman Bera, for us just to say that the 
Republican budget is bad, because the fact of the matter is the 
American people and my constituents want answers. They want us to be 
problem solvers, not problem creators, and they want us to get 
something done. The Democratic budget gets something done. Just on this 
issue of health care for our seniors, we secure Medicare for this 
generation and for generations to come because we focus on what the 
problem is, and that has been the growing costs of health care.

                              {time}  1740

  In the Affordable Care Act, we tackle the problem directly. We reduce 
overpayments to health care insurance carriers. We look for 
efficiencies in the delivery of health care. We focus on prevention. We 
make health care more accessible to more people so that when they enter 
their Medicare ages, they're healthier. The Democratic budget has a 
solution, a solution to a challenge that all Americans recognize today.
  Congressman Bera, I want to thank you for allowing me to spend some 
time to speak on behalf of not only my family, but so many of the 
families in my district in south Florida who depend on Medicare to live 
full lives.
  Mr. BERA of California. Thank you, Congresswoman Frankel.
  You know, I look at this whole issue from the eyes of a doctor. 
That's how I have to, that's how I was trained as a doctor. One of the 
first rules we take when we are sworn in as doctors, the oath and the 
promise that we make is to do good, benevolence. That is core to what 
we do, and that is core to what this body needs to understand.
  This is not about Republicans versus Democrats. We need to come 
together to do good for our parents and grandparents, to do good for 
our seniors, to make sure that we honor the promise that we made to 
them that after a lifetime of work that they would be able to get the 
care when they needed it the most. That they could rest easy and not 
have to worry about getting the care that they needed.
  Those are American values. Those aren't Democrat versus Republican. 
We

[[Page 4085]]

need to start setting aside that partisanship. And as to the oath I 
took when I became a doctor and was sworn into the field of medicine, 
we need to do good. We need to have the courage to put our patients and 
American citizens first. That is what this is about. That is why I'm on 
the floor today talking as a doctor about the patients that I've cared 
for.
  Now, I've heard from others that I represent. Tina shared a story 
with me. Her father died a few weeks ago after spending a month in the 
hospital.
  Medicare meant her family never had to worry about what the cost of 
his care was during his illness. Medicare meant that her mother doesn't 
have to live a life in bankruptcy now, that she could rest easy that 
her husband was able to get the care that he needed. Medicare meant 
that they knew in her father's last days that he was getting good 
health care, that his doctors were able to give him the care that was 
necessary at the end of his life.
  Tina has urged me to fight every day to make sure that every family 
has the same peace and the same support and the same security that her 
family had and that she felt at a time when her father needed the care. 
That's what this is about. This is about doing what we do as Americans. 
We care for one another. We build a system where we're all in this 
together, where those of us who are working are paying into a system 
over a lifetime so that the seniors of today are able to get that care 
and that we pay it forward. Those are our values. Those are American 
values, and it's not Democrat versus Republican; and we have to get 
past this.
  As we are on this floor, as we're making votes, we have to think 
about those who came before us, our parents, our grandparents, the 
seniors who built this country. That is who we are as Americans, and 
that's why we want to hear your stories about why Medicare is so 
important. Share those stories with us on Facebook. Share those stories 
with us on Twitter. Let your Representatives know why it is so 
important you want us to keep fighting for Medicare every day.
  I'd now like to actually hear a story from my colleague, the 
distinguished gentlewoman from the great State of Ohio.
  Mrs. BEATTY. Thank you so much, Congressman Bera. What a great 
opportunity for me to tell my story when I think about Medicare and 
what that means to me--but more importantly, what it means to this 
Nation, what it means to the citizens in the Third Congressional 
District that I represent, what it means to someone's mother, someone's 
grandmother, someone's spouse.
  Medicare is something that was created and seniors have paid into it, 
oftentimes for a lifetime. And then they get to a point in their life 
when they want to be able to use something that they paid into. 
Medicare is something that you're going to hear about from people.
  I agree with my colleagues that Medicare is not, nor should it be, a 
Democrat or a Republican issue. It should be something when you think 
about being able to provide health care for the same individuals who 
put so much money into it that they can now be able to use it. Medicare 
helps save lives. Medicare is part of what I think of as part of the 
American Dream. Medicare is something that we should be proud to be 
able to say that we're going to take care of our seniors.
  You see, a few years ago my father was very ill; but it was because 
of Medicare that I was able to witness him getting quality health care. 
I'm fortunate, my mother is still living. And like many of my 
colleagues who have come here today and talked about the wonderful 
benefit that they had by being able to know that their parent was being 
taken care of, and they were going to be able to have quality health 
care, isn't that something that we all want? Isn't that something we 
want as a Democrat? Isn't that something that we want as a Republican?
  Let me tell you what I know the citizens of the Third Congressional 
District want. Let me tell you what I really believe the citizens of 
this wonderful country we live in want. I think they want to see us 
working together. I think they want to hear solutions. I think they 
want to know that they can trust us, because they sent us here not to 
be in gridlock, not for us to be fighting, not for us to be arguing 
without resolve, and that's what Democrats are saying to you today.
  We have taken this issue that touches lives and reaches across 
America, and we are saying it is our responsibility as Members of 
Congress, Members of this 113th Congress, that we should make it one of 
our key responsibilities to stand on this floor and tell those stories, 
to tell those stories about Medicare, to tell those stories about the 
lady who lives down the street from me and how fortunate she was 
because Medicare saved her life. We should be able to stand on this 
floor and give speech after speech to say to America: you sent us here 
to protect those who are the most fragile citizens, those who have 
given so much that we stand here.
  So you see, my story is quite simple about Medicare. It's about 
exercising our right to protect those who paved the way for us. It's 
about me saying proudly as a Democrat our alternatives to the budget as 
it relates to Medicare is the best solution. It's about saying we 
should not make it a voucher program. It's about me saying we should 
not take moneys from Medicare and give to other companies that don't 
need it.
  You see, it's quite simple. It's a story about saving lives. It's a 
story about doing all the things that we say as public servants. It's 
about the oath that we took as an elected official that we would serve 
our communities, that we would come here and make a difference.

                              {time}  1750

  So, Congressman Bera, for me, it's about standing strong and saying 
to my colleagues on both sides of the aisle, Join us; join us in making 
a difference to help our seniors and protect and save Medicare. And 
that's my message and my story.
  Mr. BERA of California. Thank you to my colleague from the great 
State of Ohio.
  That's why we are asking folks today to share their stories. We would 
love to hear your story about how Medicare has affected you or a family 
member or a friend. Share it on Facebook or Twitter. We want to hear 
those stories. This body needs to hear those stories. This body needs 
to make sure, when we're taking votes, we're voting understanding those 
stories.
  As a doctor, I took an oath to do good, to do no harm. Well, if 
Medicare becomes a voucher program, it will do irreparable harm to 
thousands of Americans, and that is not what we need.
  The reason why I'm on the floor today is to talk about the good that 
Medicare has done for millions of Americans. Americans, like another 
one of my constituents, Pat. She shared with us a story.
  Pat was a single mom. She worked hard her whole life and raised two 
kids on her own. Pat is now 77 years old. She has high blood pressure, 
diabetes, and heart disease. She had to have open-heart surgery and 
afterwards was prescribed very expensive medications and cardiac 
rehabilitation. She had to get back on her feet because she wanted to 
be with her family.
  There's no way Pat could have afforded that surgery if she didn't 
have Medicare. There's no way Pat could have afforded the medications 
that she needed if she didn't have Medicare. There's no way that the 
doctors that cared for Pat would have been able to prescribe the 
therapies that she needed to keep her alive. That is what's at risk 
here.
  This is about protecting our seniors, making sure that after a 
lifetime of work, after a lifetime of paying into a system, that they 
can rest easy; that they don't have to worry about whether they can get 
the health care that they need when they need it the most, they can 
rest easy.
  That's why we want to hear your stories. Please share your story 
about how Medicare has impacted your life or your family's life on 
Facebook or Twitter.

[[Page 4086]]

  I would now like to yield to my dear friend and colleague from the 
great State of California, my home State, Mr. Honda.
  Mr. HONDA. I want to thank my friend, Dr. Ami Bera, for allowing me 
to speak for a few minutes.
  Mr. Speaker, we are here today to dispel the oft repeated notion that 
Medicare is somehow the problem in the current fiscal crisis. 
Republicans have, in budget after budget, attempted to voucherize the 
program and end the Medicare guarantee as we know it. They would break 
the promise we made to our Nation's seniors decades ago, one in which 
we told hardworking middle class Americans that if they paid in through 
their wages and trusted in their government that they would be taken 
care of.
  Medicare is the most efficient health plan in our country. It has a 2 
percent overhead. Let me repeat that. It has a 2 percent overhead. More 
efficient than any private plan.
  The problem isn't Medicare. The problem is the rising cost of health 
care and what it is we have to do to get that under control. It's a 
cost that has gone up exponentially in our country compared to the rest 
of the world.
  Republicans want to do nothing about the real problem of rising 
costs. Rather than tackle the hard issue, they want to shift the costs 
on to seniors, people like my mom. She's 96 right now, and she depends 
on that important program.
  Six years ago, she had to be checked up for a heart condition. She 
had had an aneurysm below her diaphragm and it was part of the arterial 
system. They said that it would be difficult to solve and that they 
would have to provide a stent because of her age, as she was 70 at that 
time.
  Well, a few years later, that aneurysm grew a little larger, and it 
became pretty critical that, if nothing was done, she would die. The 
doctors looked at her again at the advanced age of 90 and concluded 
that we could do this with her--she walked around acting like she was 
70--and would have a 9 out of 10 chance of survival. If she did not do 
anything, the chance of survival would have been a lot less.
  My mom thought about it, she pondered about it, and she said, I'm 90. 
I've lived a good life. Let's take this 9 out of 10 chance. And she put 
her faith not only in the hands of the doctors and the system, but also 
in the hands of her God. After a few hours of operation, she came out, 
and it was successful.
  But none of this could have been possible without Medicare. We would 
not have been able to afford it, and neither could she have afforded 
it.
  She grew up as a child of a businessman during prewar United States, 
and in her adult life as my mom, she worked as a domestic, so she had 
no pension plan. She had no other plans that would help her in her old 
age, except Medicare.
  So, time and time again, when Congress was looking for an easy way 
out in dealing with these issues, leaving folks like my mom holding the 
bag, this whole issue is personal. And I'm sure that this is a story 
that could be shared by almost every family in this country in one way 
or another when we think about Medicare. So, having the middle class 
Americans and people like my mom holding the bag is absolutely 
unacceptable. It is wrong and it is quite cowardly.
  One of the major reasons why our health care costs keep going up is 
because we have not changed the way patients and doctors see each 
other. We must be innovative and creative in tackling the traditional 
costs of health care.
  As a Representative covering Silicon Valley, I have helped lead the 
way in this by promoting innovative technologies, such as telemedicine, 
personal health connected devices, and other tools. I will be 
reintroducing the Health Care Innovation and Marketplace Technologies 
Act later this year to continue this effort. Let's hope that folks on 
the other side will understand its importance.
  Most importantly, however, I will continue to stand with my friends 
here in the Chamber tonight to protect Medicare and the Medicare 
guarantee. We can fix our Nation's fiscal House by being innovative, 
rather than using the same old ideology. We can improve our Nation's 
standing by being courageous and standing by our Nation's seniors.
  Mr. BERA of California. I thank my dear friend and colleague from 
California, Congressman Honda.
  The reason why we are here today, the reason why we are speaking on 
the floor today, is because of the importance of Medicare. This isn't a 
Democratic or a Republican issue. This is an issue that affects all 
Americans. It's an issue that is dear to all Americans, to all American 
families. It isn't Democratic or Republican.

                              {time}  1800

  That's why I'm wearing this pin that says, ``No Labels.'' Because 
we've got to move past these labels, Democrat versus Republican, and 
think about what our values are as Americans--the values of making sure 
we take care of our parents and grandparents, that we honor the 
foundation that they built for us, that those that came before us 
built; that we honor, after a lifetime of work, after a lifetime paying 
into a system, that they can rest easy, that they know they can get the 
health care that they need when they need it the most.
  That's why we want you to share your stories with us about how 
Medicare has impacted you personally or your family. I think about this 
and the thousands of patients that I've taken care of, and what 
Medicare has meant to them; how it saved millions of lives, how it's 
kept millions of families from falling into poverty because they were 
able to get the health care that was necessary when they needed it the 
most.
  Another one of my constituents, Katherine, shared a story with us 
recently. Katherine had a sister who was diagnosed with lung cancer and 
chronic lung disease. At first, she was hesitant. She was a little bit 
worried about using her Medicare because she didn't want to be a 
burden. She wanted to be independent. But she looked at it and she 
realized she had paid into this system her whole life and was grateful 
that it was there for her. She realized that she wasn't being a burden 
and that this is the system that she had paid into, and it was there 
for her. Medicare covered her bills and kept her alive. That's why 
we're here on the floor today talking about Medicare.
  When I talk about this, it's personal. I talk about this as a doctor. 
I talk about this as a son whose parents are aging. I think about the 
people who live in my neighborhood, like my neighbor, Jerry. He's a 
widower. His wife passed away several years ago. Jerry's also a cancer 
survivor. He has to go in for routine blood transfusions and routine 
care. He doesn't have to worry about whether he can get that care or 
not because of Medicare. Because he paid into the system his whole 
life, now he can get the care that he needs.
  Millions of families across this country depend on Medicare. That's 
why we're here talking about protecting Medicare. And that's why we 
want to hear your stories about how Medicare has impacted your life. I 
would love to here those stories and want you to share them on Facebook 
or Twitter. Medicare allows patients that I've seen--patients with 
diabetes, with high blood pressure, with high cholesterol--to get the 
medications that they need. Medicare allows me as a doctor to write 
those prescriptions and know that my patients are able to get the care 
that they need.
  Medicare is not about Democrats versus Republican. It is about doing 
the honorable thing that we do as Americans. Because that's who we are. 
Those are our values as Americans. As Americans, we want to make sure 
that after a lifetime of work, we're going to protect the promise that 
we made to our parents and grandparents. And I know it's not Democrats 
versus Republican because you can see it in that picture of when the 
Tea Party first emerged in this country in 2009. They were holding up 
their signs saying, ``Keep your hands off of our Medicare.'' You know 
what? I'd say the same thing.

[[Page 4087]]

  As we go through these budget debates, let's keep our hands off of 
Medicare. Yes, we've got to address the cost of health care. But as my 
colleague, Congressman Honda shared, Medicare works extremely well. 
It's a program that has worked for decades. It is a program that has 
allowed me as a doctor and has allowed countless doctors across this 
country to deliver the necessary care when we needed to and to do what 
we were trained to do--to be doctors.
  That is why I'm on the floor today talking about how we protect that 
promise that we made to our parents and grandparents, and how we 
protect and honor the promises that we've made. Yes, we face challenges 
in this country. Yes, we have to address our debt and deficit. And we 
have to build for the future so our children grow up in the same 
vibrant world that we grew up in with a country that's leading the way. 
But we can't do that by breaking a promise that we made to our parents 
and grandparents. We can't do that on the backs of seniors, taking care 
away from them when they need it the most.
  This has to be bipartisan. Because how we treat our elders, how we 
treat our parents and grandparents, is a direct reflection of who we 
are as Americans. We need to start talking about this in a bipartisan 
way. We need to shelve the idea of dismantling Medicare and we have to 
talk about the idea of strengthening Medicare, making it more secure so 
that it is there not only for today's seniors but that it is there for 
the generations, that it is there for our children and grandchildren. 
It is a system that works extremely well.
  Yes, we have to talk about the cost of health care. We have to 
address the cost of health care. But Medicare isn't the problem. 
Medicare works extremely well. Ask any senior. Eighty percent of 
seniors love Medicare. They don't want to see it changed. They don't 
want to see this body messing around with Medicare. They want us to 
strengthen it, and they understand that we have to deal with the cost 
of health care. But the system of Medicare has delivered care extremely 
well.
  That's why I'm on the floor asking you to share your Medicare story. 
I'm asking you to share that story on Twitter or share it through 
Facebook. Because this body needs to hear those stories. This body 
needs to understand that Medicare is a vital program for millions of 
seniors, that our parents and grandparents depend on this program, and 
that our doctors and our hospitals depend on Medicare.
  Now is not the time to be talking about dismantling Medicare. Now is 
the time to be talking about how we strengthen Medicare, how we make 
sure it's there for the generations. That's why I'm on the floor today, 
as a doctor but also as a son whose parents rely on Medicare. That's 
why I want to hear your stories, and I want you to share your Medicare 
story on Facebook or Twitter.
  I now yield to my great friend and colleague from the great State of 
Oregon.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. Members are reminded to address their 
remarks to the Chair and not to a perceived viewing audience.
  The gentleman from Oregon is recognized.
  Mr. BLUMENAUER. I want to thank my colleague from California for 
being here this evening, for sharing the time, allowing me to speak 
with him. And I must say how excited I was that a friend who actually 
had a rewarding career was willing to jump into the political fray, 
which has been difficult at times, particularly as we've had the 
contentious issues surrounding health care, and that you would be 
willing to bring your expertise, time, and energy when you had other 
choices with your life and career. We really appreciate it. Because the 
experience you have had in the medical profession, the years of study, 
the actual experience with real-life people adds a dimension that is 
helpful here in ways that I don't know that you fully appreciate, but I 
certainly do. I also appreciate focusing on the critical nature of 
Medicare and where we're going in the world of health care reform.
  I just spent last week dealing with my Republican friends' approach 
to the budget. It can only be described as an exercise in fantasy.

                              {time}  1810

  They start with the notion that somehow they're going to eliminate 
ObamaCare entirely; and they seek to transfer the burden of Medicare 
and Medicaid from the government onto the shoulders of some of 
America's most vulnerable poor and disabled, and our senior citizens. I 
really appreciate your focusing on the importance of Medicare in 
providing dignity and stability to millions of Americans.
  Now, I think there have been, between the House and the Senate, about 
50 efforts or more to repeal the health care reform. I must say I hope 
that finally people get it out of their system. I was surprised that we 
went in this direction, to turn Medicare into a voucher, a block grant 
for Medicaid, and put this burden on our senior citizens and some of 
our poor and disabled Americans, because this was the centerpiece of 
their campaign for the last 6 months. This was part of what our friend 
Paul Ryan and Governor Romney preached from coast to coast, advertised, 
campaigned; and all of a sudden it was rejected by the American public 
overwhelmingly. The President was comfortably reelected. In fact, there 
were more Democratic Senators added who support this effort. In the 
House of Representatives, not only did we gain seats, but more than a 
million voters--more voted for Democrats than Republicans.
  So you would think that this canard would be put to rest; but it is 
important for people to know that it is still a viable option as far as 
our Republican friends are concerned. It's unfortunate because we are 
making some progress in reforming the health care system--not by 
turning our back on Medicare, not by transferring the risk and 
responsibility to seniors and the most vulnerable, but by making it 
more efficient, by taking some of the experiments that we've done in my 
home State of Oregon--and as you well know there are some health care 
systems in California that have already found ways to reward value over 
volume, to be able to extend care, and do so more efficiently, and 
squeeze the approximately one-third to 40 percent or more of our health 
care spending that is wasted.
  We can do a better job. We start, I think, by protecting Medicare. We 
start by recognizing that a voucher--or premium support, or whatever 
they call it--that caps the investment does nothing to reform health 
care; but, instead, it puts seniors and our most vulnerable citizens 
out navigating the health care maze with fewer resources and more 
responsibility and actually making it harder. Because that's why we 
have Medicare in the first place. The private market did a terrible job 
meeting the needs of America's oldest and least healthy population.
  I am hopeful that we're going to be able to continue this effort that 
you're spearheading here tonight, for people to understand the 
opportunities to continue reform, to note that we are actually seeing a 
gradual stabilization of health care spending right now, and that there 
are things in the hopper that we can do going forward without taking 
advantage of people who deserve the security of a solid, reformed 
health care system, not one that the Federal Government vouchers and 
turns their back.
  I would yield back to the gentleman if there are comments. I look 
forward to hearing what you have to say, and perhaps there may be a 
little more interaction if it's useful.
  Mr. BERA of California. Well, I appreciate my friend and colleague 
from the great State of Oregon.
  We've heard wonderful stories from all across this country tonight as 
my colleagues have shared their experience with Medicare, personal 
stories about what Medicare has meant to their parents. We want to hear 
your stories as well. Your Representatives on both sides of the aisle 
need to hear your stories of what Medicare means to you personally and 
to your families. Because Medicare is a promise that we've made to our 
parents and grandparents,

[[Page 4088]]

to millions of seniors across this country. It is a promise that after 
a lifetime of work, after a lifetime paying into a system, you can rest 
easy. You don't have to worry about whether you'll be able to get the 
health care that you need at a time when you need it the most.
  This can't be a partisan issue. It can't be Democrats versus 
Republicans. Because we're all sons and daughters. We all think about 
our seniors. Those are our values as Americans. It isn't who we are as 
a Nation. We respect our elders. That's how we were raised.
  As a doctor, we rely on the importance of Medicare. We rely on the 
ability that at a time when our patients are at their most vulnerable, 
when they need health care, that I can write that prescription, that I 
can do the treatment or order that surgery when it's needed. That is 
the promise that we've made, and that's why we're here fighting every 
day.
  I urge this body, and I urge my colleagues, as we are looking to 
address the challenges of this Nation, we acknowledge and understand 
that Medicare is not one of those challenges. Medicare is one of the 
success stories of America. Medicare is a success story that has kept 
millions of Americans healthy and alive and giving them the care that 
they need.
  Yes, we face challenges. Yes, we have to address the cost of health 
care. But Medicare is a success story, and it is something that we 
should be celebrating every day. That isn't Democrat versus Republican; 
that is a success story of this body, and let's celebrate that.
  With that, I'll yield to my colleague from Oregon.
  Mr. BLUMENAUER. Thank you, Dr. Bera.
  I appreciate your focus on this and pointing out that this is 
something that shouldn't be a partisan issue, doesn't have to be a 
partisan issue, and it is in fact a success story that has made a huge 
difference in the lives of seniors from coast to coast. It's helped, in 
many cases, stabilize what's happened in terms of local health care 
economics.
  The pattern that we have seen in escalating health care costs for the 
last 40 years, yes, there are concerns about health care as it relates 
to Medicare; but if you compare the rate of increase of private health 
insurance versus the rate of increase in Medicare, Medicare spending 
has not gone up as rapidly as what's happened with the private 
insurance sector.
  No senior citizen under Medicare needs to go bankrupt because of 
medical costs. The security that you mentioned, I find it embarrassing 
and shameful that the United States is the only major country in the 
world where there are still people going bankrupt for health care 
costs. Half of all bankruptcies are a result of health care 
emergencies. It doesn't have to be this way, and it is not that way for 
American seniors.
  But if we're going to change our health care commitment to our senior 
citizens, taking away the guarantee of Medicare, flinging people into 
an uncertain private market that failed them in the past, which is why 
we had Medicare in the first place, that guarantee is not certain to be 
there.
  No one thinks that we shouldn't have a health care system with a 
Medicare that is flexible going forward. We're open to reforms, 
absolutely. We want to reward value instead of volume. We want to be 
able to deal with the pattern of unnecessary medical readmissions for 
Medicare patients after they've been in the hospital. It's too high 
still.

                              {time}  1820

  But we are working on mechanisms in Medicare and with the hospitals 
to be able to reward keeping them out of the hospital with preventable 
conditions that require readmission.
  We're in the process of looking at Medicare Advantage, which is 
growing dramatically. I come from the district that has probably the 
highest penetration of Medicare Advantage in the entire country, and it 
serves in many cases my constituencies pretty well, but there are wide 
variations across the country in Medicare Advantage. Not all Medicare 
Advantage programs are created equal.
  Again, part of what we've done with the Affordable Care Act is not to 
turn our backs on potential opportunities to improve it, but to dive in 
and find ways to reward the most efficient and effective Medicare 
Advantage programs and, frankly, reduce the support for programs that 
aren't measuring up. That's what we should be doing.
  We are moving in this direction. We don't have to take away the 
commitment that we have made to America's seniors to improve Medicare, 
Medicare Advantage, to be able to get even more value out of the 
system--not just tax dollar savings--but better quality care for our 
senior citizens, which should be our objective.
  I know, Doctor, that is something you've practiced both as an elected 
official and as a professional; and I deeply appreciate it.
  Mr. BERA of California. I genuinely appreciate my colleague from the 
great State of Oregon sharing these stories and the hard work that 
you've done on this.
  I know I'm coming up on the end of my time, and I appreciate the 
opportunity to talk about Medicare as a doctor and as a son and talk 
about the success of Medicare. It's something that we should be 
celebrating.
  I look forward to working with my Republican colleagues to hear their 
stories of how Medicare has impacted their lives, to work with them to 
strengthen Medicare, to make sure it is there, not only today, but it 
is there for the next generation and that it is stronger.
  We can do this. We know how to do it. Over the coming weeks and the 
coming months, as we address our challenges, I'll be coming to this 
floor to share those stories and those ideas of how we move forward as 
a Nation and how we move forward as Americans making sure we honor the 
promise that we've made, that after a lifetime of work, after a 
lifetime paying into a system, that our parents and grandparents, that 
our seniors can get the care that they need.
  With that, Mr. Speaker, I yield back the balance of my time.

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