1 00:00:00,000 --> 00:00:00,000 starttime 1259937035.06183 2 00:01:20,001 --> 00:01:21,000 SENATE ON C-SPAN2. 3 00:01:21,001 --> 00:01:24,000 THE PRESIDING OFFICER: THE 4 00:01:24,001 --> 00:01:34,000 SENATE WILL COME TO ORDER. 5 00:01:34,001 --> 00:01:38,000 WILL LEAD THE SENATE IN PRAYER. 6 00:01:38,001 --> 00:01:39,000 THE CHAPLAIN: LET US PRAY. 7 00:01:39,001 --> 00:01:44,000 OUR FATHER. 8 00:01:44,001 --> 00:01:46,000 WE BOW IN YOUR SACRED 9 00:01:46,001 --> 00:01:48,000 PRESENCE TO ACKNOWLEGE OUR NEED?? 10 00:01:48,001 --> 00:01:51,000 OF YOU. 11 00:01:51,001 --> 00:01:55,000 WE CAN DO WITHOUT MANY THINGS, 12 00:01:55,001 --> 00:01:57,000 BUT WITHOUT YOU WE CAN'T LIVE. 13 00:01:57,001 --> 00:02:02,000 MEET THE NEEDS OF THE MEMBERS OF 14 00:02:02,001 --> 00:02:06,000 THIS LEGISLATIVE BODY. 15 00:02:06,001 --> 00:02:08,000 WHEN SORROW AND SHADOWS FALL ON 16 00:02:08,001 --> 00:02:11,000 THEIR PATH, FILL THEM WITH YOUR 17 00:02:11,001 --> 00:02:16,000 JOY AND LIGHT. 18 00:02:16,001 --> 00:02:17,000 WHEN THEY FEEL PERPLEXED, 19 00:02:17,001 --> 00:02:22,000 PROVIDE THEM WITH YOUR BOUNTIFUL 20 00:02:22,001 --> 00:02:31,000 WISDOM. 21 00:02:31,001 --> 00:02:33,000 WHEN THEIR HEALTH FAILS, BE FOR 22 00:02:33,001 --> 00:02:35,000 THEM THE GREAT PHYSICIAN. 23 00:02:35,001 --> 00:02:36,000 LORD, WE ALSO ASK YOU TO PROTECT 24 00:02:36,001 --> 00:02:43,000 THEIR LOVED ONES WITH THE SHIELD 25 00:02:43,001 --> 00:02:47,000 OF YOUR FAVOR. 26 00:02:47,001 --> 00:02:48,000 GIVE OUR LAWMAKERS COURAGE FOR 27 00:02:48,001 --> 00:02:53,000 HARD TIMES AND STRENGTH FOR 28 00:02:53,001 --> 00:03:04,000 DIFFICULT PLACES. 29 00:03:04,001 --> 00:03:05,000 WE PRAY IN YOUR LOVING NAME. 30 00:03:05,001 --> 00:03:06,000 THE PRESIDING OFFICER: PLEASE 31 00:03:06,001 --> 00:03:08,000 JOIN ME IN RECITING THE PLEDGE 32 00:03:08,001 --> 00:03:09,000 OF ALLEGIANCE TO THE FLAG. 33 00:03:09,001 --> 00:03:11,000 I PLEDGE ALLEGIANCE TO 34 00:03:11,001 --> 00:03:12,000 THE FLAG OF THE 35 00:03:12,001 --> 00:03:13,000 UNITED STATES OF AMERICA 36 00:03:13,001 --> 00:03:15,000 AND TO THE REPUBLIC 37 00:03:15,001 --> 00:03:16,000 FOR WHICH IT STANDS, 38 00:03:16,001 --> 00:03:18,000 ONE NATION UNDER GOD, 39 00:03:18,001 --> 00:03:19,000 INDIVISIBLE, 40 00:03:19,001 --> 00:03:27,000 WITH LIBERTY AND 41 00:03:27,001 --> 00:03:28,000 JUSTICE FOR AL 42 00:03:28,001 --> 00:03:29,000 THE PRESIDING OFFICER: THE 43 00:03:29,001 --> 00:03:31,000 CLERK WILL READ A COMMUNICATION 44 00:03:31,001 --> 00:03:32,000 TO THE SENATE. 45 00:03:32,001 --> 00:03:34,000 THE CLERK: WASHINGTON D.C., 46 00:03:34,001 --> 00:03:35,000 DECEMBER 4, 2009. 47 00:03:35,001 --> 00:03:37,000 TO THE SENATE: 48 00:03:37,001 --> 00:03:38,000 UNDER THE PROVISIONS OF RULE 1, 49 00:03:38,001 --> 00:03:39,000 PARAGRAPH 3, O 50 00:03:39,001 --> 00:03:41,000 RULES OF THE SENATE, I HEREBY 51 00:03:41,001 --> 00:03:43,000 APPOINT 52 00:03:43,001 --> 00:03:44,000 THE HONORABLE MARK 53 00:03:44,001 --> 00:03:45,000 A SENATOR FROM THE 54 00:03:45,001 --> 00:03:47,000 COMMONWEALTH OF VIRGINIA, 55 00:03:47,001 --> 00:03:50,000 TO PERFORM THE DUTIES OF THE SIGNED: ROBERT C. BYRD, PRESIDENT 56 00:03:50,001 --> 00:03:51,000 PRO TEMPORE. 57 00:03:51,001 --> 00:03:52,000 MR. THE PRESIDING OFFICER: THE 58 00:03:52,001 --> 00:03:53,000 MAJORITY LEADER. 59 00:03:53,001 --> 00:03:54,000 MR. REID: FOLLOWING LEADER 60 00:03:54,001 --> 00:03:56,000 REMARKS THE SENATE WILL RESUME 61 00:03:56,001 --> 00:03:57,000 CONSIDERATION OF THE HEALTH CARE 62 00:03:57,001 --> 00:04:00,000 BILL. 63 00:04:00,001 --> 00:04:01,000 THE TIME UNTIL 64 00:04:01,001 --> 00:04:02,000 DIVIDED AND CONTROLLED BETWEEN 65 00:04:02,001 --> 00:04:03,000 THE LEADERS OR THEIR DESIGNEES. 66 00:04:03,001 --> 00:04:05,000 THE MAJORITY WILL CONTROL THE 67 00:04:05,001 --> 00:04:08,000 FIRST HALF, REPUBLICANS THE 68 00:04:08,001 --> 00:04:10,000 SECOND HALF. 69 00:04:10,001 --> 00:04:16,000 WE HAVE A NUMBER OF VOTES THAT 70 00:04:16,001 --> 00:04:17,000 WE'RE GOING TO TRY TO ARRANGE 71 00:04:17,001 --> 00:04:19,000 THIS AFTERNOON. 72 00:04:19,001 --> 00:04:20,000 WE'LL LET ALL SENATORS KNOW AS 73 00:04:20,001 --> 00:04:22,000 SOON AS WE HAVE THIS WORKED OUT. 74 00:04:22,001 --> 00:04:25,000 BUT THERE WILL BE SOME VOTES 75 00:04:25,001 --> 00:04:27,000 TODAY AND TOMORROW. 76 00:04:27,001 --> 00:04:30,000 MR. PRESIDENT, THE AMENDMENT 77 00:04:30,001 --> 00:04:31,000 PROCESS CONTINUES TO CRAWL 78 00:04:31,001 --> 00:04:34,000 FORWARD. 79 00:04:34,001 --> 00:04:36,000 WITH THIS HISTORIC HEALTH 80 00:04:36,001 --> 00:04:37,000 FOREMAN BILL CONTINUES TO EVOLVE AND IMPROVE. 81 00:04:37,001 --> 00:04:40,000 THIS IS A GOOD BILL. 82 00:04:40,001 --> 00:04:41,000 IT SAVES LIVES, SAVES MONEY AND 83 00:04:41,001 --> 00:04:43,000 SAVES MEDICARE. 84 00:04:43,001 --> 00:04:44,000 IT MAKES HEALTH INSURANCE MORE AFFORDABLE. 85 00:04:44,001 --> 00:04:45,000 IT MAKES HEALTH INSURANCE 86 00:04:45,001 --> 00:04:46,000 COMPANIES MORE ACCOUNTABLE. 87 00:04:46,001 --> 00:04:48,000 IT MAKES OUR ECONOMY STRONGER. 88 00:04:48,001 --> 00:04:50,000 THE DEMOCRATS KNOW WE CAN MAK 89 00:04:50,001 --> 00:04:53,000 IT EVEN BETTER. 90 00:04:53,001 --> 00:04:55,000 THIS IS HAPPENING BECAUSE OF THE 91 00:04:55,001 --> 00:04:56,000 DEDICATED HARD WORK THROUGHOUT 92 00:04:56,001 --> 00:04:57,000 THE DEMOCRATIC CAUCUS FROM 93 00:04:57,001 --> 00:04:59,000 VETERAN SENATOR 94 00:04:59,001 --> 00:05:00,000 SENATORS, BY THE HANDS OF MEN 95 00:05:00,001 --> 00:05:03,000 AND WOMEN FROM THE DIVERSE PARTS 96 00:05:03,001 --> 00:05:05,000 OF THE COUNTRY AND GOOD PUBLIC 97 00:05:05,001 --> 00:05:06,000 SERVANTS FROM ALL POINTS OF THE 98 00:05:06,001 --> 00:05:08,000 POLITICAL SPECTRUM. 99 00:05:08,001 --> 00:05:09,000 SENATOR MIKULSKI OF MARYLAND WHO 100 00:05:09,001 --> 00:05:11,000 FOR DECADES HAS BEEN A CHAMPION 101 00:05:11,001 --> 00:05:13,000 FOR WOMEN'S HEA 102 00:05:13,001 --> 00:05:16,000 BETTER BY MAKING SURE WOMEN CAN 103 00:05:16,001 --> 00:05:17,000 GET THE MAMMOGRAMS, CHECKUPS AND 104 00:05:17,001 --> 00:05:20,000 PREVENTIVE CARE THEY NEED TO 105 00:05:20,001 --> 00:05:21,000 STAY HEALTHY AND GET THEM AT NO 106 00:05:21,001 --> 00:05:23,000 COST. 107 00:05:23,001 --> 00:05:25,000 SENATOR BENNET OF COLORADO WHO 108 00:05:25,001 --> 00:05:26,000 SERVED SKILLFULLY H IN THIS BODY 109 00:05:26,001 --> 00:05:28,000 FOR LESS THAN 110 00:05:28,001 --> 00:05:30,000 BETTER BY REAFFIRMING OUR 111 00:05:30,001 --> 00:05:31,000 COMMITMENT TO MEDICARE, MADE IT 112 00:05:31,001 --> 00:05:33,000 BETTER BY ENSURING THAT SENIORS 113 00:05:33,001 --> 00:05:35,000 GET THE CARE THEY NEED AND THE 114 00:05:35,001 --> 00:05:36,000 QUALITY OF LIFE THEY DESERVE. 115 00:05:36,001 --> 00:05:37,000 THAT POSITIVE TREND WILL 116 00:05:37,001 --> 00:05:38,000 CONTINUE TODAY. 117 00:05:38,001 --> 00:05:39,000 SENATOR WHITEHOUSE OF RHODE 118 00:05:39,001 --> 00:05:41,000 ISLAND WHO CAME TO CONGRESS WITH 119 00:05:41,001 --> 00:05:43,000 A CLASS OF SENATORS ELECTED WITH 120 00:05:43,001 --> 00:05:44,000 A STRONG MANDATE TO CHANGE THE 121 00:05:44,001 --> 00:05:46,000 WAY WASHINGTON WORKS HAS 122 00:05:46,001 --> 00:05:48,000 PROP 123 00:05:48,001 --> 00:05:50,000 COMMON SENSE AND ACCOUNTABILITY. 124 00:05:50,001 --> 00:05:52,000 IT SAYS THAT 125 00:05:52,001 --> 00:05:53,000 TO THE HEALTH CARE OF AMERICAN 126 00:05:53,001 --> 00:05:55,000 SENIORS AND PEOPLE 127 00:05:55,001 --> 00:05:57,000 DISABILITIES CAN BE USED ONLY 128 00:05:57,001 --> 00:05:58,000 FOR THOSE PRECISE PURPOSES. 129 00:05:58,001 --> 00:06:00,000 UNFORTUNATELY, SOME REPUBLICANS 130 00:06:00,001 --> 00:06:01,000 ARE LESS INTERESTED IN SOLVING 131 00:06:01,001 --> 00:06:02,000 PROBLEMS THAN THEY ARE IN 132 00:06:02,001 --> 00:06:05,000 CREATING THEM. 133 00:06:05,001 --> 00:06:07,000 THE DAY BEFORE THIS 134 00:06:07,001 --> 00:06:08,000 DAY BEFORE THIS FLOOR DEBATE 135 00:06:08,001 --> 00:06:09,000 BEGAN, MR. PRESIDENT, THE 136 00:06:09,001 --> 00:06:11,000 ASSISTANT REPUBLICAN LEADER, THE 137 00:06:11,001 --> 00:06:12,000 JUNIOR SENATOR FROM ARIZONA, 138 00:06:12,001 --> 00:06:16,000 SAID -- AND I QUOTE -- "THERE'S 139 00:06:16,001 --> 00:06:18,000 NO WAY TO FIX THIS BILL." 140 00:06:18,001 --> 00:06:19,000 OF COURSE HE'S ABSOLUTELY 141 00:06:19,001 --> 00:06:20,000 TOTALLY WRONG. 142 00:06:20,001 --> 00:06:22,000 ALL SENATORS KNOW THERE IS A 143 00:06:22,001 --> 00:06:23,000 VERY RELIABLE WAY 144 00:06:23,001 --> 00:06:26,000 LEGISLATION, TO IMPROVE THIS BILL. 145 00:06:26,001 --> 00:06:27,000 IT'S BEEN IN USE FOR 220 YEARS. 146 00:06:27,001 --> 00:06:28,000 IT'S CALLED THE LEGISLATIVE 147 00:06:28,001 --> 00:06:30,000 PROCESS. 148 00:06:30,001 --> 00:06:32,000 IT'S CALLED DOING OUR JOBS. 149 00:06:32,001 --> 00:06:33,000 AS THIS BILL CONTINUES TO 150 00:06:33,001 --> 00:06:35,000 IMPROVE, I ONCE AGAIN REMIND MY 151 00:06:35,001 --> 00:06:36,000 COLLEAGUES NOT TO LOSE SIGHT OF 152 00:06:36,001 --> 00:06:40,000 THE BIGGER PICTURE. 153 00:06:40,001 --> 00:06:42,000 AS WE DELVE INTO THE DETAILS AND 154 00:06:42,001 --> 00:06:43,000 DEBATE THE FINE PRINT, LET'S NOT 155 00:06:43,001 --> 00:06:44,000 FORGET WHY WE'RE HERE. 156 00:06:44,001 --> 00:06:46,000 OUR GOAL REMAINS THE SAME AS IT 157 00:06:46,001 --> 00:06:47,000 WAS THE DAY WE BEGAN THIS DEBATE 158 00:06:47,001 --> 00:06:49,000 MANY MONTHS AGO. 159 00:06:49,001 --> 00:06:50,000 IT REMAINS THE SAME AS IT WAS A 160 00:06:50,001 --> 00:06:52,000 YEAR AND A HALF AGO WHEN SENATE 161 00:06:52,001 --> 00:06:54,000 FINANCE CHAIR MAX BAUCUS FIRST 162 00:06:54,001 --> 00:06:55,000 HELD A SERIES OF HEARINGS THAT 163 00:06:55,001 --> 00:06:56,000 LED TO THE LEGISLATION THAT I 164 00:06:56,001 --> 00:06:58,000 NOW BEFORE US. 165 00:06:58,001 --> 00:07:00,000 OUR GOAL REMAINS THE SAME AS IT 166 00:07:00,001 --> 00:07:03,000 WAS LAST NOVEMBER WHEN THE 167 00:07:03,001 --> 00:07:04,000 AMERICAN PEOPLE CALLED IN A LOUD 168 00:07:04,001 --> 00:07:06,000 AND CLEAR VOICE FOR CHANGE. 169 00:07:06,001 --> 00:07:08,000 IT REMAINS THE SAME AS IT DID 31 170 00:07:08,001 --> 00:07:11,000 YEARS AGO WHEN SENATOR TED 171 00:07:11,001 --> 00:07:13,000 KENNEDY CALLED IT SHAMEFUL THAT 172 00:07:13,001 --> 00:07:14,000 -- AND I QUOTE -- "IN OUR 173 00:07:14,001 --> 00:07:15,000 UNBELIEVABLY RICH LAND, THE 174 00:07:15,001 --> 00:07:19,000 QUALITY OF HEALTH CARE AVAILABLE 175 00:07:19,001 --> 00:07:20,000 TO MANY OF OUR PEOPLE IS 176 00:07:20,001 --> 00:07:22,000 UNBELIEVABLY POOR AND THE COST 177 00:07:22,001 --> 00:07:24,000 IS UNBELIEVABLY HIGH." 178 00:07:24,001 --> 00:07:26,000 IT REMAINS THE SAME AS IT DID 179 00:07:26,001 --> 00:07:28,000 THE DAY PRESIDENT TRUMAN SOUNDED 180 00:07:28,001 --> 00:07:30,000 A CALL TO ENSURE THAT AMERICAN 181 00:07:30,001 --> 00:07:33,000 FAMILIES ARE PROTECTED IN WHAT 182 00:07:33,001 --> 00:07:34,000 HE CALLED THE ECONOMIC EFFECTS 183 00:07:34,001 --> 00:07:37,000 OF SICKNESS. 184 00:07:37,001 --> 00:07:38,000 THAT WAS MORE THAN 64 YEARS 185 00:07:38,001 --> 00:07:40,000 AND MORE THAN HALF OF TODAY'S 186 00:07:40,001 --> 00:07:42,000 UNITED STATES SENATORS WEREN'T 187 00:07:42,001 --> 00:07:43,000 EVEN BORN BY THEN. 188 00:07:43,001 --> 00:07:45,000 THAT CONSTANT GOAL HAS BEEN AND 189 00:07:45,001 --> 00:07:47,000 REMAINS THIS: WE MUST MAKE IT 190 00:07:47,001 --> 00:07:49,000 POSSIBLE FOR EVERY AMERICAN, 191 00:07:49,001 --> 00:07:52,000 EACH AND 192 00:07:52,001 --> 00:07:54,000 AFFORD TO LIVE A HEALTHY LIFE. 193 00:07:54,001 --> 00:07:56,000 EACH MOMENT IN THIS FIGHT IS HISTORIC. 194 00:07:56,001 --> 00:07:57,000 NO BILL TO PUT HEALTH CARE 195 00:07:57,001 --> 00:07:58,000 DECISION IN THE HANDS OF PEOPLE 196 00:07:58,001 --> 00:08:01,000 HAS EVER COME THIS FAR. 197 00:08:01,001 --> 00:08:05,000 BUT THE MOST HISTORIC DAYS OF 198 00:08:05,001 --> 00:08:06,000 WE CAN ONLY SEIZE THAT 199 00:08:06,001 --> 00:08:08,000 OPPORTUNITY IF THIS DEBATE IS 200 00:08:08,001 --> 00:08:10,000 ABOUT FACTS, NOT ABOUT FEAR. 201 00:08:10,001 --> 00:08:11,000 I REMIND MY COLLEAGUES THAT IF 202 00:08:11,001 --> 00:08:13,000 WE'RE TRULY TO HELP THE AME 203 00:08:13,001 --> 00:08:15,000 PEOPLE AND THE AMERICAN ECONOMY, 204 00:08:15,001 --> 00:08:16,000 WE'RE TO SINCERELY DO THE WORK 205 00:08:16,001 --> 00:08:19,000 OUR NEIGHBORS SENT US HERE TO DO. 206 00:08:19,001 --> 00:08:23,000 WE'RE TO LEAVE OUR CHILDREN AND 207 00:08:23,001 --> 00:08:25,000 GRANDCHILDREN A BETTER INHERITANCE. 208 00:08:25,001 --> 00:08:26,000 IF WE'RE TO DO ANY OF THESE 209 00:08:26,001 --> 00:08:28,000 THINGS, WE MUST WORK TOGETHER 210 00:08:28,001 --> 00:08:30,000 AND NOT AGAINST EACH OTHER. 211 00:08:30,001 --> 00:08:32,000 LET'S WORK PARTISANS. 212 00:08:32,001 --> 00:08:34,000 THIS IS NOT THE FIRST TIME I'VE 213 00:08:34,001 --> 00:08:35,000 ASKED MY REPUBLICAN FRIENDS TO 214 00:08:35,001 --> 00:08:37,000 THK OF THE REAL FAMILIES 215 00:08:37,001 --> 00:08:39,000 ACROSS THIS NATION WHO FACE REAL 216 00:08:39,001 --> 00:08:43,000 PROBLEMS, FAMILIES WITH REAL 217 00:08:43,001 --> 00:08:46,000 DISEASES, REAL SICKNESSES, REAL 218 00:08:46,001 --> 00:08:49,000 MEDICAL 219 00:08:49,001 --> 00:08:51,000 IT IS NOT THE FIRST TIME I'VE 220 00:08:51,001 --> 00:08:53,000 WARNED THAT AMERICA HAS NO PLACE 221 00:08:53,001 --> 00:08:57,000 FOR THOSE WHO HOPE FOR FAILURE. 222 00:08:57,001 --> 00:08:58,000 EXTENDED MY HAND ACROSS THE 223 00:08:58,001 --> 00:09:01,000 AISLE AND ASKED MY REPUBLICAN 224 00:09:01,001 --> 00:09:02,000 FRIENDS TO ABANDON THEIR 225 00:09:02,001 --> 00:09:03,000 SHORTSIGHTED STRATEGY TO BRING 226 00:09:03,001 --> 00:09:10,000 THE SENATE TO A SCREECHING HALT, 227 00:09:10,001 --> 00:09:14,000 FOR 228 00:09:14,001 --> 00:09:16,000 MEDICATIONAL GUIDE -- INFOMATIONAL GUIDE ON HOW TO 229 00:09:16,001 --> 00:09:17,000 STOP AND SLOW THINGS. MR. PRESIDENT, THAT DOESN'T 230 00:09:17,001 --> 00:09:18,000 WORK. 231 00:09:18,001 --> 00:09:21,000 WE NEED A STRATEGY THAT SAYS WE 232 00:09:21,001 --> 00:09:22,000 CAN WIN WITH BECAUSE THAT WILL MEAN -- WE CAN WIN BECAUSE THAT 233 00:09:22,001 --> 00:09:23,000 WILL MEAN THE AMERICAN PEOPLE 234 00:09:23,001 --> 00:09:25,000 WILL NOT LOSE. 235 00:09:25,001 --> 00:09:27,000 SO I HOPE THAT FOR 236 00:09:27,001 --> 00:09:28,000 TIME WE'LL HAVE PEOPLE OF 237 00:09:28,001 --> 00:09:30,000 GOODWILL ON THE REPUBLICAN SIDE 238 00:09:30,001 --> 00:09:32,000 OF THIS CHAMBER WALK OVER AND 239 00:09:32,001 --> 00:09:34,000 SAY "LET'S WORK TOGETHER TO GET 240 00:09:34,001 --> 00:09:36,000 SOME OF THESE THINGS DONE." 241 00:09:36,001 --> 00:09:38,000 I'VE HAD A COUPLE OF GOOD 242 00:09:38,001 --> 00:09:39,000 CONVERSATIONS IN THE LAST FEW 243 00:09:39,001 --> 00:09:40,000 DAYS WITH SOME OF MY COLLEAGUES 244 00:09:40,001 --> 00:09:41,000 ON THE OTHER SIDE OF THE AISLE. 245 00:09:41,001 --> 00:09:45,000 I HOPE WE CAN MOVE FORWARD. 246 00:09:45,001 --> 00:09:46,000 THIS IS A BILL THAT DOESN'TOOK 247 00:09:46,001 --> 00:09:49,000 AT A PERSON BEING SICK OR HURT 248 00:09:49,001 --> 00:09:52,000 OR AFRAID BEING A DEMOCRAT 249 00:09:52,001 --> 00:09:53,000 REPUBLICAN OR 250 00:09:53,001 --> 00:09:55,000 THEY'RE AMERICANS. 251 00:09:55,001 --> 00:09:57,000 THEY'RE FROM VIRGINIA, THEY'RE 252 00:09:57,001 --> 00:09:59,000 FROM MONTANA, THEY'RE FROM NEVADA. 253 00:09:59,001 --> 00:10:00,000 THEY'RE FROM ALL OVER AMERICA. 254 00:10:00,001 --> 00:10:26,000 THEY'RE PEOPLE WHO ARE CALLING 255 00:10:26,001 --> 00:10:29,000 UPON US TO DO THE THE PRESIDING OFFICER: UNDER 256 00:10:29,001 --> 00:10:30,000 THE PREVIOUS ORDER, LEADERSHIP 257 00:10:30,001 --> 00:10:32,000 TIME IS RESERVED, UNDER THE PREVIOUS ORDER, THE SENATE WILL 258 00:10:32,001 --> 00:10:35,000 RESUME CONSIDERATION OF H.R. 259 00:10:35,001 --> 00:10:37,000 3590 REPORT. 260 00:10:37,001 --> 00:10:39,000 THE CLERK: CALENDAR NUMBER 261 00:10:39,001 --> 00:10:41,000 175, H.R. 3590, AN ACT TO AMEND 262 00:10:41,001 --> 00:10:44,000 THE INTERNAL REVENUE CODE 263 00:10:44,001 --> 00:10:45,000 1986 TO MODIFY THE FIRST-TIME 264 00:10:45,001 --> 00:10:47,000 HOME BUYERS CREDIT IN THE CASE 265 00:10:47,001 --> 00:10:48,000 OF MEMBERS OF THE ARMED FORCES 266 00:10:48,001 --> 00:10:51,000 AND CERTAIN OTHER FEDERAL 267 00:10:51,001 --> 00:11:07,000 EMPLOYEE 268 00:11:07,001 --> 00:11:08,000 PURPOSES. 269 00:11:08,001 --> 00:11:09,000 MR 270 00:11:09,001 --> 00:11:10,000 THE PRESIDING OFFICER: THE 271 00:11:10,001 --> 00:11:11,000 SENATOR FROM MONTANA. 272 00:11:11,001 --> 00:11:13,000 MR. BAUCUS: MR. PRESIDENT, WE 273 00:11:13,001 --> 00:11:15,000 ARE BEGINNING OUR FIFTH DAY OF 274 00:11:15,001 --> 00:11:17,000 CONSIDERATION OF THE HEALTH REFORM BILL. 275 00:11:17,001 --> 00:11:21,000 WE'LL BE IN A PERIOD 276 00:11:21,001 --> 00:11:22,000 ONLY UNTIL ABOUT 11:30. 277 00:11:22,001 --> 00:11:23,000 PENDING NOW IS THE AMENDMENT BY 278 00:11:23,001 --> 00:11:26,000 THE SENATOR FROM RHODE ISLAND, 279 00:11:26,001 --> 00:11:28,000 SENATOR RESPONSIBILITY. 280 00:11:28,001 --> 00:11:31,000 ALSO PENDING IS A MOTION TO 281 00:11:31,001 --> 00:11:32,000 COMMIT BY THE SENATOR FROM UTAH 282 00:11:32,001 --> 00:11:33,000 ON MEDICARE 283 00:11:33,001 --> 00:11:35,000 IT WOULD BE MY HOPE THAT THE 284 00:11:35,001 --> 00:11:37,000 SENATE WOULD VOTE ON 285 00:11:37,001 --> 00:11:38,000 MATTERS TODAY. 286 00:11:38,001 --> 00:11:41,000 MR. PRIDENT, I ASK CONSENT 287 00:11:41,001 --> 00:11:42,000 THAT THE FOLLOWING STAFF BE 288 00:11:42,001 --> 00:11:49,000 ALLOWED ON THE SENATE FLOOR FOR 289 00:11:49,001 --> 00:11:56,000 THE DURATION OF THE DEBATE ON 290 00:11:56,001 --> 00:11:59,000 ALAN, RYAN 291 00:11:59,001 --> 00:12:00,000 THE PRESIDING OFFICER: WITHOUT 292 00:12:00,001 --> 00:12:01,000 OBJECTION. 293 00:12:01,001 --> 00:12:02,000 MR. BAUCUS: MR. PRESIDENT 294 00:12:02,001 --> 00:12:03,000 THE PRESIDING OFFICER: THE 295 00:12:03,001 --> 00:12:04,000 SENATOR FROM MONTANA. 296 00:12:04,001 --> 00:12:06,000 MR. BAUCUS: I SUGGEST THE 297 00:12:06,001 --> 00:12:12,000 ABSENCE OF A 298 00:12:12,001 --> 00:14:40,000 CLERK WILL CALL THE ROLL. 299 00:14:40,001 --> 00:14:41,000 QUORUM CALL: 300 00:14:41,001 --> 00:14:43,000 THE PRESIDING OFFICER: THE SENATOR FROM MONTANA. 301 00:14:43,001 --> 00:14:44,000 MR. BAUCUS: I 302 00:14:44,001 --> 00:14:45,000 PROCEEDINGS UNDER THE QUORUM 303 00:14:45,001 --> 00:14:47,000 CALL BE DISPENSED WITH. 304 00:14:47,001 --> 00:14:48,000 THE PRESIDING OFFICER: WITHOUT OBJECTION. 305 00:14:48,001 --> 00:14:49,000 UNDER THE PREVIOUS ORDER, THE 306 00:14:49,001 --> 00:14:51,000 TIME UNTIL 11:30 A.M. WILL BE 307 00:14:51,001 --> 00:14:53,000 FOR DEBATE ONLY WITH THE TIME EQUALLY DIVIDED AND CONTROLLED 308 00:14:53,001 --> 00:14:54,000 BETWEEN THE TWO LEADERS OR THEIR 309 00:14:54,001 --> 00:14:56,000 DESIGNEES, WITH THE MAJORITY 310 00:14:56,001 --> 00:15:00,000 CONTROLLING THE FIRST PORTION OF 311 00:15:00,001 --> 00:15:01,000 TIME. 312 00:15:01,001 --> 00:15:03,000 MR. BAUCUS: MR. PRESIDENT? THE PRESIDING OFFICER: THE 313 00:15:03,001 --> 00:15:05,000 MR. BAUCUS: MR. PRESIDENT, 314 00:15:05,001 --> 00:15:07,000 EXPERTS AND ECONOMISTS OF EVERY 315 00:15:07,001 --> 00:15:09,000 POLITICAL STRIPE AGREE THAT 316 00:15:09,001 --> 00:15:11,000 PRESERVING AMERICA'S LONG-TERM 317 00:15:11,001 --> 00:15:13,000 ECONOMIC SECURITY MEANS 318 00:15:13,001 --> 00:15:15,000 REFORMING THE WAY WE PROVIDE AND 319 00:15:15,001 --> 00:15:17,000 PAY FOR HEALTH CARE. 320 00:15:17,001 --> 00:15:20,000 HEALTH CARE SPENDING MAKES UP 321 00:15:20,001 --> 00:15:21,000 ONE-SIXTH OF THE U.S. ECONOMY 322 00:15:21,001 --> 00:15:24,000 TODAY. 323 00:15:24,001 --> 00:15:28,000 IN FUTURE GENERATIONS -- AND 324 00:15:28,001 --> 00:15:30,000 FUTURE GENERATIONS CAN EXPECT 325 00:15:30,001 --> 00:15:32,000 INSURMOUNTABLE DEBT IF WE FAIL TO ACT. 326 00:15:32,001 --> 00:15:34,000 FISCAL CHALLENGES WE MAY FACE IN 327 00:15:34,001 --> 00:15:36,000 YEARS TO COME PALE IN COMPARISON 328 00:15:36,001 --> 00:15:37,000 TO THE THREAT OF UNCONTROLLED 329 00:15:37,001 --> 00:15:40,000 FEDERAL HEALTH CARE SPENDING. 330 00:15:40,001 --> 00:15:43,000 THE CHART BEHIND ME ESSENTIALLY 331 00:15:43,001 --> 00:15:44,000 THE CHART SHOWS THAT THE 332 00:15:44,001 --> 00:15:47,000 PERCENTAGE OF ANNUAL GROWTH 333 00:15:47,001 --> 00:15:49,000 RATES BEGINNING 334 00:15:49,001 --> 00:15:53,000 RED IS THE ECONOMY. 335 00:15:53,001 --> 00:15:56,000 THE BLUE IS HEALTH CARE COSTS. 336 00:15:56,001 --> 00:15:58,000 AND, CLEARLY, OVER TIME, 337 00:15:58,001 --> 00:16:00,000 ESPECIALLY AS THE ECONOMY DIPPED 338 00:16:00,001 --> 00:16:01,000 DURING THIS GREAT RECESSION, THE 339 00:16:01,001 --> 00:16:04,000 GAPETWEEN ECONOMIC GROWTH AND 340 00:16:04,001 --> 00:16:06,000 HEALTH CARE SPENDING HAS 341 00:16:06,001 --> 00:16:10,000 WIDENED, AND THE PROJECTIONS ARE 342 00:16:10,001 --> 00:16:13,000 IN FUTURE YEARS THEY'LL START TO 343 00:16:13,001 --> 00:16:16,000 YOU CAN SEE OUT TO THE YEAR 344 00:16:16,001 --> 00:16:19,000 2018, THE TOTAL ECONOMY IS 345 00:16:19,001 --> 00:16:24,000 PROJECTED IN THE YEAR 2018 TO BE 346 00:16:24,001 --> 00:16:29,000 7%, CLOSER TO 347 00:16:29,001 --> 00:16:33,000 THE ECONOMY IS GOING TO 348 00:16:33,001 --> 00:16:36,000 4% AND THE HEALTH CARE I SPENDING 349 00:16:36,001 --> 00:16:38,000 IS GOING TO BE ABOUT 7% OR 8%. 350 00:16:38,001 --> 00:16:40,000 DOING NOTHING MEANS INTIELT 351 00:16:40,001 --> 00:16:41,000 SPENDING MORE THAN DOUBLES IN 352 00:16:41,001 --> 00:16:43,000 THE YEAR -- MEANS ENTITLEMENT 353 00:16:43,001 --> 00:16:45,000 SPEND MORE THAN DOUBLES IN THE 354 00:16:45,001 --> 00:16:46,000 YEAR 2015. 355 00:16:46,001 --> 00:16:48,000 BUT IT'S NOT SIMPLY THE FEDERAL 356 00:16:48,001 --> 00:16:53,000 BUDGET ON 357 00:16:53,001 --> 00:16:57,000 IT'S THE FAMILY BUDGET, TOO. 358 00:16:57,001 --> 00:16:58,000 INCREDIBLY, IN TOTAL, WE SPEND 359 00:16:58,001 --> 00:17:01,000 80 TIMES AS MUCH ON HEALTH CARE 360 00:17:01,001 --> 00:17:03,000 TODAY AS WE DID FIVE DECADES AGO 361 00:17:03,001 --> 00:17:06,000 -- 80 TIMES. 362 00:17:06,001 --> 00:17:08,000 80 TIMES MORE IN HEALTH CARE 363 00:17:08,001 --> 00:17:10,000 TODAY, 80, THAN WE DID FIVE 364 00:17:10,001 --> 00:17:12,000 DECADES 365 00:17:12,001 --> 00:17:14,000 BREAKING UNDER THE STRAIN -- 366 00:17:14,001 --> 00:17:15,000 ALREADY. 367 00:17:15,001 --> 00:17:17,000 AND THAT'S GOING TO GET WORSE IF 368 00:17:17,001 --> 00:17:18,000 WE DO NOTHING. 369 00:17:18,001 --> 00:17:21,000 THE COST TO THE AVERAGE FAMILY 370 00:17:21,001 --> 00:17:24,000 HEALTH CARE PLAN WILL REACH 371 00:17:24,001 --> 00:17:25,000 $24,000 IN THE YEAR 2016. 372 00:17:25,001 --> 00:17:26,000 THAT'S NOT TOO MANY YEARS AWAY 373 00:17:26,001 --> 00:17:30,000 FROM NOW. 374 00:17:30,001 --> 00:17:37,000 THIS REPRESENTS AN 375 00:17:37,001 --> 00:17:41,000 OVER 2008 PREMIUM LEVELS. 376 00:17:41,001 --> 00:17:42,000 THAT MEANS IF WE DO NOTHING, IN 377 00:17:42,001 --> 00:17:44,000 FEWER THAN TEN YEARS, MOST 378 00:17:44,001 --> 00:17:48,000 FAMILIES WOU HAVE TO DEDICATE 379 00:17:48,001 --> 00:17:52,000 HALF OF THEIR HOUSEHOLD BLUGHT 380 00:17:52,001 --> 00:17:54,000 -- HOUSEHOLD BUDGET TO HEALTH CARE. 381 00:17:54,001 --> 00:17:56,000 EVERY DAY WE HEAR FROM FOLKS 382 00:17:56,001 --> 00:17:58,000 BACK HOME THAT SIMPLY CANNOT 383 00:17:58,001 --> 00:18:00,000 AFFORD THE CARE THAT THEY NEED. 384 00:18:00,001 --> 00:18:01,000 WE HAVE AN OPPORTUNITY TO ACT. 385 00:18:01,001 --> 00:18:02,000 WE HAVE AN OBLIGATION TO ACT. 386 00:18:02,001 --> 00:18:04,000 AND NOW WE HAVE AN OPPORTUNITY 387 00:18:04,001 --> 00:18:07,000 TO ACT. 388 00:18:07,001 --> 00:18:09,000 THE COUNTRY'S 389 00:18:09,001 --> 00:18:10,000 AND FEDERAL BUDGET EXPERTS HAVE 390 00:18:10,001 --> 00:18:12,000 LAID OUT STRATEGIES AND OPTIONS 391 00:18:12,001 --> 00:18:14,000 FOR GETTING COSTS UNDER CONTROL. 392 00:18:14,001 --> 00:18:16,000 WE'VE ALL TAKEN THEIR 393 00:18:16,001 --> 00:18:17,000 RECOMMENDATIONS TO HEART. 394 00:18:17,001 --> 00:18:19,000 THERE REALLY IS A LOT OF 395 00:18:19,001 --> 00:18:20,000 AGREEMENT AMONG THOSE WHO STUDY 396 00:18:20,001 --> 00:18:22,000 THESE ISSUES AS TO WHAT WE MUS 397 00:18:22,001 --> 00:18:26,000 DO, AND NOW WE HAVE A BILL THAT 398 00:18:26,001 --> 00:18:27,000 DOES WT THEY SUGGEST, AND IT 399 00:18:27,001 --> 00:18:29,000 ALSO PASSES THE TEST OF FISCAL 400 00:18:29,001 --> 00:18:31,000 RESPONSIBILITY. 401 00:18:31,001 --> 00:18:32,000 HAVE MANY REASONS TO 402 00:18:32,001 --> 00:18:36,000 THIS BILL. 403 00:18:36,001 --> 00:18:39,000 IT PROTECTS AND EVEN INCREASES 404 00:18:39,001 --> 00:18:41,000 MEDICARE BENEFITS FOR SENIORS. 405 00:18:41,001 --> 00:18:43,000 IT ACHIEVES NEAR-UNIVERSAL 406 00:18:43,001 --> 00:18:45,000 COVERAGE IN LESS 407 00:18:45,001 --> 00:18:47,000 THAT MEANS IT ACHIEVES THE GOAL 408 00:18:47,001 --> 00:18:48,000 OF VIRTUALLY EVERYBODY HAVING 409 00:18:48,001 --> 00:18:49,000 HEALTH INSURANCE IN THAT PERIOD 410 00:18:49,001 --> 00:18:51,000 OF TIME. 411 00:18:51,001 --> 00:18:53,000 IT SLOWS THE GROWTH OF FEDERAL 412 00:18:53,001 --> 00:18:57,000 HEALTH CARE SPENDING. 413 00:18:57,001 --> 00:18:59,000 IT STOPS INSURANCE INDUSTRY DISCRIMINATION. 414 00:18:59,001 --> 00:19:01,000 AND BASED ON INDEPENDENT 415 00:19:01,001 --> 00:19:05,000 NONPARTISAN ANALYSIS, IT MAKES A 416 00:19:05,001 --> 00:19:10,000 SERIOUS DENT IN OUR FEDER 417 00:19:10,001 --> 00:19:13,000 DEFICIT. 418 00:19:13,001 --> 00:19:15,000 MR. PRESIDENT, I'D LIKE TO CEASE 419 00:19:15,001 --> 00:19:16,000 MY STATEMENT AND PICK IT UP AT A 420 00:19:16,001 --> 00:19:17,000 LATER TIEVMENT 421 00:19:17,001 --> 00:19:21,000 MINORITY LEADER IS ON THE FLOOR 422 00:19:21,001 --> 00:19:23,000 AND IN DEFERENCE DEFERENCE TO HIRNLINGS I THINK 423 00:19:23,001 --> 00:19:25,000 IT IS ONLY APPROPRIATE THAT -- 424 00:19:25,001 --> 00:19:28,000 AND IN DEFERENCE TO HIM, I THINK 425 00:19:28,001 --> 00:19:29,000 IT IS ONLY APPROPRIATE THAT HE 426 00:19:29,001 --> 00:19:31,000 BE 427 00:19:31,001 --> 00:19:33,000 MR. McCONNELL: MR. PRESIDENT, 428 00:19:33,001 --> 00:19:34,000 I THANK THE SENATOR FOR YIELDING 429 00:19:34,001 --> 00:19:38,000 FOR MY COMMENTS. 430 00:19:38,001 --> 00:19:39,000 I WOULD ASK THAT MY COMMENTS 431 00:19:39,001 --> 00:19:41,000 APPEAR AT THE APPROPRIATE PLACE 432 00:19:41,001 --> 00:19:43,000 IN THE RECORD, NOT TO INTERRUPT 433 00:19:43,001 --> 00:19:46,000 SENATOR BAUCUS'S 434 00:19:46,001 --> 00:19:47,000 WE'VE NOW HAD A VERY, VERY 435 00:19:47,001 --> 00:19:48,000 CLARIFYING VOTE ON THE SENATE 436 00:19:48,001 --> 00:19:50,000 FLOOR ABOUT THE DIRECTION OF OUR 437 00:19:50,001 --> 00:19:53,000 FRIENDS ON THE OTHER SIDE WITH 438 00:19:53,001 --> 00:19:54,000 REGARD TO OUR HEALTH CARE SYSTEM. 439 00:19:54,001 --> 00:19:57,000 YESTERDAY ALL BUT TWO OF THEM 440 00:19:57,001 --> 00:19:59,000 VOTED TO PRESERVE NEARLY HALF A 441 00:19:59,001 --> 00:20:02,000 MILLION DOLLARS IN CUTSO 442 00:20:02,001 --> 00:20:03,000 MEDICARE, THE HEALTH PROGRAM FOR 443 00:20:03,001 --> 00:20:05,000 OUR SENIORS. 444 00:20:05,001 --> 00:20:07,000 IN THE RUN-UP TO THAT VOTE, THEY 445 00:20:07,001 --> 00:20:08,000 SAID THESE CUTS WEREN'T REALLY 446 00:20:08,001 --> 00:20:09,000 CUTS APPEARED THAT MEDICARE 447 00:20:09,001 --> 00:20:12,000 ADVANTAGE IN PARTICULAR ISN'T 448 00:20:12,001 --> 00:20:14,000 REALLY A PART OF MEDICARE, 449 00:20:14,001 --> 00:20:16,000 ARGUMENTS PLAINLY CONTRADICTED 450 00:20:16,001 --> 00:20:18,000 BY 451 00:20:18,001 --> 00:20:20,000 BY THE DEPARTMENT OF HEALTH A 452 00:20:20,001 --> 00:20:21,000 HUMAN SERVICES, BY THE 453 00:20:21,001 --> 00:20:24,000 INDEPENDENT CONGRESSIONAL BUDGET 454 00:20:24,001 --> 00:20:26,000 OFFICE, AND BY THE EXPERIENCE OF 455 00:20:26,001 --> 00:20:27,000 SENIORS THEMSELVES. 456 00:20:27,001 --> 00:20:31,000 SENIORS DO NOT WANT SENATORS 457 00:20:31,001 --> 00:20:33,000 FOOLING WITH MEDICARE 458 00:20:33,001 --> 00:20:35,000 LET ME SAY THAT AGAIN. 459 00:20:35,001 --> 00:20:38,000 SENIORS DO NOT WANT SENATORS 460 00:20:38,001 --> 00:20:40,000 FOOLING WITH MEDICARE. 461 00:20:40,001 --> 00:20:42,000 THEY WANT US TO FIX IT, TO 462 00:20:42,001 --> 00:20:44,000 STRENGTHEN IT, TO PRESERVE IT 463 00:20:44,001 --> 00:20:46,000 FOR FUTURE GENERATIONS, NOT RAID 464 00:20:46,001 --> 00:20:49,000 IT LIKE A GIANT PIGGY BANK IN 465 00:20:49,001 --> 00:20:52,000 ORDER TO CREATE SOME ENTIRELY 466 00:20:52,001 --> 00:20:54,000 NEW GOVERNMENT PROGRAM. 467 00:20:54,001 --> 00:20:57,000 YESTERDAY'S VOTE WAS 468 00:20:57,001 --> 00:20:58,000 PARTICULARLY DISTRESSING FOR THE 469 00:20:58,001 --> 00:20:59,000 MILLIONS OF SENIORS ON MEDICARE 470 00:20:59,001 --> 00:21:00,000 ADVANTAGE. 471 00:21:00,001 --> 00:21:02,000 SO TODAY MEMBERS WILL HAVE AN 472 00:21:02,001 --> 00:21:03,000 OPPORTUNITY TO UNDO THE DAMAGE 473 00:21:03,001 --> 00:21:04,000 THEY VOTED TO DO TO THIS 474 00:21:04,001 --> 00:21:08,000 PROGRAM. 475 00:21:08,001 --> 00:21:09,000 WITH YESTERDAY'S VOTE -- WITH 476 00:21:09,001 --> 00:21:12,000 YESTERDAY'S VOTE, PROPONENTS OF 477 00:21:12,001 --> 00:21:15,000 THIS MEASURE AUTHORIZED $120 478 00:21:15,001 --> 00:21:18,000 BILLION IN CUTS TO MEDICARE 479 00:21:18,001 --> 00:21:19,000 ADVANTAGE, AND IN THE 480 00:21:19,001 --> 00:21:22,000 THEY EXPRESSLY VOTED TO VIOLATE 481 00:21:22,001 --> 00:21:24,000 THE PRESIDENT'S PLEDGE THAT 482 00:21:24,001 --> 00:21:25,000 SENIORS WHO LIKE THE PLANS THEY 483 00:21:25,001 --> 00:21:26,000 HAVE CAN KEEP THEM. 484 00:21:26,001 --> 00:21:29,000 THERESIDENT HAS SAID 485 00:21:29,001 --> 00:21:30,000 WHO LIKE 486 00:21:30,001 --> 00:21:33,000 KEEP THEM. 487 00:21:33,001 --> 00:21:36,000 BECAUSE YOU CAN'T CUT $120 488 00:21:36,001 --> 00:21:38,000 BILLION FROM A BENEFITS PROGRAM, 489 00:21:38,001 --> 00:21:39,000 OBVIOUSLY, WITHOUT CUTTING 490 00:21:39,001 --> 00:21:40,000 BENEFITS. 491 00:21:40,001 --> 00:21:44,000 THE CONGRESSIONAL BUDGET OFFICE 492 00:21:44,001 --> 00:21:45,000 HAS BEEN CRYSTAL CLEAR ON THIS MATTER. 493 00:21:45,001 --> 00:21:47,000 WHEN ASKED ABOUT THE EFFECT 494 00:21:47,001 --> 00:21:49,000 THESE CUTS WOULD HAVE ON 495 00:21:49,001 --> 00:21:54,000 MEDICARE ADVANTAGE, THE DIRECTOR 496 00:21:54,001 --> 00:21:57,000 OF UNEQUIVOCAL. 497 00:21:57,001 --> 00:21:59,000 HE SAID THAT APPROXIMATELY HALF 498 00:21:59,001 --> 00:22:00,000 -- APPROXIMATELY HALF -- OF 499 00:22:00,001 --> 00:22:04,000 MEDICARE ADVANTAGE BENEFITS WILL 500 00:22:04,001 --> 00:22:05,000 BE CUT FOR NEARLY 11 MILLION 501 00:22:05,001 --> 00:22:07,000 SENIORS ENROLLED IN THIS PROGRAM 502 00:22:07,001 --> 00:22:11,000 UNDER THIS BILL. 503 00:22:11,001 --> 00:22:14,000 NOW, THIS IS THE DIRECTOR OF THE CONGRESSIONAL BUET OFFIC 504 00:22:14,001 --> 00:22:16,000 BEING 505 00:22:16,001 --> 00:22:19,000 HE SAID THAT APPROXIMATELY HALF 506 00:22:19,001 --> 00:22:23,000 OF MEDICARE ADVANTAGE BENEFITS 507 00:22:23,001 --> 00:22:27,000 WILL 508 00:22:27,001 --> 00:22:29,000 MILLION SENIORS ENROLLED IN THIS 509 00:22:29,001 --> 00:22:30,000 PROGRAM UNDER THIS BILL. 510 00:22:30,001 --> 00:22:32,000 THAT'S WHAT OUR FRIENDS ON THE 511 00:22:32,001 --> 00:22:34,000 OTHER SIDE VOTED FOR YESTERDAY, 512 00:22:34,001 --> 00:22:37,000 AND THEY KNOW IT. 513 00:22:37,001 --> 00:22:38,000 ONE DEMOCRAT LAST NIGHT WAS EXPLICIT. 514 00:22:38,001 --> 00:22:40,000 HE ADMITTED THAAFTER 515 00:22:40,001 --> 00:22:41,000 YESTERDAY'S VOTES, DEMOCRATS 516 00:22:41,001 --> 00:22:43,000 WON'T BE ABLE TO SAY THAT -- 517 00:22:43,001 --> 00:22:46,000 QUOTE -- "IF YOU LIKE WHAT YOU 518 00:22:46,001 --> 00:22:47,000 HAVE, YOU CAN KEEP 519 00:22:47,001 --> 00:22:49,000 THIS IS ONE OF OUR DEMOCRAT 520 00:22:49,001 --> 00:22:51,000 COLLEAGUES YESTERDAY SAYING, "IF 521 00:22:51,001 --> 00:22:55,000 YOU LIKE WHAT YOU HAVE, YOU CAN 522 00:22:55,001 --> 00:22:56,000 KEEP IT" CAN TO LONGER BE SAID. 523 00:22:56,001 --> 00:22:58,000 AND HE WENT ON TO SAY -- QUOTE 524 00:22:58,001 --> 00:23:01,000 -- "THAT BASIC COMMITMENT THAT A 525 00:23:01,001 --> 00:23:03,000 LOT OF US AROUND HERE HAVE MADE 526 00:23:03,001 --> 00:23:05,000 WILL BE CALLED INTO QUESTION." 527 00:23:05,001 --> 00:23:07,000 I THINK TT'S HIGHLY LIKELY. 528 00:23:07,001 --> 00:23:08,000 SO OUR FRIENDS HAVE A COUPLE OF 529 00:23:08,001 --> 00:23:10,000 CHOICES HERE TODAY. 530 00:23:10,001 --> 00:23:12,000 THEY CAN REAFFIRM THEIR PLAN TO 531 00:23:12,001 --> 00:23:14,000 CUT BENEFITS FOR NEARLY 532 00:23:14,001 --> 00:23:15,000 ONE-FOURTH 533 00:23:15,001 --> 00:23:17,000 ENROLLED IN MEDICARE, THEY CAN 534 00:23:17,001 --> 00:23:20,000 ADMIT THAT THE PRESIDENT'S 535 00:23:20,001 --> 00:23:21,000 PLEDGE ABOUT 536 00:23:21,001 --> 00:23:22,000 LIKE -- ABOUT KEEPING THE PLAN 537 00:23:22,001 --> 00:23:24,000 YOU LIKE NO LONGER APPLIES, OR 538 00:23:24,001 --> 00:23:26,000 THEY CAN REVERSE PART OF 539 00:23:26,001 --> 00:23:27,000 YESTERDAY'S VOTE LATER TODAY BY 540 00:23:27,001 --> 00:23:29,000 VOTING WITH REPUBLICANS TO 541 00:23:29,001 --> 00:23:30,000 RESTORE THOSE CUTS TO MEDICARE 542 00:23:30,001 --> 00:23:31,000 ADVANTAGE. 543 00:23:31,001 --> 00:23:41,000 MR. PRESIDENT, I YIELD THE 544 00:23:41,001 --> 00:23:42,000 FLOOR. 545 00:23:42,001 --> 00:23:43,000 MR. BAUCUS: MR. PRESIDENT? 546 00:23:43,001 --> 00:23:45,000 THE PRESIDING OFFICER: THE 547 00:23:45,001 --> 00:23:55,000 SENATOR FROM MONTANA. 548 00:23:55,001 --> 00:23:56,000 MR. BAUCUS: [ 549 00:23:56,001 --> 00:23:57,000 SOME REMARKS RECORD. 550 00:23:57,001 --> 00:24:00,000 THE PRESIDING OFFICER: WITHOUT 551 00:24:00,001 --> 00:24:02,000 OBJECTION. MR. BAUCUS: AGAIN, 552 00:24:02,001 --> 00:24:03,000 MR. PRESIDENT, THAT MEANS IF WE 553 00:24:03,001 --> 00:24:05,000 DO NOTHING IN FEWER THAN TEN 554 00:24:05,001 --> 00:24:06,000 YEARS 555 00:24:06,001 --> 00:24:08,000 TO DEDICATE HALF OF THEIR 556 00:24:08,001 --> 00:24:09,000 HOUSEHOLD BUDGETS TO HEALTH 557 00:24:09,001 --> 00:24:10,000 INSURANCE. 558 00:24:10,001 --> 00:24:12,000 FOR YEARS WE HAVE HEARD THE 559 00:24:12,001 --> 00:24:13,000 WARNINGS FROM FEDERAL BUDGET 560 00:24:13,001 --> 00:24:16,000 EXPERTS AND EVERY DAY WE HEAR 561 00:24:16,001 --> 00:24:17,000 SIMPLY CANNOT AFFORD THE HEALTH 562 00:24:17,001 --> 00:24:20,000 CARE THAT THEY NEED. 563 00:24:20,001 --> 00:24:23,000 NOW WE HAVE THE OPPORTUNITY TO ACT. 564 00:24:23,001 --> 00:24:24,000 AS I MENTIONED, THE NATION'S 565 00:24:24,001 --> 00:24:26,000 LEADING ECONOMISTS AND FEDERAL 566 00:24:26,001 --> 00:24:28,000 BUDGET EXPERTS LAID OUT STRATEGIES AND OPTIONS FOR 567 00:24:28,001 --> 00:24:30,000 GETTING COSTS 568 00:24:30,001 --> 00:24:31,000 WE TOOK THOSE RECOMMENDATIONS IN 569 00:24:31,001 --> 00:24:34,000 THIS BILL TO HEART, AND NOW WE 570 00:24:34,001 --> 00:24:35,000 HAVE A TBHAIL PASSES THE T 571 00:24:35,001 --> 00:24:37,000 AND NOW WE HAVE A BILL THAT 572 00:24:37,001 --> 00:24:38,000 PASSES THE TEST ALSO OF FISCAL 573 00:24:38,001 --> 00:24:39,000 RESPONSIBILITY. 574 00:24:39,001 --> 00:24:40,000 DOING NOTHING MEANS HEALTH CARE 575 00:24:40,001 --> 00:24:43,000 SPENDING CONTINUES GROWING 576 00:24:43,001 --> 00:24:45,000 FASTER THAN OUR ECONOMY. 577 00:24:45,001 --> 00:24:46,000 DOING NOTHING MEANS ENTITLEMENT 578 00:24:46,001 --> 00:24:49,000 SPENDING MORE THAN DOUBLES BY 579 00:24:49,001 --> 00:24:50,000 THE YEAR 2050, TACKING ONE-FIFTH 580 00:24:50,001 --> 00:24:51,000 OF OUR G.D.P. -- TAKING 581 00:24:51,001 --> 00:24:53,000 ONE-FIFTH OF OUR G.D.P. 582 00:24:53,001 --> 00:24:54,000 BUT IT IS NOT SIMPLY THE FEDERAL 583 00:24:54,001 --> 00:24:56,000 BUDGET ON 584 00:24:56,001 --> 00:24:58,000 IT IS THE FAMILY BUDGET, TOO. 585 00:24:58,001 --> 00:25:02,000 AS I MENTIONED A FEW MOMENTS 586 00:25:02,001 --> 00:25:03,000 AGO, IN TOTAL, WE TODAY SPEND E8 80 587 00:25:03,001 --> 00:25:06,000 TIMES AS MUCH ON HEALTH CARE AS 588 00:25:06,001 --> 00:25:08,000 WE DID FIVE DECADES AGO -- 80 TIMES. 589 00:25:08,001 --> 00:25:11,000 AND NOW FAMILY BUDGETS ARE 590 00:25:11,001 --> 00:25:15,000 BREAKING UNDER THE STRAIN. 591 00:25:15,001 --> 00:25:17,000 THE COST TO TH OF THE AVERAGE FAMILY 592 00:25:17,001 --> 00:25:18,000 HEALTH CARE PLAN WILL REACH 593 00:25:18,001 --> 00:25:21,000 $24,000 IN THE YEAR 2016. 594 00:25:21,001 --> 00:25:34,000 THAT REPRESENTS AN 84% INCREASE 595 00:25:34,001 --> 00:25:36,000 OVER 2008 PREMIUM LEVELS. 596 00:25:36,001 --> 00:25:38,000 IT'S DANGEROUS STOPPING IN THE 597 00:25:38,001 --> 00:25:39,000 MIDDLE OF A SPEECH. 598 00:25:39,001 --> 00:25:41,000 YOU HAVE TO FIGURE OUT WHERE YOU 599 00:25:41,001 --> 00:25:42,000 WERE. 600 00:25:42,001 --> 00:25:43,000 WE HAVE MANY REASONS TO VOTE FOR 601 00:25:43,001 --> 00:25:46,000 THIS BILL. 602 00:25:46,001 --> 00:25:48,000 IT PROTECTS AND EVEN INCREASES 603 00:25:48,001 --> 00:25:50,000 MEDICARE BENEFITS FOR SENIORS. 604 00:25:50,001 --> 00:25:51,000 IT ACHIEVES NEAR-UNIVERSAL 605 00:25:51,001 --> 00:25:53,000 COVERAGE IN LESS THAN TEN YEARS. 606 00:25:53,001 --> 00:25:55,000 IT SLOWS THE GROWTH OF FEDERAL 607 00:25:55,001 --> 00:25:57,000 HEALTH CARE SPENDING. 608 00:25:57,001 --> 00:25:58,000 IT STOPS INSURANCE INDUSTRY 609 00:25:58,001 --> 00:25:59,000 DISCRIMINATION AND BASED ON 610 00:25:59,001 --> 00:26:02,000 INDEPENDENT NONPARTISAN 611 00:26:02,001 --> 00:26:05,000 ANALYSIS, IT MAKES 612 00:26:05,001 --> 00:26:08,000 DENT 613 00:26:08,001 --> 00:26:09,000 THIS CHART BEHIND ME REPRESENTS 614 00:26:09,001 --> 00:26:11,000 THAT 615 00:26:11,001 --> 00:26:12,000 TWO WEEKS AGO 616 00:26:12,001 --> 00:26:14,000 BUDGET OFFICE AND THE JOINT 617 00:26:14,001 --> 00:26:16,000 COMMITTEE ON TAXATION CONFIRMED 618 00:26:16,001 --> 00:26:19,000 IN NO UNCERTAIN TERMS THAT 619 00:26:19,001 --> 00:26:21,000 DEFICITS GO DOWN UNDER THIS PLAN 620 00:26:21,001 --> 00:26:23,000 AND THE OFFICIAL COST ESTIMATE 621 00:26:23,001 --> 00:26:24,000 READS AS FOLLOWS: 622 00:26:24,001 --> 00:26:25,000 THE CONGRESSIONAL BUDGET OFFICE 623 00:26:25,001 --> 00:26:28,000 AND THE JOINT CMITTEE ON TAX 624 00:26:28,001 --> 00:26:30,000 ESTIMATE THAT, ON BALANCE, THE 625 00:26:30,001 --> 00:26:32,000 DIRECT SPENDING AND REVEN 626 00:26:32,001 --> 00:26:33,000 EFFECTS OF ENACTING 627 00:26:33,001 --> 00:26:37,000 LEGISLATION WOULD YIELD 628 00:26:37,001 --> 00:26:40,000 REDUCTION IN FEDERAL DEFICITS OF 629 00:26:40,001 --> 00:26:41,000 $130 BILLION OVER THE YEARS 2010 630 00:26:41,001 --> 00:26:44,000 TO 2019. 631 00:26:44,001 --> 00:26:46,000 THAT'S REPRESENTED 632 00:26:46,001 --> 00:26:49,000 BAR THERE ON THE LEFT. 633 00:26:49,001 --> 00:26:50,000 IT IS A NET $130 BILLION 634 00:26:50,001 --> 00:26:52,000 REDUCTION DURING THE FIRST TEN 635 00:26:52,001 --> 00:26:55,000 YEARS OF THIS B 636 00:26:55,001 --> 00:26:57,000 IN ADDITION, -- IN ADDITION TO 637 00:26:57,001 --> 00:26:59,000 REDUCING THE FEDERAL DEFICIT, 638 00:26:59,001 --> 00:27:00,000 THE C.B.O. ALSO CONFIRMS THIS 639 00:27:00,001 --> 00:27:02,000 BILL IS FULLY PAID FOR. 640 00:27:02,001 --> 00:27:03,000 IT DOES NOT ADD ONE DIME 641 00:27:03,001 --> 00:27:05,000 FEDERAL DEFICIT. 642 00:27:05,001 --> 00:27:07,000 IN FACT, IT REDUCES, AS I 643 00:27:07,001 --> 00:27:09,000 MENTIONED, OUR DEFICIT BY $130 644 00:27:09,001 --> 00:27:13,000 BILLION OVER THE NEXT TEN YEARS. 645 00:27:13,001 --> 00:27:14,000 BUT IT ALSO STANDS THE TEST OF 646 00:27:14,001 --> 00:27:16,000 TIME. 647 00:27:16,001 --> 00:27:19,000 THE SECOND DECADE, THE DEFICIT 648 00:27:19,001 --> 00:27:20,000 DECREASES BY ANOTHER AMOUNT, 649 00:27:20,001 --> 00:27:24,000 THIS TIME BY A MUCH GREATER 650 00:27:24,001 --> 00:27:26,000 AMOUNT -- BY $650 BILLION. 651 00:27:26,001 --> 00:27:28,000 AND BY THE END OF THE THIRD 652 00:27:28,001 --> 00:27:31,000 DECADE, OUR CHILDREN WOULD 653 00:27:31,001 --> 00:27:33,000 BENEFIT FROM A REDUCTION EQUAL 654 00:27:33,001 --> 00:27:34,000 TO -- CLOSE TO 2% OF GROSS 655 00:27:34,001 --> 00:27:36,000 DOMESTIC PRODUCT. 656 00:27:36,001 --> 00:27:40,000 THAT'S MUCH MORE THAN THE SECOND 657 00:27:40,001 --> 00:27:42,000 DECADE, WHICH IS A QUARTER -- 658 00:27:42,001 --> 00:27:43,000 .25 -- PRODUCT. 659 00:27:43,001 --> 00:27:45,000 YOU CAN SEE IN EACH OF THE 660 00:27:45,001 --> 00:27:48,000 DECADES -- THE FIRST DECADE, 661 00:27:48,001 --> 00:27:50,000 $130 BILLION, THE SECOND 662 00:27:50,001 --> 00:27:54,000 THE REDUCTION OF THE D.V.D. $650 663 00:27:54,001 --> 00:27:55,000 BILLION, AND IN THE -- AND THE 664 00:27:55,001 --> 00:27:57,000 THIRD SENIOR SENATOR MUCH MORE THAN THAT. 665 00:27:57,001 --> 00:28:00,000 I CAN'T DO THE C 666 00:28:00,001 --> 00:28:04,000 BUT R 667 00:28:04,001 --> 00:28:06,000 ROUGHLY IT WOULD BE HUNDREDS OF 668 00:28:06,001 --> 00:28:07,000 BILLIONS OF DOLLARS GREATER THAN 669 00:28:07,001 --> 00:28:09,000 THE REDUCTION IN THE SECOND 670 00:28:09,001 --> 00:28:11,000 DECADE. 671 00:28:11,001 --> 00:28:12,000 THIS IS SERIOUS DEFICIT 672 00:28:12,001 --> 00:28:13,000 REDUCTION. 673 00:28:13,001 --> 00:28:16,000 IN TODAY'S DOLLARS, THAT WOULD 674 00:28:16,001 --> 00:28:20,000 MEAN THAT THERE WOULD BE MORE 675 00:28:20,001 --> 00:28:22,000 THAN -- THAT WOULD BE MORE THAN 676 00:28:22,001 --> 00:28:23,000 WE SPEND ON THE ENTIRE MEDICAID 677 00:28:23,001 --> 00:28:26,000 PROGRAM THIS YEAR. 678 00:28:26,001 --> 00:28:27,000 ACCORDING TO C.B.O. THIS BILL 679 00:28:27,001 --> 00:28:29,000 ALSO SLOWS THE GROWTH IN 680 00:28:29,001 --> 00:28:32,000 MEDICARE COSTS, WHICH HAS BEEN A PRINCIPAL GOAL IN OUR HEALTH 681 00:28:32,001 --> 00:28:34,000 CARE DEBATE FROM DAY 682 00:28:34,001 --> 00:28:37,000 MEDICARE SPEND WOOING GROW 6% 683 00:28:37,001 --> 00:28:38,000 ANNUALLY INSTEAD OF 8% 684 00:28:38,001 --> 00:28:40,000 IN OTHER WORDS, MEDICARE WOULD 685 00:28:40,001 --> 00:28:42,000 CONTINUE TO GROW BUTNLIKE 686 00:28:42,001 --> 00:28:44,000 TODAY IT WOULD GROW AT A 687 00:28:44,001 --> 00:28:46,000 SUSTAINABLE RATE. 688 00:28:46,001 --> 00:28:47,000 OF COURSE, NO PROJECTIONS, EVEN 689 00:28:47,001 --> 00:28:49,000 FROM THE CONGRESSIONAL BUDGET 690 00:28:49,001 --> 00:28:52,000 OFFI 691 00:28:52,001 --> 00:28:53,000 WE CAN SAFELY SAY THIS BILL WILL 692 00:28:53,001 --> 00:28:55,000 PUTS ON THE RIGHT TRACK. 693 00:28:55,001 --> 00:28:58,000 I CAN SAFELY SAY THIS BILL IS 694 00:28:58,001 --> 00:29:00,000 BETTER THAN DOING NOTHING. 695 00:29:00,001 --> 00:29:06,000 NO HONEST ASSESSMENT CHALLENGES 696 00:29:06,001 --> 00:29:08,000 THE CASE FOR ENACTING IT GNA GNAW TO 697 00:29:08,001 --> 00:29:09,000 SLOW THE GROWTH -- IT NOW TO 698 00:29:09,001 --> 00:29:11,000 SLOW THE GROWTH OF SPENDING. 699 00:29:11,001 --> 00:29:13,000 D NO HONEST ASSESSMENT OF THIS 700 00:29:13,001 --> 00:29:17,000 BILL CHALLENGES THE C.B.O. ANALYSIS. 701 00:29:17,001 --> 00:29:19,000 I HAVE NOT HEARD AN HONEST 702 00:29:19,001 --> 00:29:22,000 CHALLENGE TO THIS -- TO THE 703 00:29:22,001 --> 00:29:27,000 C.B.O. ANALYSIS, NOR HAVE I 704 00:29:27,001 --> 00:29:29,000 HEARD OF AN HONEST CASE FOR NOT 705 00:29:29,001 --> 00:29:30,000 ACTING NOW TO SLOW THE GROWTH OF SPENDING. 706 00:29:30,001 --> 00:29:32,000 WHICH MEANS WE HAVE MANY REASONS 707 00:29:32,001 --> 00:29:35,000 TO PASS HEALTH CARE REFORM, NOT 708 00:29:35,001 --> 00:29:43,000 THE LEAST OF WHICH IS THE 709 00:29:43,001 --> 00:29:47,000 LONG-TERM COST OF RESTORING THE 710 00:29:47,001 --> 00:29:49,000 HETION OF OUR NATION. 711 00:29:49,001 --> 00:29:51,000 FORCED INTO BANKRUPTCY BY 712 00:29:51,001 --> 00:29:54,000 MEDICAL TRAGEDY, THIS IS ABOUT 713 00:29:54,001 --> 00:29:56,000 STOPPING INSURANCE INDUSTRY DISCRIMINATION. 714 00:29:56,001 --> 00:29:59,000 THIS IS ABOUT SAVING MEDICARE 715 00:29:59,001 --> 00:30:05,000 FOR OUR SENIORS AND REDUCING THE 716 00:30:05,001 --> 00:30:07,000 DEFICIT FOR OUR GRANDCHILDREN. 717 00:30:07,001 --> 00:30:08,000 MR. PRESIDENT, I DON'T KNOW WHAT 718 00:30:08,001 --> 00:30:10,000 OTHER SENATORS WE HAVE. 719 00:30:10,001 --> 00:30:12,000 I GUESS SENATOR BINGAMAN WOULD 720 00:30:12,001 --> 00:30:24,000 LIKE TO SEEK 721 00:30:24,001 --> 00:30:26,000 THE TIME WE HAVE. 722 00:30:26,001 --> 00:30:27,000 HAVE AND HOW MANY SPEAKERS WE HAVE. 723 00:30:27,001 --> 00:30:28,000 THE PRESIDING OFFICER: 40 724 00:30:28,001 --> 00:30:29,000 MINUTES. 725 00:30:29,001 --> 00:30:30,000 MR. BAUCUS: 40 MINUTES. 726 00:30:30,001 --> 00:30:31,000 HOW MANY SPEAKERS? 727 00:30:31,001 --> 00:30:38,000 OKAY, 15. 728 00:30:38,001 --> 00:30:39,000 GO FOR IT. 729 00:30:39,001 --> 00:30:41,000 MR. BINGAMAN: MR. PRESIDENT? THE PRESIDING OFFICER: THE 730 00:30:41,001 --> 00:30:43,000 SENATOR FROM NEW MEXICO. 731 00:30:43,001 --> 00:30:44,000 MR. BINGAMAN: LET ME FIRST 732 00:30:44,001 --> 00:30:45,000 THANK SENATOR BAUCUS FOR HIS 733 00:30:45,001 --> 00:30:47,000 LEADERSHIP ON THIS ISSUE. 734 00:30:47,001 --> 00:30:48,000 I MENTIONED TO HIM MANY TIMES 735 00:30:48,001 --> 00:30:50,000 AND STRONGLY BELIEVE THAT 736 00:30:50,001 --> 00:30:53,000 WITHOUT HIS LEADERSHIP, WE WOULD 737 00:30:53,001 --> 00:30:55,000 NOT BE WHERE WE ARE TODAY IN OUR 738 00:30:55,001 --> 00:30:59,000 EFFORT TO REFORM HEALTH CARE IN THIS COUNTRY. 739 00:30:59,001 --> 00:31:05,000 SO I CONGRATULATE HIM ON THE 740 00:31:05,001 --> 00:31:09,000 SUPERB EFFORT HE'S MADE. 741 00:31:09,001 --> 00:31:10,000 I WANT TO SPEND A FEW MINUTES 742 00:31:10,001 --> 00:31:11,000 TALKING ABOUT HEALTH CARE REFORM 743 00:31:11,001 --> 00:31:13,000 BOTH AS IT AFFECTS THE COUNTRY, 744 00:31:13,001 --> 00:31:15,000 BUT ALSO AS IT AFFECTS MY HOME 745 00:31:15,001 --> 00:31:17,000 STATE OF NEW MEXICO. 746 00:31:17,001 --> 00:31:19,000 FIRST I'D LIKE TO DISCUSS THE 747 00:31:19,001 --> 00:31:21,000 CONTEXT FOR THIS HEALTH REFORM 748 00:31:21,001 --> 00:31:23,000 BILL, AND THAT IS THE VERY 749 00:31:23,001 --> 00:31:27,000 SERIOUS PROBLEM THAT WE FACE AS 750 00:31:27,001 --> 00:31:29,000 A COUNTRY WITH GROWING COSTS OF 751 00:31:29,001 --> 00:31:31,000 HEALTH CARE IF THE CONGRESS FAILS TO ACT. 752 00:31:31,001 --> 00:31:33,000 NOW WE HAVE A CHART THAT I'LL 753 00:31:33,001 --> 00:31:34,000 PUT UP, SINCE EVERYONE'S GOT 754 00:31:34,001 --> 00:31:35,000 CHART. 755 00:31:35,001 --> 00:31:38,000 THIS IS A CHART 756 00:31:38,001 --> 00:31:40,000 WHAT'S HAPPENING TO 757 00:31:40,001 --> 00:31:42,000 CARE COS 758 00:31:42,001 --> 00:31:46,000 HAPPENING SINCE 1960. 759 00:31:46,001 --> 00:31:48,000 AND YOU CAN SEE THAT AS 760 00:31:48,001 --> 00:31:50,000 PERCENT OF THE GROSS DOMESTIC 761 00:31:50,001 --> 00:31:53,000 PRODUCT, BACK IN 1960 WE WERE 762 00:31:53,001 --> 00:31:55,000 SPENDING RIGHT AT 5% OF OUR 763 00:31:55,001 --> 00:31:58,000 GROSS DOMESTIC PRODUCT ON ALL 764 00:31:58,001 --> 00:32:00,000 HEALTH CARE IN THIS COUNTRY. 765 00:32:00,001 --> 00:32:04,000 TODAY WE ARE SPENDING MUCH MORE 766 00:32:04,001 --> 00:32:06,000 LIKE 16% OF THE GROSS DOMESTIC 767 00:32:06,001 --> 00:32:09,000 PRODUCT ON HEALTH CARE. 768 00:32:09,001 --> 00:32:11,000 AND THE PROJECTIONS FOR THE 769 00:32:11,001 --> 00:32:13,000 FUTURE IF WE DO NOT ACT TO 770 00:32:13,001 --> 00:32:14,000 REFORM THE HEALTH CARE SYSTEM, 771 00:32:14,001 --> 00:32:18,000 THE PROJECTIONS FOR THE 772 00:32:18,001 --> 00:32:21,000 ARE VERY SERIOUS INDEED. 773 00:32:21,001 --> 00:32:22,000 LET ME ALLUDE TO AN ARTICLE THAT 774 00:32:22,001 --> 00:32:23,000 WAS IN THE MORNING "NEW YORK 775 00:32:23,001 --> 00:32:27,000 TIMES." 776 00:32:27,001 --> 00:32:30,000 THIS IS BY OUR, BY 777 00:32:30,001 --> 00:32:34,000 AWARD-WINNING, THE NOBLE 778 00:32:34,001 --> 00:32:37,000 AWARD-WINNING ECONOMISTAUG 779 00:32:37,001 --> 00:32:39,000 PAUL KRUGMAN AT PRINCETON UNIVERSITY. 780 00:32:39,001 --> 00:32:40,000 HE TALKS ABOUT THIS ISSUE OF 781 00:32:40,001 --> 00:32:44,000 FISCAL RESPONSIBILITY AND THE 782 00:32:44,001 --> 00:32:46,000 IMPACT OF HEALTH CARE REFORM ON 783 00:32:46,001 --> 00:32:50,000 THE DEFICIT AND TALKS ABOUT HOW 784 00:32:50,001 --> 00:32:52,000 SOME SENATORS SEEM TO BELIEVE 785 00:32:52,001 --> 00:32:54,000 THAT THEY HAVE CONCERNS ABOUT 786 00:32:54,001 --> 00:32:55,000 GOING AHEAD WITH THIS HEALTH 787 00:32:55,001 --> 00:32:56,000 CARE REFORM BILL BECAUSE OF WHAT 788 00:32:56,001 --> 00:32:58,000 IT MIGHT COST. 789 00:32:58,001 --> 00:33:00,000 HE MAKES THE POINT, HE SAYS "IF 790 00:33:00,001 --> 00:33:01,000 THEY ARE REALLY CONCERNED WITH 791 00:33:01,001 --> 00:33:02,000 FISCAL RESPONSIBILITY, THEY 792 00:33:02,001 --> 00:33:05,000 SHOULD NOT BE WORRIED ABOUT WHAT 793 00:33:05,001 --> 00:33:07,000 WOULD HAPPEN IF HEALTH REFORM PASSES. 794 00:33:07,001 --> 00:33:10,000 THEY SHOULD INSTEAD BE WORRIED 795 00:33:10,001 --> 00:33:11,000 ABOUT WHAT WOULD HAPPEN IF IT 796 00:33:11,001 --> 00:33:13,000 DOES NOT PASS. 797 00:33:13,001 --> 00:33:14,000 FOR AMERICA CAN'T GET CONTROL OF 798 00:33:14,001 --> 00:33:15,000 ITS BUDGET WITHOUT CONTROLLING 799 00:33:15,001 --> 00:33:17,000 HEALTH CARE COSTS. 800 00:33:17,001 --> 00:33:20,000 AND THIS IS OUR LAST BEST CHANCE 801 00:33:20,001 --> 00:33:22,000 TO DEAL WITH THESE COSTS IN A 802 00:33:22,001 --> 00:33:24,000 RATIONAL WAY." 803 00:33:24,001 --> 00:33:25,000 MR. PRESIDENT, I'D ASK THAT HIS 804 00:33:25,001 --> 00:33:27,000 FULL COLUMN FROM "THE NEW YORK 805 00:33:27,001 --> 00:33:29,000 TIMES" THIS MORNING BE INCLUDED 806 00:33:29,001 --> 00:33:33,000 IN THE RECORD FOLLOWING MY REMARKS. 807 00:33:33,001 --> 00:33:35,000 THE PRESIDING OFFICER: WITHOUT 808 00:33:35,001 --> 00:33:37,000 OBJECTION. 809 00:33:37,001 --> 00:33:38,000 MR. BINGAMAN: AS AS THIS CHART 810 00:33:38,001 --> 00:33:39,000 DEMONSTRATES, THE ONE HERE ON MY 811 00:33:39,001 --> 00:33:41,000 LEFT, ACCORDING TO THE 812 00:33:41,001 --> 00:33:45,000 CONGRESSIONAL BUDGET 813 00:33:45,001 --> 00:33:46,000 WE DON'T ACT -- IF WE DON'T ACT 814 00:33:46,001 --> 00:33:48,000 TO DEAL WITH THE GROWTH IN 815 00:33:48,001 --> 00:33:50,000 HEALTH CARE COSTS, FEDERAL 816 00:33:50,001 --> 00:33:52,000 SPENDING ON MEDICARE AND 817 00:33:52,001 --> 00:33:55,000 MEDICAID COMBINED WILL GROW FROM 818 00:33:55,001 --> 00:33:58,000 5% OF G.D.P. TODAY TO ALMOST 10% 819 00:33:58,001 --> 00:34:02,000 BY 2035. 820 00:34:02,001 --> 00:34:03,000 BY 2080, THE GOVERNMENT WOULD BE 821 00:34:03,001 --> 00:34:06,000 SPENDING ALMOST AS MUCHS A 822 00:34:06,001 --> 00:34:08,000 SHARE OF THE ECONOMY ON JUST ITS 823 00:34:08,001 --> 00:34:11,000 TWO MAJOR HEALTH CARE PROGRAM 824 00:34:11,001 --> 00:34:14,000 AS IT HAS SPENT ON ALL OF ITS 825 00:34:14,001 --> 00:34:17,000 PROGRAMS AND SERVICES IN RECENT YEARS. 826 00:34:17,001 --> 00:34:19,000 LET ME PUT UP ANOTHER CHART THAT 827 00:34:19,001 --> 00:34:21,000 DEMONSTRATES THAT 828 00:34:21,001 --> 00:34:22,000 INCREASE IN COST IS NOT THE 829 00:34:22,001 --> 00:34:26,000 RESULT OF OUR AGING POPULATION. 830 00:34:26,001 --> 00:34:27,000 WE DO HAVE AN AGING POPULATION, 831 00:34:27,001 --> 00:34:29,000 AND THAT DOES ADD TO THE COST OF 832 00:34:29,001 --> 00:34:31,000 HEALTH CARE, BECAUSE AS PEOPLE 833 00:34:31,001 --> 00:34:32,000 GET OLDER THEY TEND TO NEED 834 00:34:32,001 --> 00:34:35,000 HEALTH CARE. 835 00:34:35,001 --> 00:34:37,000 BU WHAT THIS CHART SHOWS IS THE 836 00:34:37,001 --> 00:34:41,000 DARK BLUE HERE SHOWS THE 837 00:34:41,001 --> 00:34:43,000 INCREASE THAT IS EXPECTED IN 838 00:34:43,001 --> 00:34:47,000 HEALTH CARE COSTS BY VIRTUE OF AGING. 839 00:34:47,001 --> 00:34:49,000 BUT THE LIGHTER BLUE TALKS ABOUT 840 00:34:49,001 --> 00:34:51,000 THE EFFECT OF EXCESS COST GROWTH. 841 00:34:51,001 --> 00:34:56,000 AND THAT IS NOT RELATED TO AGING. 842 00:34:56,001 --> 00:34:57,000 THAT IS JUST THAT THE GROWTH 843 00:34:57,001 --> 00:34:59,000 THAT HEALTH CARE COSTS ARE OUT 844 00:34:59,001 --> 00:35:00,000 OF CONTROL IN OUR CURRENT 845 00:35:00,001 --> 00:35:02,000 SYSTEM. 846 00:35:02,001 --> 00:35:03,000 SUCH SPENDING IS UNSUSTAINABLE. 847 00:35:03,001 --> 00:35:05,000 IT HAS LED THE CONGRESSIONAL 848 00:35:05,001 --> 00:35:06,000 BUDGET OFFICE TO SAY THAT 849 00:35:06,001 --> 00:35:07,000 SLOWING THE GROWTH RATE OF 850 00:35:07,001 --> 00:35:09,000 OUTLAYS FOR MEDICARE AND 851 00:35:09,001 --> 00:35:11,000 MEDICAID IS THE CENTRAL 852 00:35:11,001 --> 00:35:12,000 LONG-TERM CHALLENGE FOR FISCAL 853 00:35:12,001 --> 00:35:13,000 POLICY. 854 00:35:13,001 --> 00:35:15,000 MOREOVER, ACROSS THE COUNTRY 855 00:35:15,001 --> 00:35:18,000 PREMIUMS CONTINUE TO INCREASE. 856 00:35:18,001 --> 00:35:19,000 THEY'RE BECOMING MORE AND MORE 857 00:35:19,001 --> 00:35:20,000 UNAFFORDABLE FOR INDIVID 858 00:35:20,001 --> 00:35:23,000 FOR BUSINESSES. 859 00:35:23,001 --> 00:35:25,000 I HEAR ON A REGULAR BASIS AS I 860 00:35:25,001 --> 00:35:27,000 GO AROUND NEW MEXICO -- AND I'M 861 00:35:27,001 --> 00:35:28,000 SURE ALL MY COLLEAGUES HEAR FROM 862 00:35:28,001 --> 00:35:31,000 THEIR CONSTITUENTS AS THEY 863 00:35:31,001 --> 00:35:33,000 TRAVEL IN THEIR STATES -- THAT 864 00:35:33,001 --> 00:35:38,000 PEOPLE CANNOT CONTINUE TO PAY 865 00:35:38,001 --> 00:35:39,000 MORE AND MORE EACH YEAR FOR 866 00:35:39,001 --> 00:35:42,000 THEIR HEALTH CARE COVERAGE. 867 00:35:42,001 --> 00:35:43,000 ACCORDING TO AN AUGUST REPORT BY 868 00:35:43,001 --> 00:35:46,000 THE COMMONWEALTH FUND, 869 00:35:46,001 --> 00:35:47,000 NATION 870 00:35:47,001 --> 00:35:52,000 EMPLOYER-SPONSORED HEALTH 871 00:35:52,001 --> 00:35:54,000 INSURANCE INCREASED 119% BETWEEN 872 00:35:54,001 --> 00:35:57,000 1999 AND 2008. 873 00:35:57,001 --> 00:36:00,000 AND IF COST GROWTH CONTINUES ON 874 00:36:00,001 --> 00:36:03,000 ITS CURRENT COURSE, THOSE 875 00:36:03,001 --> 00:36:08,000 PREMMS COULD INCREASE ANOTHER 876 00:36:08,001 --> 00:36:12,000 94% TO AN AVERAGE OF $23-RBGZ 877 00:36:12,001 --> 00:36:14,000 84 -- $23,842 PER FAMILY BY 20. 878 00:36:14,001 --> 00:36:15,000 I'M NOT SURE WHAT THE 879 00:36:15,001 --> 00:36:18,000 CIRCUMSTANCE IS IN MANY STATES 880 00:36:18,001 --> 00:36:19,000 BUT I KNOW IN THE STATE OF NEW 881 00:36:19,001 --> 00:36:22,000 MEXICO, THERE ARE MANY FAMILIES 882 00:36:22,001 --> 00:36:28,000 THAT CANNOT AFFORD TO BE PAYING 883 00:36:28,001 --> 00:36:30,000 $23-RBGZ -- $23,800 IN HEALTH 884 00:36:30,001 --> 00:36:32,000 CARE PREMIUMS. 885 00:36:32,001 --> 00:36:34,000 NOWHERE IS THE GROWTH FELT MORE 886 00:36:34,001 --> 00:36:35,000 ACUTELY THAN IN MY STATE. 887 00:36:35,001 --> 00:36:39,000 WITHOUT HEALTH REFORM IN MY 888 00:36:39,001 --> 00:36:41,000 STAT THESE ARE THE PROJECTIONS. 889 00:36:41,001 --> 00:36:43,000 WE ARE EXPECTED TO EXPERIENCE 890 00:36:43,001 --> 00:36:44,000 THE GREATEST INCREASE IN HEALTH 891 00:36:44,001 --> 00:36:47,000 INSURANCE PREMIUMS OF ANY STATE 892 00:36:47,001 --> 00:36:50,000 IN THE UNION. 893 00:36:50,001 --> 00:36:51,000 FOR EXAMPLE, THE AVERAGE 894 00:36:51,001 --> 00:36:52,000 EMPLOYER-SPONSORED INSURANCE 895 00:36:52,001 --> 00:36:55,000 PREMIUM FOR A FAMILY IN NEW 896 00:36:55,001 --> 00:36:57,000 MEXICO WAS ABOUT $6,000 IN THE 897 00:36:57,001 --> 00:37:00,000 YEAR 2000. 898 00:37:00,001 --> 00:37:01,000 BY 2006, THIS RATE HAD ALMOST 899 00:37:01,001 --> 00:37:05,000 DOUBLED, OR THE COST HAD ALMOST 900 00:37:05,001 --> 00:37:07,000 DOUBLED TO $11,000. 901 00:37:07,001 --> 00:37:11,000 BY 2016, THE AMOUNT IS EXPECTED 902 00:37:11,001 --> 00:37:13,000 TO RISE TO AN ASTONISHING 903 00:37:13,001 --> 00:37:20,000 IN ADDITION, HEALTH INSURANCE 904 00:37:20,001 --> 00:37:22,000 LARGER PERCENTAGE OF NEW 905 00:37:22,001 --> 00:37:23,000 MEXICO'S INCOME, THE INCOME OF 906 00:37:23,001 --> 00:37:26,000 THE AVERAGE NEW MEXICO FAMILY 907 00:37:26,001 --> 00:37:34,000 THAN ALMOST ALL OTHER STATES. 908 00:37:34,001 --> 00:37:35,000 WE ARE PAYING 31.18%, OVER 31% 909 00:37:35,001 --> 00:37:37,000 OF THE AVERAGE INCOME OF A 910 00:37:37,001 --> 00:37:38,000 FAMILY IN INCOME INCOME IS GOING 911 00:37:38,001 --> 00:37:40,000 TO PAY -- FAMILY IN NEW MEXICO 912 00:37:40,001 --> 00:37:43,000 IS GOING TO 913 00:37:43,001 --> 00:37:46,000 THIS IS EXPECTED TO GROW TO 66% 914 00:37:46,001 --> 00:37:47,000 IF WE DO NOT REFORM OUR HEALTH 915 00:37:47,001 --> 00:37:49,000 CARE SYSTEM. 916 00:37:49,001 --> 00:37:50,000 IT'S IMPORTANT TO HIGHLIGHT THAT 917 00:37:50,001 --> 00:37:53,000 THE HIGHER SPENDING ON HEALTH 918 00:37:53,001 --> 00:37:54,000 CARE IN THE UNITED STATES DOES 919 00:37:54,001 --> 00:37:56,000 NOT NECESSARILY PROLONG LIVES. 920 00:37:56,001 --> 00:37:59,000 I HEAR A LOT OF SPEECHES AROUND 921 00:37:59,001 --> 00:38:00,000 HERE ABOUT HOW WE HAVE THE 922 00:38:00,001 --> 00:38:04,000 GREATEST HEALTH CARE SYSTEM IN THE WORLD. 923 00:38:04,001 --> 00:38:06,000 WE'RE THE ENVY OF THE WORLD, AND 924 00:38:06,001 --> 00:38:07,000 PEOPLE WILL JUST LOVE TO HAVE 925 00:38:07,001 --> 00:38:08,000 ACCESS TO OUR HEALTH CARE 926 00:38:08,001 --> 00:38:12,000 SYSTEM. 927 00:38:12,001 --> 00:38:14,000 THIS CHART ILLUSTRATES THAT IN 928 00:38:14,001 --> 00:38:15,000 2000, THE UNITED STATES SPENT 929 00:38:15,001 --> 00:38:18,000 MORE ON HEALTH CARE THAN ANY 930 00:38:18,001 --> 00:38:21,000 OTHER COUNTRY IN THE WORLD, AN 931 00:38:21,001 --> 00:38:23,000 AVERAGE OF $4,500 PER PERSON. 932 00:38:23,001 --> 00:38:25,000 THAT WAS IN 2000. 933 00:38:25,001 --> 00:38:32,000 SWITZERLAND WAS THE SECOND 934 00:38:32,001 --> 00:38:34,000 HIGHEST AT $3,300, SUBSTANTIALLY LESS. 935 00:38:34,001 --> 00:38:36,000 ESSENTIALLY PAY, IN SWITZERLAND 936 00:38:36,001 --> 00:38:38,000 THE COST PER PERSON WAS 71% OF 937 00:38:38,001 --> 00:38:40,000 WHAT IT WAS IN THE UNITED STATES 938 00:38:40,001 --> 00:38:41,000 RING THAT YEAR. 939 00:38:41,001 --> 00:38:44,000 NEVERTHELESS, THE AVERAGE U.S. 940 00:38:44,001 --> 00:38:45,000 LIFE EXPECTANCY COMES OUT AT 941 00:38:45,001 --> 00:38:49,000 27th IN THE WORLD. 942 00:38:49,001 --> 00:38:50,000 OUR LIFE EXPECTANCY AVERAGE IS 943 00:38:50,001 --> 00:38:53,000 77 YEARS. 944 00:38:53,001 --> 00:38:55,000 MANY COUNTRIES -- 26 TO BE 945 00:38:55,001 --> 00:38:56,000 EXACT -- ACHIEVE HIGHER LIFE 946 00:38:56,001 --> 00:38:57,000 EXPECTANCY RATES WITH 947 00:38:57,001 --> 00:38:58,000 SIGNIFICANTLY LOWER SPENDING ON 948 00:38:58,001 --> 00:39:02,000 HEALTH CARE. 949 00:39:02,001 --> 00:39:03,000 DATA FROM THE MACKENZIE GLOBAL 950 00:39:03,001 --> 00:39:04,000 INSTITUTE CLEARLY INDICATES THAT 951 00:39:04,001 --> 00:39:07,000 THERE IS A CONSIDERABLE LEVEL OF 952 00:39:07,001 --> 00:39:08,000 WASTE IN OUR CURRENT SYSTEM. 953 00:39:08,001 --> 00:39:11,000 MACKENZIE ESTIMATES THAT THE 954 00:39:11,001 --> 00:39:13,000 UNITED STATES SPENDS NEARLY $500 955 00:39:13,001 --> 00:39:15,000 BILLION ANNUAL IN EXCESS OF 956 00:39:15,001 --> 00:39:20,000 OTHER SIMILARLY SITUATED NATIONS. 957 00:39:20,001 --> 00:39:22,000 OF THIS, ABOUT $224 BILLION IN 958 00:39:22,001 --> 00:39:23,000 EXCESS COSTS ARE FOU IN 959 00:39:23,001 --> 00:39:25,000 HOSPITAL CARE. 960 00:39:25,001 --> 00:39:26,000 ABOUT $178 BILLION ARE FOUND IN 961 00:39:26,001 --> 00:39:28,000 OUTPATIENT CARE. 962 00:39:28,001 --> 00:39:32,000 TOGETHER THESE ACCOUNT FOR MORE 963 00:39:32,001 --> 00:39:35,000 THAN 80% OF U.S. SPENDING ABOVE 964 00:39:35,001 --> 00:39:36,000 THE LEVELS OF OTHER NATIONS. 965 00:39:36,001 --> 00:39:38,000 HERE'S ONE OTHER CHART. 966 00:39:38,001 --> 00:39:41,000 THIS IS ONE THAT I'VE USED 967 00:39:41,001 --> 00:39:45,000 BEFORE HERE ON THE SENATE FLO. 968 00:39:45,001 --> 00:39:47,000 NOT SURPRISINGLY, AS COSTS AND INEFFICIES CONTINUE TO 969 00:39:47,001 --> 00:39:50,000 BUILD, ACCESS TO HEALTH CARE IS 970 00:39:50,001 --> 00:39:52,000 BECOMING MORE AND MORE DIFFICULT 971 00:39:52,001 --> 00:39:55,000 FOR MIDDLE- AND LOWER-INCOME AMERICANS. 972 00:39:55,001 --> 00:39:56,000 THIS CHART INDICATES THE RATE OF 973 00:39:56,001 --> 00:39:58,000 UNINSURANCE THROUGHOUT THE 974 00:39:58,001 --> 00:39:59,000 COUNTRY. 975 00:39:59,001 --> 00:40:04,000 FIRST, ON THE LEFT-HAND SIDE, 976 00:40:04,001 --> 00:40:05,000 THIS IS IN THE YEAR 977 00:40:05,001 --> 00:40:07,000 ON THE RIGHT-HAND SIDE, THE YEAR IS 2008. 978 00:40:07,001 --> 00:40:10,000 YOU CAN SEE THE DARK COLOR, THE 979 00:40:10,001 --> 00:40:16,000 DARK BLUE STATES ARE STATES 980 00:40:16,001 --> 00:40:19,000 WHERE 23% OR MORE OF THE 981 00:40:19,001 --> 00:40:20,000 POPULATION AGE 18 TO 64 ARE 982 00:40:20,001 --> 00:40:21,000 UNINSURED. 983 00:40:21,001 --> 00:40:23,000 BACK IN THE YEAR 2000, NEW 984 00:40:23,001 --> 00:40:26,000 MEXICO AND TEXAS WERE THE ONLY 985 00:40:26,001 --> 00:40:29,000 TWO STATES WHERE THE RATE OF 986 00:40:29,001 --> 00:40:33,000 UNINSURANCE EXCEEDED 23%. 987 00:40:33,001 --> 00:40:35,000 NOW YOU CAN SEE THAT THE RATE OF 988 00:40:35,001 --> 00:40:36,000 UNINSURANCE EXCEEDS 23% FOR MANY 989 00:40:36,001 --> 00:40:41,000 OF THE STATES, PARTICULARLY 990 00:40:41,001 --> 00:40:44,000 ACROSS THE SOUTHERN PART OF OUR COUNTRY. 991 00:40:44,001 --> 00:40:46,000 SO, WE HAVE A VERY SERIOUS 992 00:40:46,001 --> 00:40:48,000 PROBLEM THAT NEEDS ADDRESSING. 993 00:40:48,001 --> 00:40:51,000 IT'S CLEAR THAT THE U.S. HEALTH 994 00:40:51,001 --> 00:40:53,000 CARE SYSTEM IS FAILING MANY 995 00:40:53,001 --> 00:40:55,000 AMERICANS, AND THE SITUATION IS 996 00:40:55,001 --> 00:40:58,000 BECOMING MORE AND MORE URGENT. 997 00:40:58,001 --> 00:41:00,000 ACCORDING TO A STUDY PUBLISHED 998 00:41:00,001 --> 00:41:01,000 BY THE HARVARD MEDICAL SCHOOL IN 999 00:41:01,001 --> 00:41:03,000 AUGUST, MEDICAL COSTS HAVE LED 1000 00:41:03,001 --> 00:41:05,000 TO ALMOST TWO-THIRDS OF THE 1001 00:41:05,001 --> 00:41:08,000 BANKRUPTCIES IN THIS COUNTRY. 1002 00:41:08,001 --> 00:41:10,000 MORE THAN 62% OF THE 1003 00:41:10,001 --> 00:41:13,000 BANKRUPTCIES ARE ATTRIBUTABLE TO HEALTH CARE PROBLEMS. 1004 00:41:13,001 --> 00:41:16,000 THE STUDY FOUND THAT MOST 1005 00:41:16,001 --> 00:41:18,000 MEDICAL DEBTORS WERE WELL 1006 00:41:18,001 --> 00:41:20,000 EDUCATED, OWNED THEIR OWN HOMES, 1007 00:41:20,001 --> 00:41:23,000 HAD MIDDLE-CLASS OCCUPATIONS, 1008 00:41:23,001 --> 00:41:24,000 AND SHOCKINGLY THREE-QUARTERS 1009 00:41:24,001 --> 00:41:25,000 HAD HEALTH INSURANCE. 1010 00:41:25,001 --> 00:41:27,000 SO THESE WERE PEOPLE WHO HAD 1011 00:41:27,001 --> 00:41:29,000 COVERAGE, BUT THE COVERAGE WAS 1012 00:41:29,001 --> 00:41:30,000 NOT ADEQUATE TO MEET THE NEEDS. 1013 00:41:30,001 --> 00:41:32,000 UNFORTUNATELY FOR MANY 1014 00:41:32,001 --> 00:41:34,000 INDIVIDUALS, T VERY HIGH COST 1015 00:41:34,001 --> 00:41:37,000 OF MEDICAL CARE LEAVES THEM TO 1016 00:41:37,001 --> 00:41:38,000 DEY OR TO AVOID RECEIVING 1017 00:41:38,001 --> 00:41:42,000 MEDICAL CARE ALTOGETHER. 1018 00:41:42,001 --> 00:41:45,000 THE URBAN INSTITUTE REPORTS THAT 1019 00:41:45,001 --> 00:41:47,000 137,000 PEOPLE IN THIS COUNTRY 1020 00:41:47,001 --> 00:41:49,000 DIED BETWEEN 2000 AND 2006 1021 00:41:49,001 --> 00:41:50,000 BECAUSE THEY LACKED HEALTH 1022 00:41:50,001 --> 00:41:53,000 INSURANC 1023 00:41:53,001 --> 00:41:55,000 THAT INCLUDES 22,000 P 1024 00:41:55,001 --> 00:41:58,000 THE YEAR 2006. 1025 00:41:58,001 --> 00:42:00,000 SO CLEARLY, THE NEED FOR HEALTH, 1026 00:42:00,001 --> 00:42:04,000 NATIONAL HEALTH REFORM HAS NEVER 1027 00:42:04,001 --> 00:42:05,000 BEEN SO GREAT. 1028 00:42:05,001 --> 00:42:07,000 THE PATIENT PROTECTION AND 1029 00:42:07,001 --> 00:42:08,000 AFFORDABLE CARE ACT, WHICH IS 1030 00:42:08,001 --> 00:42:10,000 THE LEGISLATION WE ARE DEBATING 1031 00:42:10,001 --> 00:42:13,000 HERE ON THE FLOOR, WHICH WAS 1032 00:42:13,001 --> 00:42:14,000 INTRODUCED BY SENATOR REID AND 1033 00:42:14,001 --> 00:42:17,000 OTHERS A FEW WEEKS AGO AND 1034 00:42:17,001 --> 00:42:20,000 INCLUDES THE KEY REFORMS THAT WE 1035 00:42:20,001 --> 00:42:21,000 HAVE COME UP WITH AND THAT THE 1036 00:42:21,001 --> 00:42:25,000 EXPERTS HAVE COME UP WITH THAT 1037 00:42:25,001 --> 00:42:27,000 ARE AIMED AT ADDRESSING SHE THESE 1038 00:42:27,001 --> 00:42:29,000 VERY SERIOUS PROBLEMS WHILE 1039 00:42:29,001 --> 00:42:31,000 PROTECTING THE ASPECTS OF OUR 1040 00:42:31,001 --> 00:42:36,000 SYSTEM THAT ARE WORKING TODAY. 1041 00:42:36,001 --> 00:42:38,000 FIRST, THIS BILL INCLUDES LONG 1042 00:42:38,001 --> 00:42:39,000 OVER DUE REFORMS TO INCREASE THE 1043 00:42:39,001 --> 00:42:40,000 QUALITY OF THE HEALTH CARE 1044 00:42:40,001 --> 00:42:41,000 SYSTEM WHILE REDUCG OVERALL 1045 00:42:41,001 --> 00:42:42,000 COSTS. 1046 00:42:42,001 --> 00:42:45,000 THE LEGISLATION INCLUDES PAYMENT 1047 00:42:45,001 --> 00:42:47,000 REFORMS THAT I'VE CHAMPIONED TO 1048 00:42:47,001 --> 00:42:48,000 SHIFT FROM A FEE-FOR-SERVICE 1049 00:42:48,001 --> 00:42:49,000 PAYMENT SYSTEM TO A BUNDLE 1050 00:42:49,001 --> 00:42:52,000 PAYMENT SYSTEM. 1051 00:42:52,001 --> 00:42:54,000 THIS WILL RESHAPE OUR HEALTH 1052 00:42:54,001 --> 00:42:56,000 CARE REIMBURSEMENT SYSTEM TO 1053 00:42:56,001 --> 00:42:57,000 REWARD BETTER CARE AND NOT 1054 00:42:57,001 --> 00:42:58,000 SIMPLY MORE CARE AS IT DOES 1055 00:42:58,001 --> 00:43:00,000 TODAY. 1056 00:43:00,001 --> 00:43:01,000 SECOND, IT INCLUDES A BROAD NEW 1057 00:43:01,001 --> 00:43:03,000 FRAMEWORK TO ENSURE THAT ALL 1058 00:43:03,001 --> 00:43:04,000 AMERICANS HAVE ACCESS TO QUALITY 1059 00:43:04,001 --> 00:43:08,000 AND AFFORDABLE HEALTH CARE. 1060 00:43:08,001 --> 00:43:09,000 THIS INCLUDES THE CREATION OF A 1061 00:43:09,001 --> 00:43:11,000 NEW HEALTH INSURANCE EXCHANGE IN 1062 00:43:11,001 --> 00:43:12,000 EACH STATE WHICH WILL PROVIDE 1063 00:43:12,001 --> 00:43:17,000 AMERICANS A CENTRALIZED SOURCE 1064 00:43:17,001 --> 00:43:19,000 OF MEANINGFUL PRIVATE INSURANCE 1065 00:43:19,001 --> 00:43:21,000 AS WELL REFUNDABLE TAX CREDITS 1066 00:43:21,001 --> 00:43:22,000 TO ENSURE THAT COVERAGE IS 1067 00:43:22,001 --> 00:43:25,000 AFFORDABLE. 1068 00:43:25,001 --> 00:43:28,000 AND FINALLY, THESE NEW HEALTH 1069 00:43:28,001 --> 00:43:30,000 INSURANCE EXCHANGES WILL HELP 1070 00:43:30,001 --> 00:43:32,000 IMPROVE CHOICES BY ALLOWING 1071 00:43:32,001 --> 00:43:33,000 FAMILIES AND BUSINESSES TO 1072 00:43:33,001 --> 00:43:35,000 COMPARE INSURANCE PLANS ON THE 1073 00:43:35,001 --> 00:43:37,000 BASIS OF PRICE AND PEFORMANCE. 1074 00:43:37,001 --> 00:43:39,000 THIS PUTS FAMILIES RATHER THAN 1075 00:43:39,001 --> 00:43:41,000 THE INSURANCE COMPANIES OR THE 1076 00:43:41,001 --> 00:43:44,000 GOVERNMENT BUREAUCRATS IN CHARGE OF HEALTH CARE. 1077 00:43:44,001 --> 00:43:47,000 IT HELPS PEOPLE TO DECIDE WHICH 1078 00:43:47,001 --> 00:43:49,000 QUALITY, AFFORDABLE INSURANCE 1079 00:43:49,001 --> 00:43:50,000 OPTION IS RIGHT FOR THEM. 1080 00:43:50,001 --> 00:43:52,000 THE CONGRESSIONAL BUDGET OFFICE, 1081 00:43:52,001 --> 00:43:53,000 WHICH IS CITED HERE -- AND I 1082 00:43:53,001 --> 00:43:55,000 THINK IT'S HEALTHY, QUITE 1083 00:43:55,001 --> 00:43:57,000 FRANKLY, I NOTICE THAT THE CONGRESSIONAL BUDGET OFFICE IS 1084 00:43:57,001 --> 00:43:59,000 CITED BY BOTH THE DEMOCRATS AND 1085 00:43:59,001 --> 00:44:00,000 THE REPUBLICANS IN THIS DEBATE. 1086 00:44:00,001 --> 00:44:02,000 THAT IS A CREDIT TO THE 1087 00:44:02,001 --> 00:44:03,000 CONGRESSIONAL BUDGET OFFICE. 1088 00:44:03,001 --> 00:44:09,000 THEY ARE SEEN AS NONPARTISAN. 1089 00:44:09,001 --> 00:44:10,000 THEY ARE NONPARTISAN, AND I 1090 00:44:10,001 --> 00:44:11,000 CONGRATULATE DOUG ELMENDORF FOR 1091 00:44:11,001 --> 00:44:12,000 THE GOOD WORK THAT THE C.B.O. 1092 00:44:12,001 --> 00:44:14,000 HAS BEEN DOING IN SUPPORTF OUR 1093 00:44:14,001 --> 00:44:16,000 EFFORTS TO COME TO THE RIGHT 1094 00:44:16,001 --> 00:44:17,000 ANSWER ON HEALTH CARE REFORM. 1095 00:44:17,001 --> 00:44:19,000 BUT THE C.B.O. FORECASTS THAT 1096 00:44:19,001 --> 00:44:23,000 THIS LEGISLATION WOULD NOT ADD 1097 00:44:23,001 --> 00:44:24,000 TO THE DEFICIT, AS THE CHART 1098 00:44:24,001 --> 00:44:26,000 THAT SENATOR BAUCUS HADP HERE 1099 00:44:26,001 --> 00:44:28,000 JUST A FEW MINUTES AGO CLEARLY 1100 00:44:28,001 --> 00:44:31,000 INDICATES, THE DEFICIT WOULD BE 1101 00:44:31,001 --> 00:44:32,000 REDUCED IN THE FIRST TEN YEARS 1102 00:44:32,001 --> 00:44:34,000 BY $130 BILLION. 1103 00:44:34,001 --> 00:44:38,000 IT WOULD BE REDUCED IN THE 1104 00:44:38,001 --> 00:44:41,000 SECOND TEN YEARS, GOING UP TO 1105 00:44:41,001 --> 00:44:44,000 2029, BY SOMETHING OVER $600 1106 00:44:44,001 --> 00:44:46,000 BILLION. 1107 00:44:46,001 --> 00:44:47,000 LET ME JUST ALSO POINT OUT THE 1108 00:44:47,001 --> 00:44:48,000 CONTRAST HERE. 1109 00:44:48,001 --> 00:44:50,000 WE'RE TALKING HERE ABOUT A BILL 1110 00:44:50,001 --> 00:44:52,000 WHICH 1111 00:44:52,001 --> 00:44:55,000 OFFICE SAYS WILL REDUCE THE SIZE 1112 00:44:55,001 --> 00:44:58,000 OF THE DEFICIT IN FUTURE DECADES. 1113 00:44:58,001 --> 00:44:59,000 I CAN REMBER A COUPLE OF 1114 00:44:59,001 --> 00:45:05,000 CONGRESSES AGO WHEN WE HAD 1115 00:45:05,001 --> 00:45:08,000 DEBATE HERE ON ADDING SUBPART-D 1116 00:45:08,001 --> 00:45:09,000 TO MEDICARE, PART-D TO 1117 00:45:09,001 --> 00:45:10,000 AND THERE WERE MANY ON THE FLOOR 1118 00:45:10,001 --> 00:45:12,000 HERE WHO ARE CONCERNED ABOUT 1119 00:45:12,001 --> 00:45:14,000 COSTS TODAY -- AT LEAST THEY SAY 1120 00:45:14,001 --> 00:45:17,000 SO IN THEIR SPEECHES -- WHO WERE 1121 00:45:17,001 --> 00:45:19,000 VERY ANXIOUS TO ADD THAT 1122 00:45:19,001 --> 00:45:21,000 LEGISLATION TO MEDICARE, ADDING 1123 00:45:21,001 --> 00:45:24,000 ANOTHER $500 BILLION -- THAT WAS 1124 00:45:24,001 --> 00:45:26,000 ESTIMATED BY THE C.B.O. AT THAT 1125 00:45:26,001 --> 00:45:28,000 TIME -- ANOTHER 1126 00:45:28,001 --> 00:45:37,000 OVER A TEN-YEAR PERIOD TO THE 1127 00:45:37,001 --> 00:45:41,000 COST THA MEDICARE WAS MARRIED. 1128 00:45:41,001 --> 00:45:42,000 THE EFFORTS TO BRING THE COSTS 1129 00:45:42,001 --> 00:45:45,000 DOWN IN MEDICARE IS ESSENTIAL IF 1130 00:45:45,001 --> 00:45:46,000 WE'RE GOING TO KEEP MEDICARE 1131 00:45:46,001 --> 00:45:48,000 SOLVENT IN THE FUTURAND PART 1132 00:45:48,001 --> 00:45:50,000 OF THE SOLVENCY PROBLEM MEDICARE 1133 00:45:50,001 --> 00:45:52,000 HAS IN THE FUTURE FRANKLY IS 1134 00:45:52,001 --> 00:45:54,000 RELATED TO WHAT WE DID IN SUBPART-D. 1135 00:45:54,001 --> 00:45:56,000 MR. PRESIDENT, I SEE MY TIME IS 1136 00:45:56,001 --> 00:45:57,000 UP. 1137 00:45:57,001 --> 00:45:58,000 AND THE ARE OTHER WAITING TO 1138 00:45:58,001 --> 00:46:00,000 SPEAK. 1139 00:46:00,001 --> 00:46:01,000 LET ME 1140 00:46:01,001 --> 00:46:03,000 UNANIMOUS CONSENT THAT THE 1141 00:46:03,001 --> 00:46:04,000 BALANCE OF MY STATEMENT BE 1142 00:46:04,001 --> 00:46:05,000 INCLUDED IN THE 1143 00:46:05,001 --> 00:46:10,000 THE PRESIDING OFFICER: WITHOUT 1144 00:46:10,001 --> 00:46:12,000 OBJECTION. 1145 00:46:12,001 --> 00:46:18,000 THE SENATOR FROM 1146 00:46:18,001 --> 00:46:19,000 BUT HOW MUCH TIME REMAINS UNDER THE 1147 00:46:19,001 --> 00:46:22,000 TIME OF THE MAJORITY? 1148 00:46:22,001 --> 00:46:25,000 THE PRESIDING OFFICER: 24 MR. BAUCUS: I YIELD TEN 1149 00:46:25,001 --> 00:46:27,000 MINUTES TO THE SENATOR FROM 1150 00:46:27,001 --> 00:46:28,000 MASSACHUSETTS. 1151 00:46:28,001 --> 00:46:29,000 A SENATOR: THANK YOU. 1152 00:46:29,001 --> 00:46:32,000 MR. BAUCUS: WE MIGHT BE ABLE 1153 00:46:32,001 --> 00:46:33,000 TO FIND EXTRA TIME. 1154 00:46:33,001 --> 00:46:34,000 RIGHT NOW THAT'S ALL WE HAVE IN 1155 00:46:34,001 --> 00:46:35,000 THIS FIRST BLOCK. 1156 00:46:35,001 --> 00:46:41,000 BUT SOMETIMES WE CAN WORK THINGS 1157 00:46:41,001 --> 00:46:48,000 OUT IF Y LONGER. 1158 00:46:48,001 --> 00:46:49,000 BUT RIGHT NOW IT IS TEN. 1159 00:46:49,001 --> 00:46:51,000 MR. KIRK: THANK YOU, 1160 00:46:51,001 --> 00:46:55,000 MR. PRESIDENT. 1161 00:46:55,001 --> 00:46:58,000 TODAY APPROXIMATELY 2 MILLION OF 1162 00:46:58,001 --> 00:47:00,000 -- 200 MILLION OF OUR CITIZENS 1163 00:47:00,001 --> 00:47:03,000 ARE ELDERLY. 1164 00:47:03,001 --> 00:47:05,000 THEY ARE FAMILY MEMBERS AND 1165 00:47:05,001 --> 00:47:07,000 LOVED ONCE -- VALUABLE, 1166 00:47:07,001 --> 00:47:09,000 CHALLENGED AND OFTEN FORGOTTEN 1167 00:47:09,001 --> 00:47:10,000 BUT THEY WERE N FORGOTTEN BY 1168 00:47:10,001 --> 00:47:11,000 THEIR FRIEND AND ADVOCATE, 1169 00:47:11,001 --> 00:47:13,000 SENATOR TED KENNEDY. 1170 00:47:13,001 --> 00:47:15,000 HE UNDERSTOOD THAT A FAIR AND 1171 00:47:15,001 --> 00:47:18,000 CIVILIZED SOCIETY SHOULD BE 1172 00:47:18,001 --> 00:47:19,000 JUDGED ON HOW IT TREATS ITS MOST 1173 00:47:19,001 --> 00:47:21,000 VULNERABLE CITIZENS. 1174 00:47:21,001 --> 00:47:23,000 SADLY, MILLIONS OF SENIORS AND 1175 00:47:23,001 --> 00:47:25,000 PERSONS LIVING WITH DISABILITIES 1176 00:47:25,001 --> 00:47:28,000 STRUGGLE TO OBTAIN THE SERVICES 1177 00:47:28,001 --> 00:47:29,000 AND SUPPORTS THEY NEED TO LIVE 1178 00:47:29,001 --> 00:47:31,000 FULFILLING LIVES AND TO REMAIN 1179 00:47:31,001 --> 00:47:35,000 IN THEIR COMMUNITIES, AMONG 1180 00:47:35,001 --> 00:47:38,000 THEIR FRIENDS AND FAMILIES, IN 1181 00:47:38,001 --> 00:47:39,000 WHAT THEY HOPED WOULD BE THEIR 1182 00:47:39,001 --> 00:47:44,000 PRODUCTIVE, GOADEN YEARS. 1183 00:47:44,001 --> 00:47:46,000 SENATOR KENNEDY UNDERSTOOD IT IS 1184 00:47:46,001 --> 00:47:47,000 MORALLY WRONG FOR SO MANY ME 1185 00:47:47,001 --> 00:47:53,000 AND WOMEN WHO NEED ASSISTANCE TO 1186 00:47:53,001 --> 00:47:56,000 BE FORCED TO FACE THE 1187 00:47:56,001 --> 00:47:59,000 HEARREAKING DECISIONS -- DO I 1188 00:47:59,001 --> 00:48:01,000 GIVE UP MY AMERICAN DREAM IN 1189 00:48:01,001 --> 00:48:03,000 ORDER TO QUALIFY FOR MED CAIRKSD 1190 00:48:03,001 --> 00:48:04,000 THE ONLY GOVERNMENT PROGRAM THAT 1191 00:48:04,001 --> 00:48:05,000 CAN PROVIDE ME WITH THE SUPPORT 1192 00:48:05,001 --> 00:48:07,000 I NEED? 1193 00:48:07,001 --> 00:48:08,000 OR DO I FOREGO MY INDEPENDENCE 1194 00:48:08,001 --> 00:48:12,000 AND RESIGN MYSELF TO LIVING THE 1195 00:48:12,001 --> 00:48:15,000 REST OF MY LIFE CONFINED TO A FACILITY? 1196 00:48:15,001 --> 00:48:17,000 SENATOR KENNEDY ALSO UNDERSTOOD 1197 00:48:17,001 --> 00:48:21,000 THAT IT IS MORALLY WRONG WHEN 1198 00:48:21,001 --> 00:48:23,000 THAT INFIRMED OR ELDERLY 1199 00:48:23,001 --> 00:48:24,000 INDIVIDUAL'S FRIENDS OR LOVED 1200 00:48:24,001 --> 00:48:25,000 ONES MUST ALSO FACE 1201 00:48:25,001 --> 00:48:27,000 HEARTBREAKING CHOICES. 1202 00:48:27,001 --> 00:48:30,000 DO I GIVE UP MY JOB AND COMMIT 1203 00:48:30,001 --> 00:48:33,000 MY TIME TO CARE FOR MY INFIRMED 1204 00:48:33,001 --> 00:48:35,000 PARENT AT THE EXPENSE OF MY OWN 1205 00:48:35,001 --> 00:48:37,000 FAMILY AND CHILDREN, OR DO I 1206 00:48:37,001 --> 00:48:39,000 RESIGN MYSELF TO CONFINING MY 1207 00:48:39,001 --> 00:48:41,000 AILING MOTHER OR FATHER TO A FACILITY? 1208 00:48:41,001 --> 00:48:44,000 FAMILIES ACROSS 1209 00:48:44,001 --> 00:48:45,000 UNDERSTAND THIS HARSH CRISIS 1210 00:48:45,001 --> 00:48:48,000 TOO WELL. 1211 00:48:48,001 --> 00:48:50,000 A RECENT POLL FOUND THAT 1212 00:48:50,001 --> 00:48:52,000 60% OF THOSE SURVEYED HAD A 1213 00:48:52,001 --> 00:48:53,000 PERSONAL EXPERIENCE 1214 00:48:53,001 --> 00:48:56,000 LONG-TERM CARE. 1215 00:48:56,001 --> 00:48:59,000 AND AS THIS CHART DEMONSTRATES, 1216 00:48:59,001 --> 00:49:01,000 NEARLY 1217 00:49:01,001 --> 00:49:04,000 TO SUPPORT HEALTH CARE REFORM IF 1218 00:49:04,001 --> 00:49:06,000 -- IF -- IT INCLUDED A LONG-TERM 1219 00:49:06,001 --> 00:49:09,000 CARE PROGRAM. 1220 00:49:09,001 --> 00:49:10,000 THESE FAMILIES KNOW THAT THE 1221 00:49:10,001 --> 00:49:11,000 CURRENT LG-TERM CARE DRY IS 1222 00:49:11,001 --> 00:49:14,000 NOT MEETING THEIR CURRENT NEEDS 1223 00:49:14,001 --> 00:49:16,000 AND THAT CHANGE MUST COME. 1224 00:49:16,001 --> 00:49:19,000 AS ALWAYS, SENATOR KENNEDY CARED 1225 00:49:19,001 --> 00:49:20,000 HOW OUR SOCIETY WOULD BE JUDGED. 1226 00:49:20,001 --> 00:49:22,000 HE DIDN'T JUST SIT BY. 1227 00:49:22,001 --> 00:49:25,000 HE ACTED. 1228 00:49:25,001 --> 00:49:26,000 HE DRAFTED THE COMMUNITY LIVING 1229 00:49:26,001 --> 00:49:28,000 ASSISTANCE SERVICE AND SUPPORTS 1230 00:49:28,001 --> 00:49:29,000 ACT, KNOWN AS THE CLASS ACT, 1231 00:49:29,001 --> 00:49:31,000 WHICH WE ARE DEBATING THIS 1232 00:49:31,001 --> 00:49:33,000 MORNING. 1233 00:49:33,001 --> 00:49:35,000 THIS PROGRAM WAS AT THE HEART OF 1234 00:49:35,001 --> 00:49:37,000 HIS EFFORT TO HELP PEOPLE WITH 1235 00:49:37,001 --> 00:49:39,000 FUNCTIONAL LIMITATIONS AND THEIR 1236 00:49:39,001 --> 00:49:41,000 FAMILIES TO OBTAIN THE SERVICES 1237 00:49:41,001 --> 00:49:43,000 AND SUPPORTS THEY NEED. 1238 00:49:43,001 --> 00:49:45,000 IT GIVES THEM THE CHANCE TO 1239 00:49:45,001 --> 00:49:46,000 MAINTAIN THEIR INDEPENDENCE AND 1240 00:49:46,001 --> 00:49:48,000 REMAIN ACTIVE, PRODUCTIVE 1241 00:49:48,001 --> 00:49:51,000 MEMBERS OF THEIR COMMUNITIES. 1242 00:49:51,001 --> 00:49:53,000 UNDER THE CLASS ACT, A WORKER IN 1243 00:49:53,001 --> 00:49:56,000 MASSACHUSETTS OR ANY OTHER STATE 1244 00:49:56,001 --> 00:49:58,000 CAN CHOOSE TO PAY A PREMIUM INTO 1245 00:49:58,001 --> 00:50:00,000 THIS VOLUNTARY INSURANCE PROGRAM 1246 00:50:00,001 --> 00:50:01,000 THROUGH AFFORDABLE PAYROLL 1247 00:50:01,001 --> 00:50:03,000 DEDUCTIONS. 1248 00:50:03,001 --> 00:50:05,000 AFTER CONTRIBUTIN 1249 00:50:05,001 --> 00:50:07,000 YEARS, THEY BECOME ELIGIBLE FOR 1250 00:50:07,001 --> 00:50:11,000 A CASH BENEFIT OF AT LEAST 1251 00:50:11,001 --> 00:50:13,000 DAY 1252 00:50:13,001 --> 00:50:15,000 THAT CASH 1253 00:50:15,001 --> 00:50:17,000 DIFFERENCE IN ALLOWING A 1254 00:50:17,001 --> 00:50:20,000 DISABLED PERSON TO LIVE WITH 1255 00:50:20,001 --> 00:50:22,000 INDEPENDENCE, SELF-RESPECT, AND DIGNITY. 1256 00:50:22,001 --> 00:50:24,000 FOR EXAMPLE, IT CAN PAY FOR 1257 00:50:24,001 --> 00:50:26,000 HAVING A RAMP INSTALLED TO THEIR 1258 00:50:26,001 --> 00:50:27,000 HOME OR TO PAY FOR NEEDED 1259 00:50:27,001 --> 00:50:29,000 TRANSPORTATION OR TO PURCHASE A 1260 00:50:29,001 --> 00:50:31,000 COMPUTER TO WORK FROM HOME AND 1261 00:50:31,001 --> 00:50:33,000 REMAIN SELF-SUFFICIENT. 1262 00:50:33,001 --> 00:50:35,000 IT CAN ALSO PAY FOR A CARE GIVER 1263 00:50:35,001 --> 00:50:38,000 TO COME TO THEIR HOME, HELP THEM 1264 00:50:38,001 --> 00:50:40,000 BATHE, GET DRESSED, AND COOK 1265 00:50:40,001 --> 00:50:42,000 MEALS, SERVICES THAT OTHERWISE 1266 00:50:42,001 --> 00:50:46,000 OFTEN FALL TO FAMILY AND FRIENDS 1267 00:50:46,001 --> 00:50:48,000 WHO ARE FORCED TO WORK REDUCED 1268 00:50:48,001 --> 00:50:50,000 HOURS ON THEIR OWN JOBS 1269 00:50:50,001 --> 00:50:52,000 THOSE JOBS ALTOGETHER TO PROVIDE 1270 00:50:52,001 --> 00:50:53,000 THAT NEEDED CARE. 1271 00:50:53,001 --> 00:50:56,000 CURRENTLY, LONG-TERM CARE AS 1272 00:50:56,001 --> 00:50:57,000 KNOW IT IS PAID FOR THROUGH A 1273 00:50:57,001 --> 00:50:59,000 FRAGMENTED COMBINATION OF 1274 00:50:59,001 --> 00:51:01,000 SOURCES INCLUDING FAMILY 1275 00:51:01,001 --> 00:51:02,000 BUDGETS, MEDICAID, MEDICARE, AND 1276 00:51:02,001 --> 00:51:05,000 PRIVATE INSURANCE. 1277 00:51:05,001 --> 00:51:06,000 WITHOUT A PRIOR AND VOLUNTARY 1278 00:51:06,001 --> 00:51:08,000 INSURANCE INVESTMENT, WHICH THE 1279 00:51:08,001 --> 00:51:10,000 CLASS ACT OFFERS, PAYING FOR 1280 00:51:10,001 --> 00:51:12,000 LONG-TERM CARE CAN BE THE 1281 00:51:12,001 --> 00:51:16,000 FINANCIALLY -- CAN BE 1282 00:51:16,001 --> 00:51:19,000 FINANCIALLY CATASTROPHIC SINCE 1283 00:51:19,001 --> 00:51:20,000 NURSING HOMES AND HOME CARE CAN 1284 00:51:20,001 --> 00:51:22,000 COST THOUSANDS OF DOLLARS A YEAR. 1285 00:51:22,001 --> 00:51:24,000 ONLY O IN FIVE INDIVIDUALS CAN 1286 00:51:24,001 --> 00:51:26,000 AFFORD PRIVATE LONG-TERM CARE 1287 00:51:26,001 --> 00:51:27,000 INSURANCE AND MANY ARE EXCLUDED 1288 00:51:27,001 --> 00:51:29,000 BECAUSE OF PREEXISTING 1289 00:51:29,001 --> 00:51:31,000 CONDITIONS. 1290 00:51:31,001 --> 00:51:33,000 MEDICARE'S ROLE IN PROVIDING 1291 00:51:33,001 --> 00:51:36,000 LONG-TERM SERVICES IS EXTREMELY 1292 00:51:36,001 --> 00:51:37,000 LIMITED COVERING ONLY 1293 00:51:37,001 --> 00:51:39,000 SHORT-TERM, SKILLED NURSING 1294 00:51:39,001 --> 00:51:41,000 CARE, AND HOME HEALTH. 1295 00:51:41,001 --> 00:51:43,000 THIS LACK OF OPTION FORS MANY 1296 00:51:43,001 --> 00:51:46,000 PEOPLE TO TURN TO MEDICAID, 1297 00:51:46,001 --> 00:51:49,000 WHICH IS OUR NATION'S PRIMARY 1298 00:51:49,001 --> 00:51:50,000 PAYER AND SOLE SAFETY NET 1299 00:51:50,001 --> 00:51:51,000 PROGRAM PROVIDING COMPREHENSIVE 1300 00:51:51,001 --> 00:51:54,000 LONG-TERM SERVICES AND SUPPORTS. 1301 00:51:54,001 --> 00:51:57,000 BUT WHO IS ELIGIBLE FOR MEDICAID? 1302 00:51:57,001 --> 00:52:00,000 PEOPLE ONLY QUALIFY FOR MEDICAID 1303 00:52:00,001 --> 00:52:01,000 IF THEY ARE OR BECOME POOR. 1304 00:52:01,001 --> 00:52:03,000 THIS CRITERION FCES MANY 1305 00:52:03,001 --> 00:52:05,000 FAMILIES TO IMPOVERISH 1306 00:52:05,001 --> 00:52:06,000 THEMSELVES TO OBTAIN THE 1307 00:52:06,001 --> 00:52:08,000 MEDICAID SUPPORT THEY NEED. 1308 00:52:08,001 --> 00:52:10,000 WE HAVE ALL HEARD THE STORIES. 1309 00:52:10,001 --> 00:52:13,000 A FAMILY MEMBER WORKS HARD ALL 1310 00:52:13,001 --> 00:52:15,000 HIS OR HER LIFE AND THEN, DUE TO 1311 00:52:15,001 --> 00:52:17,000 AN ACCIDENT, TY CANNOT AFFORD 1312 00:52:17,001 --> 00:52:18,000 TO PAY FOR NEEDED SERVICES AND 1313 00:52:18,001 --> 00:52:21,000 SUPPORTS OUT OF THEIR POCKET. 1314 00:52:21,001 --> 00:52:23,000 SO THEY NOW MUST GIVE UP THEIR 1315 00:52:23,001 --> 00:52:25,000 SAVINGS TO BECOME ELIGIBLE, TO 1316 00:52:25,001 --> 00:52:28,000 TURN TO THE GOVERNMENT AND TO 1317 00:52:28,001 --> 00:52:29,000 MEDICAID TO PROVIDE THE PROPER 1318 00:52:29,001 --> 00:52:32,000 CARE THEY NEED TO SUR 1319 00:52:32,001 --> 00:52:34,000 NO ONE 1320 00:52:34,001 --> 00:52:36,000 ELDERLY PARENT, NOT THE FAMILY 1321 00:52:36,001 --> 00:52:38,000 CAREGIVER, NOT THE GOVERNMENT, 1322 00:52:38,001 --> 00:52:40,000 AND NOT MEDICAID. 1323 00:52:40,001 --> 00:52:42,000 I HAVE A LETTER FROM A WOMAN WHO 1324 00:52:42,001 --> 00:52:43,000 LIVES ON CAPE COD IN 1325 00:52:43,001 --> 00:52:50,000 MASSACHUSETTS. 1326 00:52:50,001 --> 00:52:51,000 SHE KNOWS FIRST IFIRSTHAND HOW POWERFUL 1327 00:52:51,001 --> 00:52:52,000 THE CLASS ACT CAN BE FOR 1328 00:52:52,001 --> 00:52:53,000 FAMILIES. 1329 00:52:53,001 --> 00:52:56,000 SHE IS CARING FOR A FAMILY 1330 00:52:56,001 --> 00:52:57,000 MEMBER THAT IS LEGALLY BLIND AND 1331 00:52:57,001 --> 00:52:59,000 INCONTINENT. 1332 00:52:59,001 --> 00:53:01,000 SMEE WRITES, "CAYING FOR MY 1333 00:53:01,001 --> 00:53:04,000 SISSER AT HOME HAS SAVEDHE 1334 00:53:04,001 --> 00:53:06,000 STATE THOUSANDS AND THOUSANDS OF 1335 00:53:06,001 --> 00:53:08,000 DOLLARS EVERY YEAR AND WE HAVE 1336 00:53:08,001 --> 00:53:10,000 DONE THIS FOR 38 YEARS. 1337 00:53:10,001 --> 00:53:13,000 WE ARE HOLDING DOWN FULL-TIME 1338 00:53:13,001 --> 00:53:14,000 JOBS WHICH ALSO SUPPLEMENT MY 1339 00:53:14,001 --> 00:53:15,000 SISTER'S CARE. 1340 00:53:15,001 --> 00:53:16,000 THIS IS WRONG. 1341 00:53:16,001 --> 00:53:18,000 INSTEAD OF ENCOURAGE FAMILIES 1342 00:53:18,001 --> 00:53:20,000 WHO WANT TO KEEP THEIR LOVED 1343 00:53:20,001 --> 00:53:22,000 ONES AT HOME," SHE WRITES, "AND 1344 00:53:22,001 --> 00:53:23,000 SAVE THE STATE MONEY, THEY WORK 1345 00:53:23,001 --> 00:53:25,000 AGAINST US. 1346 00:53:25,001 --> 00:53:27,000 SO I BELIEVE W WILL GIVE UP AND 1347 00:53:27,001 --> 00:53:29,000 JUST PLACE THEM IN A NURSING 1348 00:53:29,001 --> 00:53:31,000 HOME, WHICH IN TURN COSTS THE 1349 00:53:31,001 --> 00:53:34,000 STATE MONEY. 1350 00:53:34,001 --> 00:53:35,000 IS THIS NOT CRAZY," SHE ASKS. 1351 00:53:35,001 --> 00:53:36,000 SHE IS ASKING THE RIGHT 1352 00:53:36,001 --> 00:53:37,000 QUESTION. 1353 00:53:37,001 --> 00:53:40,000 THE CLASS ACT WILL HELP TURN 1354 00:53:40,001 --> 00:53:42,000 THIS SERIOUS 1355 00:53:42,001 --> 00:53:44,000 INTO AN EVERYONE-WINS RESULT. 1356 00:53:44,001 --> 00:53:46,000 IT GIVES INDIVIDUALS WITH DISABILITIES AND THEIR FAMILIES 1357 00:53:46,001 --> 00:53:48,000 THE FUNDS THEY NEED TO OBTAIN 1358 00:53:48,001 --> 00:53:50,000 SOME OF THE SERVICES THEY NEED. 1359 00:53:50,001 --> 00:53:52,000 WITHOUT HAVING TO RETURN OR 1360 00:53:52,001 --> 00:53:54,000 RETORT TO MEDICAID. 1361 00:53:54,001 --> 00:53:57,000 THE CURRENT RELIANCE ON MEDICAID 1362 00:53:57,001 --> 00:53:58,000 IS NOT ONLY A STRAIN ON OUR 1363 00:53:58,001 --> 00:54:00,000 FAMILIES; IT IS ALSO A STRAIN ON 1364 00:54:00,001 --> 00:54:03,000 OUR ALREADY OVERBURDENED 1365 00:54:03,001 --> 00:54:05,000 MEDICAID SYSTEM. 1366 00:54:05,001 --> 00:54:07,000 TODAY MEDICAID SPENDS NEARLY $50 1367 00:54:07,001 --> 00:54:11,000 BILLION A YEAR ON LONG-TERM 1368 00:54:11,001 --> 00:54:14,000 SERVICES AND SUPPORTS. 1369 00:54:14,001 --> 00:54:20,000 ESTIMATES INDICATE THAT BY 2045, 1370 00:54:20,001 --> 00:54:22,000 THAT SPENDING COULD EXCEED $2 BILLION. 1371 00:54:22,001 --> 00:54:25,000 OBVIOUSLY, THIS IS UNSUSTAINABLE. 1372 00:54:25,001 --> 00:54:26,000 IN ADDITION, THE PRIVATE 1373 00:54:26,001 --> 00:54:28,000 ENOUGH TO MEET THE GROWING 1374 00:54:28,001 --> 00:54:32,000 DEMAND FOR SUCH CARE. 1375 00:54:32,001 --> 00:54:34,000 AGING BABY BOOMERS AND A LONGER 1376 00:54:34,001 --> 00:54:41,000 LIFE SPAN WILL INCREASE THE 1377 00:54:41,001 --> 00:54:45,000 DEMAND FOR 1378 00:54:45,001 --> 00:54:46,000 YET 95% OF PEOPLE OVER 45 DO NOT 1379 00:54:46,001 --> 00:54:47,000 HAVE LONG-TERM CARE INSURANCE 1380 00:54:47,001 --> 00:54:50,000 AND FEWER AND FEWER PEOPLE ARE 1381 00:54:50,001 --> 00:54:52,000 ABLE TO BUY SUCH 1382 00:54:52,001 --> 00:54:55,000 MAKE NO MISTAKE, AS IT STANDS 1383 00:54:55,001 --> 00:54:58,000 TODAY, IF SOMEONE WITHOUT 1384 00:54:58,001 --> 00:54:59,000 ADEQUATE LONG-TERM CARE BECOMES 1385 00:54:59,001 --> 00:55:01,000 DISABLED, THEY WILL HAVE TO TURN 1386 00:55:01,001 --> 00:55:02,000 TO THE MED 1387 00:55:02,001 --> 00:55:04,000 THE HELP THEY NEED. 1388 00:55:04,001 --> 00:55:07,000 THE CLASS ACT IS DESIGNED 1389 00:55:07,001 --> 00:55:08,000 SPECIFICALLY TO REMEDY THIS 1390 00:55:08,001 --> 00:55:11,000 LOOMING CRISIS BY GIVING PEOPLE 1391 00:55:11,001 --> 00:55:13,000 AN AFFORDABLE OPTION OTHER THAN 1392 00:55:13,001 --> 00:55:15,000 MEDICAID, THE ACT WILL SAVE THE 1393 00:55:15,001 --> 00:55:17,000 SYSTEM OVER $1.6 BILLION OVER 1394 00:55:17,001 --> 00:55:20,000 THE FIRST FOUR YEARS THAT PEOPLE 1395 00:55:20,001 --> 00:55:21,000 START RECEIVING BENEFITS. 1396 00:55:21,001 --> 00:55:22,000 NOW SOME 1397 00:55:22,001 --> 00:55:24,000 ACT ARGUE THAT THE PROGRAM WILL 1398 00:55:24,001 --> 00:55:26,000 NOT BE SUSTAINABLE OVER TIME AND 1399 00:55:26,001 --> 00:55:28,000 THAT IT WILL BECOME INS 1400 00:55:28,001 --> 00:55:29,000 AND END UP COSTING TAXPAYERS 1401 00:55:29,001 --> 00:55:30,000 LARGE AMOUNTS. 1402 00:55:30,001 --> 00:55:32,000 THAT ARGUMENT COULD NOT BE 1403 00:55:32,001 --> 00:55:35,000 FURTHER FROM THE TRUTH. 1404 00:55:35,001 --> 00:55:36,000 AND LET'S GIVE PROPER CREDIT 1405 00:55:36,001 --> 00:55:38,000 WHERE IT'S DUE. 1406 00:55:38,001 --> 00:55:39,000 WITH THE HELP OF OUR FRIENDS ON 1407 00:55:39,001 --> 00:55:41,000 THE OTHER SIDE OF THE AISLE, WE 1408 00:55:41,001 --> 00:55:43,000 HAVE TAKEN REAL STEPS TO ENSURE 1409 00:55:43,001 --> 00:55:45,000 THAT THE PROGRAM REMAINS SOLVENT 1410 00:55:45,001 --> 00:55:49,000 FOR YEARS TO COME. 1411 00:55:49,001 --> 00:55:50,000 THE ACT STE ESTABLISHES A STRONG 1412 00:55:50,001 --> 00:55:52,000 WORK REQUIREMENT TO MAKE SURE 1413 00:55:52,001 --> 00:55:54,000 THAT FUNDS CONTINUE TO COME INTO 1414 00:55:54,001 --> 00:55:56,000 THE PROGRAM FROM THE PAYROLL TAX 1415 00:55:56,001 --> 00:55:58,000 DEDUCTION OR FROM AN 1416 00:55:58,001 --> 00:56:00,000 INDIVIDUAL'S VOLUNTARILY PAID PREMIUM. 1417 00:56:00,001 --> 00:56:04,000 IT REQUIRES THE SECRETARY OF 1418 00:56:04,001 --> 00:56:06,000 PREMIUMS ANNUALLY, TO ENSURE 1419 00:56:06,001 --> 00:56:08,000 THAT THE PROGRAM WILL REMAIN 1420 00:56:08,001 --> 00:56:09,000 SOFLTS FOR THE NEXT -- WILL 1421 00:56:09,001 --> 00:56:12,000 REMAIN SOLVENT FOR THE NEXT 75 1422 00:56:12,001 --> 00:56:15,000 YEARS T DIRECTS THE 1423 00:56:15,001 --> 00:56:16,000 IN 1424 00:56:16,001 --> 00:56:17,000 PROJECTIONS 25 YEARS IN THE 1425 00:56:17,001 --> 00:56:19,000 FUTURE 1426 00:56:19,001 --> 00:56:20,000 TAXPAYER FUNDS WILL BE 1427 00:56:20,001 --> 00:56:22,000 PAY BENEFITS. 1428 00:56:22,001 --> 00:56:24,000 LET ME REPEAT THAT FINAL POINT 1429 00:56:24,001 --> 00:56:26,000 SINCE I HAVE OFTEN HEARD IT 1430 00:56:26,001 --> 00:56:28,000 MISREPRESENTED. 1431 00:56:28,001 --> 00:56:30,000 NO TAXPAYER FUNDS WILL BE USED 1432 00:56:30,001 --> 00:56:32,000 TO PAY BENEFITS. 1433 00:56:32,001 --> 00:56:34,000 BENEFITS WILL BE PAID THROUGH 1434 00:56:34,001 --> 00:56:35,000 SELF-FUNDED AND VOLUNTARY 1435 00:56:35,001 --> 00:56:37,000 PREMIUMS. 1436 00:56:37,001 --> 00:56:39,000 DURING THE PARKUP IN THE "HELP" 1437 00:56:39,001 --> 00:56:41,000 COMMITTEE THIS SUMMER, SENATOR 1438 00:56:41,001 --> 00:56:43,000 PROGRAM. 1439 00:56:43,001 --> 00:56:45,000 WITH THE HELP OF THE REPUBLICANS 1440 00:56:45,001 --> 00:56:48,000 ON THE COMMITTEE, ESPECIALLY 1441 00:56:48,001 --> 00:56:49,000 SENATOR GREGG OF NEW HAMPSHIRE, 1442 00:56:49,001 --> 00:56:51,000 ADDITIONAL SAFEGUARDS WERE 1443 00:56:51,001 --> 00:56:52,000 INCLUDED TO ENSURE THAT THE ACT 1444 00:56:52,001 --> 00:56:55,000 WILL STAND ON STRONG FINANCIAL 1445 00:56:55,001 --> 00:56:57,000 FOOTING FOR YEARS TO COME. 1446 00:56:57,001 --> 00:57:00,000 AFTER THE COMMITTEE ADOPTED 1447 00:57:00,001 --> 00:57:02,000 SENATOR GREGG'S 75-YEAR SOLVENCY 1448 00:57:02,001 --> 00:57:04,000 AMENDMENT, THE PROGRAM 1449 00:57:04,001 --> 00:57:07,000 STRONG WORDS OF SUPPORT FROM 1450 00:57:07,001 --> 00:57:10,000 BOTH PARTIES. 1451 00:57:10,001 --> 00:57:12,000 WE C 1452 00:57:12,001 --> 00:57:14,000 CONSTRUCTIVE CONTRIBUTION. 1453 00:57:14,001 --> 00:57:15,000 THIS CLASS ACT WILL DO ALL THE 1454 00:57:15,001 --> 00:57:17,000 THINGS IT SHOULD DO: 1455 00:57:17,001 --> 00:57:19,000 PROVIDE FINANCIAL AND HEALTH 1456 00:57:19,001 --> 00:57:21,000 SECURITY TO ELDERLY AND INFIRMED AMERICANS. 1457 00:57:21,001 --> 00:57:23,000 IT'LL STRENGTHENEDICARE. 1458 00:57:23,001 --> 00:57:24,000 AND IT'LL MAKE HEALTH REFORM THE 1459 00:57:24,001 --> 00:57:26,000 EXACT THING THAT THE AMERICAN 1460 00:57:26,001 --> 00:57:27,000 PEOPLE NEEDED. 1461 00:57:27,001 --> 00:57:31,000 AND WITH THAT, I YIELD THE FLOOR 1462 00:57:31,001 --> 00:57:32,000 AND THANK YOU, MR. PRESIDENT. 1463 00:57:32,001 --> 00:57:35,000 THE PR 1464 00:57:35,001 --> 00:57:37,000 SENATOR FROM MONTANA. 1465 00:57:37,001 --> 00:57:38,000 MR. BAUCUS: MR. PRESIDENT, I 1466 00:57:38,001 --> 00:57:40,000 YIELD TO THE SENATOR FROM 1467 00:57:40,001 --> 00:57:42,000 WISCONSIN, THE CHAIRMAN OF THE 1468 00:57:42,001 --> 00:57:44,000 SPECIAL CO 1469 00:57:44,001 --> 00:57:45,000 MR. KOHL: THANK YOU VERY MUCH, 1470 00:57:45,001 --> 00:57:46,000 SENATOR BAUCUS. 1471 00:57:46,001 --> 00:57:47,000 THE PRESIDING OFFICER: THE 1472 00:57:47,001 --> 00:57:48,000 SENA 1473 00:57:48,001 --> 00:57:50,000 MR. KOHL: I COME TO THE FLOOR 1474 00:57:50,001 --> 00:57:51,000 TODAY TO TALK ABOUT THE MANY 1475 00:57:51,001 --> 00:57:54,000 WAYS IN WHICH THIS BILL WILL 1476 00:57:54,001 --> 00:57:55,000 HAVE A POSITIVE IMPACT FOR SENIORS. 1477 00:57:55,001 --> 00:57:58,000 OVER THE PAST YEAR WE'VE SEEN 1478 00:57:58,001 --> 00:57:59,000 CONFUSION ABOUT WHAT HEALTH CARE 1479 00:57:59,001 --> 00:58:01,000 REFORM WILL MEAN FOR AMERICANS, 1480 00:58:01,001 --> 00:58:02,000 AND PARTICULARLY FOR SENIORS. 1481 00:58:02,001 --> 00:58:04,000 I HAD HOPED THAT ONCE THE SENATE 1482 00:58:04,001 --> 00:58:08,000 VOTED TO MOVE FORWARD WITH 1483 00:58:08,001 --> 00:58:11,000 DEBATE ON ONE MERGED BILL WE 1484 00:58:11,001 --> 00:58:12,000 COULD ANSWER WHY HEALTH REFORM 1485 00:58:12,001 --> 00:58:13,000 WILL HELP THEM. 1486 00:58:13,001 --> 00:58:15,000 UNFORTUNATELY, HERE WE ARE ON 1487 00:58:15,001 --> 00:58:19,000 THE FLOOR CONTINUING TO SEND 1488 00:58:19,001 --> 00:58:20,000 MIXED PLEDGE MESSAGES ABOUT SOME VERY 1489 00:58:20,001 --> 00:58:22,000 CONCRETE PROVISIONS. 1490 00:58:22,001 --> 00:58:26,000 I WANT TO HELP SET THE RECORD 1491 00:58:26,001 --> 00:58:27,000 STATE FOR OLDER AMERICANS. 1492 00:58:27,001 --> 00:58:30,000 THIS HEALTH REFORM BILL IS NOT 1493 00:58:30,001 --> 00:58:32,000 GOING TO CUT MEDICARE BENEFITS. INDEPENDENT GROUPS SUCH AS THE 1494 00:58:32,001 --> 00:58:34,000 AARP AND THE NATIONAL COMMITTEE 1495 00:58:34,001 --> 00:58:36,000 TO PRESERVE SOCIAL SECURITY AND 1496 00:58:36,001 --> 00:58:37,000 MEDICARE HAVE SAID THAT THIS 1497 00:58:37,001 --> 00:58:39,000 BILL WILL STRENGTHEN MEDICARE 1498 00:58:39,001 --> 00:58:41,000 AND NOT HARM IT. 1499 00:58:41,001 --> 00:58:44,000 AARP BELIEVES THAT THIS BILL 1500 00:58:44,001 --> 00:58:48,000 WILL TRANSITION MEDICARE TO A 1501 00:58:48,001 --> 00:58:50,000 MORE EFFICIENT SYSTEM WHERE 1502 00:58:50,001 --> 00:58:51,000 QUALITY HEALTH CARE OUTCOMES ARE 1503 00:58:51,001 --> 00:58:53,000 REWARDED AND WASTE WHICH 1504 00:58:53,001 --> 00:58:55,000 ACCOUNTS FOR UP TO 30% OF 1505 00:58:55,001 --> 00:58:57,000 MEDICARE SPEND SOMETHING REDUCED. 1506 00:58:57,001 --> 00:58:58,000 IN TERMS OF THE CUTS TO MEDICARE 1507 00:58:58,001 --> 00:59:01,000 ADVANTAGE, THIS BILL WILL ONLY 1508 00:59:01,001 --> 00:59:03,000 CUT BACK ON OVEAYMENTS TO 1509 00:59:03,001 --> 00:59:06,000 THESE PRIVATE MEDICARE PLANS, 1510 00:59:06,001 --> 00:59:08,000 BENEFITS WILL NOT BE AFFECTED. 1511 00:59:08,001 --> 00:59:09,000 AARP ALSO SUPPORTS THESE CUTS 1512 00:59:09,001 --> 00:59:11,000 BECAUSE THEY UNDERSTAND THAT 1513 00:59:11,001 --> 00:59:13,000 MOST OF THE OVERPAYMENTS ARE 1514 00:59:13,001 --> 00:59:15,000 GOING TO INSURANCE COMPANY 1515 00:59:15,001 --> 00:59:17,000 PROFITS, NOT TO SENIORS' 1516 00:59:17,001 --> 00:59:19,000 BENEFITS AND THAT THIS 1517 00:59:19,001 --> 00:59:25,000 OVERSPENDING IS PUTTING MEDICARE 1518 00:59:25,001 --> 00:59:26,000 ON A FASTER PATH TO INSOLVENCY. 1519 00:59:26,001 --> 00:59:28,000 EXPERTS SAY THAT HEALTH REFORM 1520 00:59:28,001 --> 00:59:29,000 WILL EXTEND THE SOLVENCY OF 1521 00:59:29,001 --> 00:59:31,000 MEDICARE TRUST FUND FOR FIVE 1522 00:59:31,001 --> 00:59:33,000 YEARS WITHOUT MAKING ONE CUT TO 1523 00:59:33,001 --> 00:59:34,000 GUARANTEED BENEFITS. 1524 00:59:34,001 --> 00:59:36,000 I UNDERSTAND THAT PEOPLE 1525 00:59:36,001 --> 00:59:38,000 COMPLAIN THAT THIS BILL IS TOO LONG. 1526 00:59:38,001 --> 00:59:40,000 BUT ANY BILL THAT SEEKS TO OFFER 1527 00:59:40,001 --> 00:59:43,000 CHOICE AND MEET THE NEEDS OF SO 1528 00:59:43,001 --> 00:59:48,000 MANY AMERICANS IS, BY NECESSITY, 1529 00:59:48,001 --> 00:59:50,000 COMPLEX. WE CANNOT GLOSS 1530 00:59:50,001 --> 00:59:52,000 OVER THESE VITAL ISSUES, SO I'D 1531 00:59:52,001 --> 00:59:53,000 LIKE TO TAKE A MOMENT TO SHARE 1532 00:59:53,001 --> 00:59:55,000 WITH YOU SOME OF THE ISSUES THAT 1533 00:59:55,001 --> 00:59:58,000 HAVE NOT RECEIVED AS MUCH 1534 00:59:58,001 --> 01:00:00,000 ATTENTION BUT ARE NEVERTHELESS 1535 01:00:00,001 --> 01:00:02,000 CRUCIAL TO IMPROVI HEALTH CARE SYSTEM. 1536 01:00:02,001 --> 01:00:03,000 THERE IS A LOT IN THIS BILL FOR 1537 01:00:03,001 --> 01:00:04,000 OLDER AMERICANS, RETIREES AND 1538 01:00:04,001 --> 01:00:07,000 THOSE PLANNING AHEAD FOR A 1539 01:00:07,001 --> 01:00:09,000 HEALTHY AND HAPPY LONG LIFE. 1540 01:00:09,001 --> 01:00:10,000 THE AGING COMMITTEE HAS WORKED 1541 01:00:10,001 --> 01:00:11,000 CLOSELY WITH THE LEADERSHIP OF 1542 01:00:11,001 --> 01:00:13,000 THE "HELP" AND FINANCE 1543 01:00:13,001 --> 01:00:15,000 COMMITTEES TO INCLUDE SEVERAL OF 1544 01:00:15,001 --> 01:00:16,000 OUR PROVISIONS, MOST OF WHICH 1545 01:00:16,001 --> 01:00:19,000 HAVE BIPARTISAN SUPPORT. 1546 01:00:19,001 --> 01:00:21,000 I'D LIKE PARTICULARLY TO THANK 1547 01:00:21,001 --> 01:00:23,000 SENATOR BAUCUS, SENATOR DODD, 1548 01:00:23,001 --> 01:00:27,000 SENATOR HARKIN, AND MAJORITY 1549 01:00:27,001 --> 01:00:28,000 LEADER REID FOR BEING SO WILLING 1550 01:00:28,001 --> 01:00:29,000 IMPORTANT ISSUES. 1551 01:00:29,001 --> 01:00:31,000 WE HAVE ENLISTED HELP FROM 1552 01:00:31,001 --> 01:00:33,000 SENIORS' GROUPS OF EVERY STRIPE 1553 01:00:33,001 --> 01:00:35,000 TO ENSURE THAT HEALTH REFORM 1554 01:00:35,001 --> 01:00:37,000 MAKES COMMONSENSE IMPROVEMENTS 1555 01:00:37,001 --> 01:00:38,000 THAT IN SOME CASES ARE 1556 01:00:38,001 --> 01:00:40,000 DESPERATELY NEEDED. 1557 01:00:40,001 --> 01:00:42,000 THIS BILL WILL SIGNIFICANTLY 1558 01:00:42,001 --> 01:00:43,000 IMPROVE THE STANDARD OF CARE IN 1559 01:00:43,001 --> 01:00:46,000 NURSING HOMES NATIONWIDE FOR THE 1560 01:00:46,001 --> 01:00:48,000 FIRST TIME IN 22 YEARS, AND I 1561 01:00:48,001 --> 01:00:50,000 THK MY KHRAOERBGS SENATOR 1562 01:00:50,001 --> 01:00:52,000 GRASSLEY -- MY COLLEAGUE, 1563 01:00:52,001 --> 01:00:53,000 SENATOR GRASSLEY, FOR WORKING 1564 01:00:53,001 --> 01:00:54,000 TOGETHER TO MAKE SURE THIS 1565 01:00:54,001 --> 01:00:56,000 IMPORTANT ISSUE WAS NOT 1566 01:00:56,001 --> 01:00:59,000 OVERLOOKED AS PART OF HEALTH REFORM. 1567 01:00:59,001 --> 01:01:01,000 IN AND OF ITSELF, THIS IS A 1568 01:01:01,001 --> 01:01:03,000 UNDERTAKING BUT IT'S JUST ONE 1569 01:01:03,001 --> 01:01:04,000 PIECE OF THE PUZZLE TO 1570 01:01:04,001 --> 01:01:05,000 COMPREHENSIVELY REFORM OUR 1571 01:01:05,001 --> 01:01:07,000 HEALTH CARE SYSTE 1572 01:01:07,001 --> 01:01:09,000 THIS BILL WILL ALSO TRAIN AND 1573 01:01:09,001 --> 01:01:11,000 EXPAND THE HEALTH CARE WORKFORCE 1574 01:01:11,001 --> 01:01:13,000 SO THEY ARE PPARED TO CARE FOR 1575 01:01:13,001 --> 01:01:14,000 THE GROWING ELDERLY POPULATION. 1576 01:01:14,001 --> 01:01:16,000 BY IMPLEMENTING RECOMMENDATIONS 1577 01:01:16,001 --> 01:01:18,000 FROM THE INSTITUTE OF MEDICINE, 1578 01:01:18,001 --> 01:01:19,000 WE WILL BEGIN TO ADDRESS THE 1579 01:01:19,001 --> 01:01:21,000 SEVERE SHORTAGE WE FACE OF 1580 01:01:21,001 --> 01:01:22,000 DIRECT CARE WORKERS. 1581 01:01:22,001 --> 01:01:24,000 THIS BILL WILL PROTECT 1582 01:01:24,001 --> 01:01:26,000 VULNERABLE PATIENTS BY CREATING 1583 01:01:26,001 --> 01:01:28,000 A NATIONWIDE SYSTEM OF 1584 01:01:28,001 --> 01:01:30,000 BACKGROUND CHECKS FOR LONGTERM CARE WORKERS. 1585 01:01:30,001 --> 01:01:32,000 THIS POLICY IS MORE THAN JUST A 1586 01:01:32,001 --> 01:01:34,000 GOOD IDEA IN THEORY. 1587 01:01:34,001 --> 01:01:37,000 WE HAVE IMPLEMENTED IT IN SEVEN 1588 01:01:37,001 --> 01:01:38,000 STATES AND SEEN ITS RESULTS. 1589 01:01:38,001 --> 01:01:40,000 COMPREHENSIVE BACKGROUND CHECKS 1590 01:01:40,001 --> 01:01:41,000 ARE ROUTINE FOR THOSE WHO WORK 1591 01:01:41,001 --> 01:01:44,000 WITH YOUNG CHILDREN AND WE 1592 01:01:44,001 --> 01:01:46,000 SHOULD BE PROTECTING VULNERABLE 1593 01:01:46,001 --> 01:01:48,000 SENIORS AND DISABLED AMERICANS 1594 01:01:48,001 --> 01:01:49,000 IN THE SAME WAY. 1595 01:01:49,001 --> 01:01:50,000 THIS BILL WILL MAKE IT EASIER 1596 01:01:50,001 --> 01:01:52,000 FOR SENIORS TO GET THE CARE THEY 1597 01:01:52,001 --> 01:01:55,000 NEED IN THEIR OWN HOMES BECAUSE 1598 01:01:55,001 --> 01:01:56,000 WHEN IT 1599 01:01:56,001 --> 01:01:59,000 ONE SIDE DOES NOT FIT ALL. 1600 01:01:59,001 --> 01:02:01,000 THE GOAL OF LONG-TERM CARE 1601 01:02:01,001 --> 01:02:02,000 SHOULD BE TO ALLOW OLDER OR 1602 01:02:02,001 --> 01:02:04,000 DISABLED AMERICANS TO LIVE AS 1603 01:02:04,001 --> 01:02:06,000 INDEPENDENTLY AS POSSIBLE. 1604 01:02:06,001 --> 01:02:08,000 THIS BILL WILL HELP UPDATE OUR 1605 01:02:08,001 --> 01:02:10,000 CURRENT LONG-TERM CARE SYSTEM IN 1606 01:02:10,001 --> 01:02:12,000 ORDER TOFFER CHOICES TAILORED 1607 01:02:12,001 --> 01:02:14,000 TO AN INDIVIDUAL'S NEEDS. 1608 01:02:14,001 --> 01:02:16,000 IT WILL ALSO HELP TO ALLEVIATE 1609 01:02:16,001 --> 01:02:18,000 THE HUGE FINANCIAL AND EMOTIONAL 1610 01:02:18,001 --> 01:02:20,000 BURDEN ON MARRIED COUPLES WHO 1611 01:02:20,001 --> 01:02:23,000 NEED LONG-TERM CARE. 1612 01:02:23,001 --> 01:02:24,000 I WORKED WITH MY COLLEAGUE, 1613 01:02:24,001 --> 01:02:25,000 SENATOR CANTWELL, TO ENSURE THAT 1614 01:02:25,001 --> 01:02:27,000 MARRIED COUPLES WHO RECEIVE CARE 1615 01:02:27,001 --> 01:02:28,000 IN THEIR HOME AND COMMUNITY ARE 1616 01:02:28,001 --> 01:02:31,000 NOT REQUIRED TO SPEND THE VAST 1617 01:02:31,001 --> 01:02:34,000 MAJORITY OF 1618 01:02:34,001 --> 01:02:35,000 RECEIVE ASSISTANCE. 1619 01:02:35,001 --> 01:02:37,000 INCLUDE A PROVISION THAT WILL 1620 01:02:37,001 --> 01:02:40,000 BENEFIT ALL AMERICANS REGARDLESS 1621 01:02:40,001 --> 01:02:42,000 OF AGE BY HELPING TO LOWER THE 1622 01:02:42,001 --> 01:02:43,000 COST OF PRESCRIPTION DRUGS AND 1623 01:02:43,001 --> 01:02:45,000 MEDICAL DEVICES. 1624 01:02:45,001 --> 01:02:47,000 OUR POLICY AIMS TO MAKE 1625 01:02:47,001 --> 01:02:49,000 TRANSPARENT THE INFLUENCE OF 1626 01:02:49,001 --> 01:02:51,000 INDUSTRY GIFTS AND PAYMENTS TO DOCTORS. 1627 01:02:51,001 --> 01:02:53,000 THESE ARE ONLY A FEW OF THE 1628 01:02:53,001 --> 01:02:56,000 AGING COMMITTEE'S PRIORITIES. 1629 01:02:56,001 --> 01:02:57,000 THIS BILL MAKES MANY OTHER 1630 01:02:57,001 --> 01:02:59,000 IMPROVEMENTS IN OUR CURRENT 1631 01:02:59,001 --> 01:03:00,000 HEALTH CARE SYSTEM FOR OLDER AMERICANS. 1632 01:03:00,001 --> 01:03:02,000 OF THE SENATE BILL WILL REDUCE 1633 01:03:02,001 --> 01:03:05,000 THE COST FOR PREVENTIVE SERVICES 1634 01:03:05,001 --> 01:03:06,000 AND ADD A NEW FOCUS ON PAYING 1635 01:03:06,001 --> 01:03:08,000 DOCTORS TO KEEP PATIENTS WELL 1636 01:03:08,001 --> 01:03:10,000 AND NOT JUST PAYING THEM FOR 1637 01:03:10,001 --> 01:03:11,000 WHEN THEIR PATIENTS GET SICK. 1638 01:03:11,001 --> 01:03:15,000 TODAY'S SENIORS PAY 20% OF THE 1639 01:03:15,001 --> 01:03:17,000 COST OF MANY PREVENTIVE SERVICES 1640 01:03:17,001 --> 01:03:19,000 WHILE ELIMINATING THE CO-PAYMENT 1641 01:03:19,001 --> 01:03:22,000 AND DEDUCTIBLES IN MEDICARE FOR 1642 01:03:22,001 --> 01:03:23,000 IMPORTANT SERVICES SUCH AS 1643 01:03:23,001 --> 01:03:25,000 IMMUNIZATIONS, CHOLESTEROL 1644 01:03:25,001 --> 01:03:27,000 SCREENING, BONE CALCIUM LEVEL 1645 01:03:27,001 --> 01:03:29,000 SCREENING AND COLONOSCOPIES, WE 1646 01:03:29,001 --> 01:03:30,000 WILL HELP SAVE LIVES AS WELL AS 1647 01:03:30,001 --> 01:03:31,000 LOWER HEALTH CARE COSTS. 1648 01:03:31,001 --> 01:03:33,000 THE BILL WILL ALSO PROVIDE FOR 1649 01:03:33,001 --> 01:03:35,000 THE FIRST TIME AN ANNUAL 1650 01:03:35,001 --> 01:03:36,000 WELLNESS VISIT AT NO COST TO THE 1651 01:03:36,001 --> 01:03:38,000 MEDICARE BENEFICIARY. 1652 01:03:38,001 --> 01:03:41,000 PATIENTS WILL BE ABL TO RECEIVE 1653 01:03:41,001 --> 01:03:42,000 A PERSONALIZED HEALTH RISK 1654 01:03:42,001 --> 01:03:44,000 ASSESSMENT FOR CHRONIC DISEASE, 1655 01:03:44,001 --> 01:03:46,000 HAVE A COMPLETE REVIEW OF THEIR 1656 01:03:46,001 --> 01:03:47,000 PERSONAL AND FAMILY MEDICAL 1657 01:03:47,001 --> 01:03:49,000 HISTORY, AND RECEIVE A PLAN FOR 1658 01:03:49,001 --> 01:03:50,000 THEIR CARE. 1659 01:03:50,001 --> 01:03:51,000 THIS BILL WILL REMOVE THE 1660 01:03:51,001 --> 01:03:55,000 ABILITY OF INSURANCE COMPANIES 1661 01:03:55,001 --> 01:03:56,000 TO DENY ACCESS TO CONSUMERS 1662 01:03:56,001 --> 01:03:58,000 BASED ON PREEXISTING CONDITION. 1663 01:03:58,001 --> 01:03:59,000 WE KNOW THAT HAVING HEALTH CARE 1664 01:03:59,001 --> 01:04:02,000 IS ESSENTIAL THROUGHOUT ONE'S 1665 01:04:02,001 --> 01:04:04,000 LI 1666 01:04:04,001 --> 01:04:06,000 BUT MANY OLDER AMERICANS COUNT 1667 01:04:06,001 --> 01:04:07,000 THE DAYS UNTIL THEY BECOME 1668 01:04:07,001 --> 01:04:10,000 ELIGIBLE FOR MEDICARE BECAUSE 1669 01:04:10,001 --> 01:04:11,000 THEY'RE NOT ABLE TO FIND 1670 01:04:11,001 --> 01:04:13,000 INSURANCE COVERAGE AT ANY COST 1671 01:04:13,001 --> 01:04:16,000 DUE TO A HEALTH CONDITION IN THEIR PAST. 1672 01:04:16,001 --> 01:04:17,000 I COULD GO ON ABOUT THE MANY 1673 01:04:17,001 --> 01:04:19,000 OTHER IMPROVEMENTS SMALL AND 1674 01:04:19,001 --> 01:04:21,000 LARGE THAT WILL BENEFIT OUR 1675 01:04:21,001 --> 01:04:22,000 NATION'S SENIORS, BUT I'LL STOP 1676 01:04:22,001 --> 01:04:24,000 HERE AND SIMPLY URGE MY 1677 01:04:24,001 --> 01:04:26,000 COLLEAGUES TO WORK TO EDUCATE 1678 01:04:26,001 --> 01:04:27,000 SENIORS AND NOT SCARE THEM ABOUT 1679 01:04:27,001 --> 01:04:30,000 THE IMPORTANT CHANGES THIS BILL 1680 01:04:30,001 --> 01:04:32,000 WILL MAKE TO PROVIDE THEM WITH 1681 01:04:32,001 --> 01:04:35,000 BETTER HEALTH CARE AT LOWER COST. 1682 01:04:35,001 --> 01:04:38,000 THANK YOU, 1683 01:04:38,001 --> 01:04:43,000 THE PRESIDING OFFICER: THE 1684 01:04:43,001 --> 01:04:45,000 SENATOR FROM MONTANA. MR. BAUCUS: HOW MUCH TIME IS 1685 01:04:45,001 --> 01:04:46,000 LEFT FOR 1686 01:04:46,001 --> 01:04:47,000 THE PRESIDING 1687 01:04:47,001 --> 01:04:49,000 MINUTES. MR. BAUCUS: MR. PRESIDENT, I 1688 01:04:49,001 --> 01:04:50,000 ASK CONSENT THERE BE 1689 01:04:50,001 --> 01:04:51,000 ADDITIONAL FIVE MINUTES UNDER 1690 01:04:51,001 --> 01:04:53,000 THE CONTROL OF THE MAJORITY AT 1691 01:04:53,001 --> 01:04:55,000 THIS TIME AND THERE BE AN 1692 01:04:55,001 --> 01:04:56,000 ADDITIONAL SIX 1693 01:04:56,001 --> 01:04:58,000 FOR EACH SIDE. 1694 01:04:58,001 --> 01:04:59,000 THE PRESIDING OFFICER: WITHOUT OBJECTION. 1695 01:04:59,001 --> 01:05:03,000 MR. BAUCUS: MR. PRESIDENT I 1696 01:05:03,001 --> 01:05:05,000 NOW YIELD TO THE SENATOR FROM 1697 01:05:05,001 --> 01:05:08,000 OREGON THE REMAINING TIME, WHICH 1698 01:05:08,001 --> 01:05:10,000 WILL BE TEN MINUTES. 1699 01:05:10,001 --> 01:05:11,000 MR. WYDEN: MR. PRESIDENT? THE PRESIDING OFFICER: THE 1700 01:05:11,001 --> 01:05:12,000 SENATOR FROM OREGON. 1701 01:05:12,001 --> 01:05:15,000 MR. WYDEN: I WANT TO SPEND A 1702 01:05:15,001 --> 01:05:17,000 FEW M ABOUT MEDICARE ADVANTAGE AND 1703 01:05:17,001 --> 01:05:19,000 PARTICULARLY TO HIGHLIGHT THE FACT THAT I THINK IT IS 1704 01:05:19,001 --> 01:05:21,000 IMPORTANT TO SUPPORT THE 1705 01:05:21,001 --> 01:05:22,000 LANGUAGE PUT TOGETHER BY THE 1706 01:05:22,001 --> 01:05:23,000 CHAIRMAN OF THE FINANCE 1707 01:05:23,001 --> 01:05:26,000 COMMITTEE ON MEDICARE ADVANTAGE 1708 01:05:26,001 --> 01:05:29,000 AND TO REJECT THE AMENDMENT 1709 01:05:29,001 --> 01:05:31,000 OFFERED BY OUR FRIEND FROM UTAH, SENATOR HATCH. 1710 01:05:31,001 --> 01:05:34,000 AND I WANT TO BEGIN MY COMMENTS 1711 01:05:34,001 --> 01:05:35,000 WITH RESPECT TO MEDICARE 1712 01:05:35,001 --> 01:05:38,000 ADVANTAGE BY POINTING OUT THAT 1713 01:05:38,001 --> 01:05:41,000 IT IS CLEAR THAT NOT ALL 1714 01:05:41,001 --> 01:05:42,000 MEDICARE ADVANTAGE IS CREATED 1715 01:05:42,001 --> 01:05:44,000 EQUAL. 1716 01:05:44,001 --> 01:05:46,000 SOME MEDICARE ADVANTAGE IS A 1717 01:05:46,001 --> 01:05:51,000 MODEL OF EFFICIENCY AND SOME OF 1718 01:05:51,001 --> 01:05:52,000 IT IS PRETTY MUCH A RIP-OFF OF 1719 01:05:52,001 --> 01:05:55,000 BOTH TAXPAYERS AND SENIORS. 1720 01:05:55,001 --> 01:05:57,000 AND I'D REFER, AS IT RELATES TO 1721 01:05:57,001 --> 01:05:59,000 THE ABUSIVE PLANS, TO THE VERY 1722 01:05:59,001 --> 01:06:01,000 IMPORTANT HEARINGS CHAIRED BY 1723 01:06:01,001 --> 01:06:04,000 SENATOR BAUCUS IN THE FINANCE COMMITTEE. 1724 01:06:04,001 --> 01:06:06,000 I RECALL ON ONE OCCASION SITTING 1725 01:06:06,001 --> 01:06:08,000 NEXT TO OUR FRIEND FROM 1726 01:06:08,001 --> 01:06:11,000 ARKANSAS, SENATOR LINCOLN, WE 1727 01:06:11,001 --> 01:06:13,000 HAD WITNESSES DESCRIBE HOW 1728 01:06:13,001 --> 01:06:17,000 MEDICARE ADVANTAGEAS BEING 1729 01:06:17,001 --> 01:06:19,000 SOLD DOOR TO DOOR IN HER PART OF 1730 01:06:19,001 --> 01:06:22,000 THE COUNTRY BY INDIVIDUALS 1731 01:06:22,001 --> 01:06:24,000 DRESSED UP IN SCRUBS AS 1732 01:06:24,001 --> 01:06:26,000 PHYSICIANS AND HEALTH CARE PROVIDERS. 1733 01:06:26,001 --> 01:06:29,000 AND IN THE DISCUSSION OF HOW TO 1734 01:06:29,001 --> 01:06:32,000 HANDLE IT, WE LOOKED AT VARIOUS 1735 01:06:32,001 --> 01:06:34,000 KINDS OF REFORMS TO REIN IN ABUSIVE PRACTICES. 1736 01:06:34,001 --> 01:06:42,000 I CAME TO THE CONCLUSION, WHEN 1737 01:06:42,001 --> 01:06:43,000 YOU DO SOMETHING LIKE THAT, THE 1738 01:06:43,001 --> 01:06:45,000 C.E.O.'S OUGHT TO BE PUT IN 1739 01:06:45,001 --> 01:06:46,000 SKWRAEUFPLT THAT IS WHAT IS 1740 01:06:46,001 --> 01:06:47,000 DOCUMENTED ON THE R 1741 01:06:47,001 --> 01:06:49,000 RELATION TO THE COMMITTEES HELD 1742 01:06:49,001 --> 01:06:51,000 IN THE SENATE FINANCE COMMITTEE 1743 01:06:51,001 --> 01:06:52,000 AND WHY I COME TO THE FLOOR. 1744 01:06:52,001 --> 01:06:55,000 I THINK IT IS IMPORTANT TPO 1745 01:06:55,001 --> 01:06:56,000 DISTINISH BETWEEN THE 1746 01:06:56,001 --> 01:06:57,000 GOOD-QUALITY MEDICARE ADVANTAGE 1747 01:06:57,001 --> 01:06:58,000 PLANS AND THOSE THAT HAVE BEEN 1748 01:06:58,001 --> 01:06:59,000 LIVING HIGH ON THE HOG THROUGH 1749 01:06:59,001 --> 01:07:02,000 SOME OF THE OVERPAYMENTS THAT WE 1750 01:07:02,001 --> 01:07:04,000 HAVE DOCUMENTED ON THIS FLOOR. 1751 01:07:04,001 --> 01:07:07,000 MR. PRESIDENT, MY STATE HAS THE 1752 01:07:07,001 --> 01:07:09,000 HIGHEST PERCENTAGE OF OLDER 1753 01:07:09,001 --> 01:07:10,000 PEOPLE IN MEDICARE ADVANTAGE IN 1754 01:07:10,001 --> 01:07:12,000 THE COUNTRY. 1755 01:07:12,001 --> 01:07:15,000 AND I HAD AN OPPORTUNITY TO WORK 1756 01:07:15,001 --> 01:07:17,000 CLOSELY WITH CHAIRMAN BAUCUS IN 1757 01:07:17,001 --> 01:07:19,000 TERMS OF 1758 01:07:19,001 --> 01:07:21,000 ADVANTAGE, AND I THINK WITH THE 1759 01:07:21,001 --> 01:07:28,000 CHAIRMAN'S LEADERSHIP IT'S BEEN 1760 01:07:28,001 --> 01:07:30,000 FIND SAVINGS IN THE MEDICARE 1761 01:07:30,001 --> 01:07:33,000 PROGRAM WITHOUT HARMING OLDER 1762 01:07:33,001 --> 01:07:35,000 PEOPLE, WITHOUT REDUCING THEIR 1763 01:07:35,001 --> 01:07:37,000 GUARANTEED 1764 01:07:37,001 --> 01:07:40,000 ESSENTIAL BENEFITS, AS WE HAVE 1765 01:07:40,001 --> 01:07:41,000 LEARNED WITH MEDICARE ADVANTAGE. 1766 01:07:41,001 --> 01:07:44,000 THE WAY CHAIRMAN BAUCUS GOES 1767 01:07:44,001 --> 01:07:45,000 ABOUT DOING THAT IS BYORCING 1768 01:07:45,001 --> 01:07:48,000 THE INEFFICIENT MEDICARE 1769 01:07:48,001 --> 01:07:50,000 ADVANTAGE PLANS TO FOLLOW THE 1770 01:07:50,001 --> 01:07:52,000 MODEL OF THE EFFICIENT ONES. 1771 01:07:52,001 --> 01:07:55,000 AND THE WAY WE HAVE BEEN ABLE TO 1772 01:07:55,001 --> 01:07:57,000 DO THAT IS ESSENTIALLY THROUGH A 1773 01:07:57,001 --> 01:08:00,000 TWO-PART STRATEGY. 1774 01:08:00,001 --> 01:08:01,000 FIRST, ENCOURAGE COMPETIVE 1775 01:08:01,001 --> 01:08:03,000 BIDDING. 1776 01:08:03,001 --> 01:08:05,000 AND, SECOND, PROVIDE INCENTIVES 1777 01:08:05,001 --> 01:08:08,000 FOR QUALITY, WHICH IS DONE 1778 01:08:08,001 --> 01:08:10,000 THROUGH THE BONUS PAYMENT 1779 01:08:10,001 --> 01:08:11,000 PROVISIONS THAT ARE IN THE 1780 01:08:11,001 --> 01:08:15,000 LEGISLATION. 1781 01:08:15,001 --> 01:08:17,000 SO FIRST, ON COMPETIVE 1782 01:08:17,001 --> 01:08:20,000 BIDDING, YOU HAVE PLAN BIDS -- 1783 01:08:20,001 --> 01:08:21,000 YOU USE THE PLAN BIDS TO SET 1784 01:08:21,001 --> 01:08:22,000 MEDICARE ADVANTAGE BENCHMARKS 1785 01:08:22,001 --> 01:08:24,000 WHICH WOULD ENCOURAGE THE PLANS 1786 01:08:24,001 --> 01:08:28,000 TO COMPETE MORE DIRECTLY ON THE 1787 01:08:28,001 --> 01:08:29,000 BASIS OF PRICE AND QUALITY 1788 01:08:29,001 --> 01:08:30,000 RATHER THAN ON THE LEVEL OF 1789 01:08:30,001 --> 01:08:32,000 EXTRA BENEFITS OFFERED TO THOSE 1790 01:08:32,001 --> 01:08:35,000 WHO ARE ENROLLING. 1791 01:08:35,001 --> 01:08:36,000 WITH COMPETITIVE BIDDING, PLANS 1792 01:08:36,001 --> 01:08:37,000 COMPETE TO BE THE MOST EFFICIENT 1793 01:08:37,001 --> 01:08:39,000 AND HOLD DOWN COSTS. 1794 01:08:39,001 --> 01:08:42,000 I WANT TO COMMEND CHAIRMAN 1795 01:08:42,001 --> 01:08:47,000 BAUCUS FOR MAKING THIS A CENTRAL 1796 01:08:47,001 --> 01:08:48,000 ADVANTAGE WOULD BE HANDLED, AND 1797 01:08:48,001 --> 01:08:49,000 CERTAINLY OUR PART OF THE 1798 01:08:49,001 --> 01:08:52,000 COUNTRY HAS SHOWN THIS IS A PATH 1799 01:08:52,001 --> 01:08:53,000 TO GET MORE VALUE FOR THE 1800 01:08:53,001 --> 01:08:55,000 MEDICARE ADVANTAGE DOLLAR IN THE 1801 01:08:55,001 --> 01:08:57,000 DAYS AHEAD. 1802 01:08:57,001 --> 01:08:58,000 IN ADDITION, IN THE FINANCE 1803 01:08:58,001 --> 01:09:00,000 COMMITTEE, I OFFERED AN 1804 01:09:00,001 --> 01:09:04,000 AMENDMENT WITH SEVERAL KAOEGZ 1805 01:09:04,001 --> 01:09:05,000 THAT -- 1806 01:09:05,001 --> 01:09:07,000 SEVERAL COLLEAGUES THAT WOULD 1807 01:09:07,001 --> 01:09:08,000 BOOST THE PAYMENT TO THOSE PLANS 1808 01:09:08,001 --> 01:09:09,000 THAT ACCORDING TO THE 1809 01:09:09,001 --> 01:09:11,000 GOVERNMENT -- AND THE GOVERNMENT 1810 01:09:11,001 --> 01:09:13,000 USES A SYSTEM OF STARS IN EFFECT 1811 01:09:13,001 --> 01:09:15,000 TO REWARD QUALITY. 1812 01:09:15,001 --> 01:09:18,000 OUR AMENDMENT WOULD BOOST THE 1813 01:09:18,001 --> 01:09:22,000 PAYMENTS TO THOSE MEDICARE 1814 01:09:22,001 --> 01:09:23,000 ADVANTAGE PLANS WITH FOUR- AND 1815 01:09:23,001 --> 01:09:25,000 FIVE-STAR QUALITY RATED. 1816 01:09:25,001 --> 01:09:26,000 SO IN EFFECT WITH OUR 1817 01:09:26,001 --> 01:09:29,000 LEGISLATION, THERE ARE BOTH 1818 01:09:29,001 --> 01:09:32,000 CARROTS AND STICKS. 1819 01:09:32,001 --> 01:09:33,000 COMPETITIVE BIDDING PLUS BONUS 1820 01:09:33,001 --> 01:09:35,000 PAYMENTS OFFERS BOTH, SO THAT 1821 01:09:35,001 --> 01:09:37,000 THE PLANS COMPETE TO PROVIDE THE 1822 01:09:37,001 --> 01:09:39,000 BEST VALUE FOR SENIORS BY 1823 01:09:39,001 --> 01:09:41,000 ENCOURAGING THE PLANS TO BE MORE 1824 01:09:41,001 --> 01:09:43,000 EFFICIENT, IT'S POSSIBLE TO 1825 01:09:43,001 --> 01:09:46,000 ACHIEVE SIGNIFICANT SAVINGS FOR 1826 01:09:46,001 --> 01:09:47,000 OLDER PEOPLE, HELP SHORE UP THE 1827 01:09:47,001 --> 01:09:50,000 SOLVENCY OF THE MEDICARE TRUST 1828 01:09:50,001 --> 01:09:52,000 FUND AND MEET THE COST-SAVING 1829 01:09:52,001 --> 01:09:54,000 GOALS OF THE LEGISLATION. 1830 01:09:54,001 --> 01:09:56,000 ONE FINAL POINT THAT HAS BEEN 1831 01:09:56,001 --> 01:09:58,000 DISCUSSED BY COLLEAGUES ON THE 1832 01:09:58,001 --> 01:10:01,000 FLOOR OF THE SENATE, AND THAT IS 1833 01:10:01,001 --> 01:10:04,000 THIS MATTER OF INDIVIDUALS BEING 1834 01:10:04,001 --> 01:10:06,000 ABLE TO KEEP WHAT THEY HAVE. 1835 01:10:06,001 --> 01:10:09,000 AND I HAVE HEARD THAT THAT IS 1836 01:10:09,001 --> 01:10:10,000 NOT THE CASE WITH MEDICARE 1837 01:10:10,001 --> 01:10:12,000 ADVANTAGE PLANS. 1838 01:10:12,001 --> 01:10:14,000 THAT SOMEHOW UNDER THE 1839 01:10:14,001 --> 01:10:16,000 LEGISLATION THAT HAS BEEN 1840 01:10:16,001 --> 01:10:17,000 OFFERED BY THE FINANCE 1841 01:10:17,001 --> 01:10:20,000 COMMITTEE, OLDER PEOPLE WOULD 1842 01:10:20,001 --> 01:10:22,000 NOT BE ABLE TO KEEP WHAT THEY 1843 01:10:22,001 --> 01:10:23,000 HAVE, ACCORDING TO SOME ON THE 1844 01:10:23,001 --> 01:10:27,000 FLOOR. 1845 01:10:27,001 --> 01:10:29,000 THAT IS SIMPLY ICCURATE. 1846 01:10:29,001 --> 01:10:32,000 SENIORS WHO HAVE MEDICARE 1847 01:10:32,001 --> 01:10:35,000 ADVANTAGE PLANS UNDER THE BAUCUS 1848 01:10:35,001 --> 01:10:38,000 LEGISLATION WILL BE ABLE TO KEEP THOSE PLANS. 1849 01:10:38,001 --> 01:10:42,000 THEY'LL BE ABLE TO STAY WITH 1850 01:10:42,001 --> 01:10:43,000 WHAT THEY HAVE, KEEP THEIR 1851 01:10:43,001 --> 01:10:45,000 GUARANTEED ESSENTIAL BENEFITS, 1852 01:10:45,001 --> 01:10:47,000 AND THROUGH THE LANGUAGE THAT 1853 01:10:47,001 --> 01:10:48,000 HAS BEEN AUTHORED NOW IN THE 1854 01:10:48,001 --> 01:10:52,000 LEGISLATION BEFORE US, THERE 1855 01:10:52,001 --> 01:10:54,000 WILL BE LOWER COSTS FOR TAXPAYERS. 1856 01:10:54,001 --> 01:10:56,000 LAST POINT, MR. CHAIRMAN, I'VE 1857 01:10:56,001 --> 01:10:58,000 HEARD A LOT OF TALK ABOUT 1858 01:10:58,001 --> 01:10:59,000 GRANDMA ON THE FLOOR OF THE 1859 01:10:59,001 --> 01:11:01,000 UNITED STATES SENATE. 1860 01:11:01,001 --> 01:11:02,000 I SPENT THE BULK OF MY 1861 01:11:02,001 --> 01:11:04,000 PROFESSIONAL LIFE IN EFFECT 1862 01:11:04,001 --> 01:11:06,000 WORKING WITH GRANDMA. 1863 01:11:06,001 --> 01:11:08,000 I WAS THE COFINDER OF THE OREGON 1864 01:11:08,001 --> 01:11:11,000 GRAY PANTHERS, RAN 1865 01:11:11,001 --> 01:11:13,000 PROGRAM FOR OLDER PEOPLE IN OUR 1866 01:11:13,001 --> 01:11:15,000 HOME STATE FOR A NUMBER OF 1867 01:11:15,001 --> 01:11:18,000 YEARS, AND I WANT IT UNDERSTOOD 1868 01:11:18,001 --> 01:11:20,000 THAT I THINK WITH THE BAUCUS 1869 01:11:20,001 --> 01:11:22,000 LEGISLATION ON MEDICARE 1870 01:11:22,001 --> 01:11:25,000 ADVANTAGE THAT PROVES THAT IT IS 1871 01:11:25,001 --> 01:11:27,000 POSSIBLE 1872 01:11:27,001 --> 01:11:29,000 MEDICARE PROGRAM WITHOUT CUTTING 1873 01:11:29,001 --> 01:11:31,000 ESSENTIAL BENEFITS, USING 1874 01:11:31,001 --> 01:11:34,000 COMMONSENSE PRINCIPLES OF 1875 01:11:34,001 --> 01:11:37,000 COMPETITIVE BIDDING, NUMBER ONE, 1876 01:11:37,001 --> 01:11:39,000 AND 1877 01:11:39,001 --> 01:11:41,000 THINK GRANDMA'S GOING TO BE JUST 1878 01:11:41,001 --> 01:11:42,000 FINE UNDER OUR LANGUAGE FOR 1879 01:11:42,001 --> 01:11:44,000 MEDICARE 1880 01:11:44,001 --> 01:11:45,000 MR. PRESIDENT W-RBGS THAT, 1881 01:11:45,001 --> 01:11:47,000 YIELD THE FLOOR. 1882 01:11:47,001 --> 01:11:52,000 -- MR. PRESIDENT, WITH THAT, I 1883 01:11:52,001 --> 01:11:53,000 YIELD THE 1884 01:11:53,001 --> 01:11:55,000 MR. BAUCUS: HOW MUCH TIME 1885 01:11:55,001 --> 01:11:57,000 REMA 1886 01:11:57,001 --> 01:11:59,000 THE PRESIDING OFFICER: THREE MINUTES. 1887 01:11:59,001 --> 01:12:01,000 SIDE? 1888 01:12:01,001 --> 01:12:02,000 THE PRESIDING OFFICER: 55 1889 01:12:02,001 --> 01:12:03,000 MINUTES. 1890 01:12:03,001 --> 01:12:08,000 MR. BAUCUS: I RESERVE T 1891 01:12:08,001 --> 01:12:12,000 BALANCE OF THE MAJORITY T 1892 01:12:12,001 --> 01:12:14,000 SENATOR FROM 1893 01:12:14,001 --> 01:12:16,000 MR. ALEXANDER: MR. PRESIDENT, 1894 01:12:16,001 --> 01:12:17,000 DURING THE 1895 01:12:17,001 --> 01:12:19,000 WE'LL HAVE SEVERAL REPUBLICAN 1896 01:12:19,001 --> 01:12:20,000 SENATORS COME TO THE FLOOR. 1897 01:12:20,001 --> 01:12:21,000 AND I ASK UNANIMOUS CONSENT THAT 1898 01:12:21,001 --> 01:12:23,000 DURING THAT TIME SENATOR 1899 01:12:23,001 --> 01:12:26,000 McCAIN BE ALLOWED TO BE THE 1900 01:12:26,001 --> 01:12:27,000 MANAGER OF A COLLOQUY AMONG THE 1901 01:12:27,001 --> 01:12:28,000 REPUBLICAN SENATORS. 1902 01:12:28,001 --> 01:12:29,000 THANK YOU, MR. PRESIDENT. 1903 01:12:29,001 --> 01:12:30,000 THE PRESIDING OFFICER: WITHOUT 1904 01:12:30,001 --> 01:12:31,000 OBJECTION. 1905 01:12:31,001 --> 01:12:33,000 MR. ALEXANDER: BEFORE SENATOR 1906 01:12:33,001 --> 01:12:35,000 McCAIN BEGINS, I'D LIKE TO, IF 1907 01:12:35,001 --> 01:12:38,000 I MAY TAKE A MOMENT JUST TO 1908 01:12:38,001 --> 01:12:40,000 ESTABLISH WHERE WE 1909 01:12:40,001 --> 01:12:45,000 WHAT HAPPENED YESTERDAY, AND AS 1910 01:12:45,001 --> 01:12:46,000 A LEAD-IN TO WHAT HE'S ABOUT TO DISCUSS. 1911 01:12:46,001 --> 01:12:48,000 YESTERDAY SENATOR McCAIN 1912 01:12:48,001 --> 01:12:49,000 OFFERED AN AMENDMENT ON THE 1913 01:12:49,001 --> 01:12:50,000 FLOOR OF THE SENATE THAT WOULD 1914 01:12:50,001 --> 01:12:51,000 DO TWO THINGS. 1915 01:12:51,001 --> 01:12:54,000 IT WOULD SEND BACK TO THE 1916 01:12:54,001 --> 01:12:55,000 FINANCE COMMITTEE THIS, THE 1917 01:12:55,001 --> 01:12:57,000 DEMOCRATIC HEALTH CARE BILL, 1918 01:12:57,001 --> 01:12:58,000 WHICH IS THE 2,000-PAGE BILL 1919 01:12:58,001 --> 01:13:00,000 RIGHT HERE. 1920 01:13:00,001 --> 01:13:02,000 AND IT WOULD SAY TO THEM, ONE, 1921 01:13:02,001 --> 01:13:05,000 TAKE OUT THE CUTS INEDICARE. 1922 01:13:05,001 --> 01:13:07,000 AND, TWO, ANY SAVINGS IN 1923 01:13:07,001 --> 01:13:08,000 MEDICARE MUST GO TO MAKE 1924 01:13:08,001 --> 01:13:11,000 MEDICARE MORE SOLVENT. 1925 01:13:11,001 --> 01:13:13,000 THAT WAS THE McCAIN AMENDMENT. 1926 01:13:13,001 --> 01:13:15,000 THAT WAS DEFEATED. 1927 01:13:15,001 --> 01:13:16,000 58 DEMOCRATS SAID YES TO THE 1928 01:13:16,001 --> 01:13:19,000 CUTS IN MEDICARE. 1929 01:13:19,001 --> 01:13:21,000 THEY SAID NO TO USING -- THEY 1930 01:13:21,001 --> 01:13:24,000 SAID YES TO USING THE MONEY THAT 1931 01:13:24,001 --> 01:13:27,000 COMES FROM THESE CUTS TO CREATE 1932 01:13:27,001 --> 01:13:29,000 A NEW ENTITLEMENT PROGRAM. 1933 01:13:29,001 --> 01:13:31,000 40 REPUBLICANS SAID NO, WE DON'T 1934 01:13:31,001 --> 01:13:33,000 WANT TO DO THAT, AND TWO 1935 01:13:33,001 --> 01:13:34,000 DEMOCRATS JOINED IN THAT AS WELL. 1936 01:13:34,001 --> 01:13:37,000 SO YESTERDAY WE MADE IT CLEAR 1937 01:13:37,001 --> 01:13:38,000 THAT THE CENTRAL CORE OF 1938 01:13:38,001 --> 01:13:40,000 BILL INCLUDES NEARLY $500 1939 01:13:40,001 --> 01:13:42,000 BILLION IN CUTS IN MEDICARE. 1940 01:13:42,001 --> 01:13:43,000 THERE'S NO QUESTION ABOUT THAT. 1941 01:13:43,001 --> 01:13:45,000 EVERYONE CONCEDES THAT. 1942 01:13:45,001 --> 01:13:47,000 THE PRESIDENT HAS SAID THAT WHEN 1943 01:13:47,001 --> 01:13:48,000 HE ADDRESSED US. THE CONGRESSIONAL BUDGET OFFICE 1944 01:13:48,001 --> 01:13:49,000 SAYS THAT. 1945 01:13:49,001 --> 01:13:52,000 THE QUESTION IS WHETHER IT'S A 1946 01:13:52,001 --> 01:13:55,000 GOOD IDEA OR BAD IDEA. 1947 01:13:55,001 --> 01:13:58,000 AND YESTERDAY BY 58 VOTES THE 1948 01:13:58,001 --> 01:13:59,000 DEMOCRATS SAID YES TO THESE CUTS 1949 01:13:59,001 --> 01:14:00,000 IN M 1950 01:14:00,001 --> 01:14:01,000 TODAY WHAT WE WANT TO DO IS TALK 1951 01:14:01,001 --> 01:14:04,000 ABOUT ONE OF THOSE CUTS AND TO 1952 01:14:04,001 --> 01:14:07,000 TRY TO DO IT IN A CAREFUL, 1953 01:14:07,001 --> 01:14:09,000 ACCURATE WAY SO THAT 11 MILLION 1954 01:14:09,001 --> 01:14:12,000 SENIORS WHO HAVE MEDICARE 1955 01:14:12,001 --> 01:14:17,000 WHAT THE RISK IS TO THEIR 1956 01:14:17,001 --> 01:14:18,000 YOU CAN SEE THAT UNDER THE CUTS 1957 01:14:18,001 --> 01:14:22,000 APPROVED, AGAIN, YESTERDAY IN 1958 01:14:22,001 --> 01:14:24,000 THIS BILL ARE $120 BILLION OVER 1959 01:14:24,001 --> 01:14:25,000 THE NEXT TEN YEARS IN CUTS TO 1960 01:14:25,001 --> 01:14:27,000 MEDICARE ADVANTAGE. 1961 01:14:27,001 --> 01:14:30,000 WHAT IS MEDICARE ADVANTAGE? 1962 01:14:30,001 --> 01:14:33,000 MEDICARE 1963 01:14:33,001 --> 01:14:35,000 THAT SENIORS HAVE. 1964 01:14:35,001 --> 01:14:37,000 MEDICARE, IF YOU CHOOSE THAT 1965 01:14:37,001 --> 01:14:38,000 OPTION, PAYS A FIXED AMOUNT FOR 1966 01:14:38,001 --> 01:14:39,000 YOUR CARE EVERY YEAFOR 1967 01:14:39,001 --> 01:14:40,000 COMPANIES THAT MIGHT COME TO YOU 1968 01:14:40,001 --> 01:14:43,000 AND OFFER A MEDICARE ADVANTAGE 1969 01:14:43,001 --> 01:14:44,000 PLAN WHICH YOU CAN 1970 01:14:44,001 --> 01:14:47,000 INSTEAD OF THE ORIGINAL MEDICARE 1971 01:14:47,001 --> 01:14:50,000 PLAN. 1972 01:14:50,001 --> 01:14:51,000 MANY SENIORS CHOOSE THESE PLANS. 1973 01:14:51,001 --> 01:14:54,000 11 MILLION SENIORS, NEARLY ONE 1974 01:14:54,001 --> 01:14:55,000 OUT OF FOUR SENIORS IN AMERICA, 1975 01:14:55,001 --> 01:14:57,000 WHO IS PART OF MEDICARE, CHOOSES 1976 01:14:57,001 --> 01:14:58,000 THE MEDICARE ADVANTAGE PLAN N MY 1977 01:14:58,001 --> 01:15:01,000 HOME STATE OF TENNESSEE, THE 1978 01:15:01,001 --> 01:15:02,000 NUER IS TENNESSEANS. 1979 01:15:02,001 --> 01:15:04,000 WHY DO THEY CHOOSE IT? 1980 01:15:04,001 --> 01:15:06,000 WELL, 1981 01:15:06,001 --> 01:15:07,000 THAT THEY MAY NOT HAVE IN THE 1982 01:15:07,001 --> 01:15:10,000 ORIGINAL MEDICARELAN. 1983 01:15:10,001 --> 01:15:13,000 THESE ARE DENTAL CARE, VISION 1984 01:15:13,001 --> 01:15:14,000 CARE, HEARING COVERAGE, REDUCED 1985 01:15:14,001 --> 01:15:16,000 HOSPITAL DEDUCTIBLES, INCLUDES 1986 01:15:16,001 --> 01:15:17,000 LOWER CO-PAYMENTS, LOWER 1987 01:15:17,001 --> 01:15:19,000 PREMIUMS, COORDINATED CHRONIC 1988 01:15:19,001 --> 01:15:22,000 CARE MANAGEMENT,ND PHYSICAL 1989 01:15:22,001 --> 01:15:24,000 FITNESS PROGRAMS. 1990 01:15:24,001 --> 01:15:25,000 NOW, THE DISTINGUISHED SENATOR 1991 01:15:25,001 --> 01:15:28,000 FROM OREGON WAS ON THE FLOOR. 1992 01:15:28,001 --> 01:15:30,000 HE MENTIONED 1993 01:15:30,001 --> 01:15:32,000 I'VE MENTIONED GRANDMA A FEW TIMES. 1994 01:15:32,001 --> 01:15:33,000 NO DISRESPECT TO GRANDPA. 1995 01:15:33,001 --> 01:15:35,000 HE IS IN THE SAME BOAT. 1996 01:15:35,001 --> 01:15:36,000 AND HE SAID THAT GRANDMA DIDN'T 1997 01:15:36,001 --> 01:15:38,000 NEED TO WORRY ABOUT HER MEDICARE 1998 01:15:38,001 --> 01:15:40,000 ADVANTAGE PLAN BECAUSE NONE OF 1999 01:15:40,001 --> 01:15:42,000 THE BENEFITS WOULD BE CUT. 2000 01:15:42,001 --> 01:15:44,000 BUT, MR. PRESIDENT, THAT'S NOT 2001 01:15:44,001 --> 01:15:45,000 WHAT THE DIRECTOR OF THE 2002 01:15:45,001 --> 01:15:52,000 CONGRESSIONAL BUDGET OFFICE, 2003 01:15:52,001 --> 01:15:53,000 WHO'S OFTEN SITED CITED BY THE BUDGET 2004 01:15:53,001 --> 01:15:57,000 OF THE COMMITTEE. 2005 01:15:57,001 --> 01:15:59,000 HE SAID THAT NEARLY HALF OF THE 2006 01:15:59,001 --> 01:16:00,000 BENEFITS CURRENTLY PVIDED TO 2007 01:16:00,001 --> 01:16:01,000 SENIORS WOULD DISAPPEAR UNDER 2008 01:16:01,001 --> 01:16:03,000 THE FINANCE COMMITTEE PLAN WHICH 2009 01:16:03,001 --> 01:16:05,000 IS MUCH LIKE THE PLAN WE'RE CONSIDERING. 2010 01:16:05,001 --> 01:16:06,000 THESE WOULD INCLUDE THOSE I WAS 2011 01:16:06,001 --> 01:16:10,000 MENTIONING. 2012 01:16:10,001 --> 01:16:11,000 SO TODAY, MR. PRESIDENT, WITH 2013 01:16:11,001 --> 01:16:14,000 SENATOR McCAIN LEADING THE 2014 01:16:14,001 --> 01:16:17,000 DISCUSSION, WE'D LIKE TO TALK 2015 01:16:17,001 --> 01:16:21,000 ABOUT THE MEDICARE ADVANTAGE 2016 01:16:21,001 --> 01:16:22,000 PLAN AND WHY IT'S SUCH A 2017 01:16:22,001 --> 01:16:24,000 ESSENTIAL PART OF THIS BILL. 2018 01:16:24,001 --> 01:16:25,000 THIS IS A $2.5 TRILLION BILL. 2019 01:16:25,001 --> 01:16:27,000 THAT'S WHAT IT WOULD COST OVER 2020 01:16:27,001 --> 01:16:29,000 TEN YEARS. 2021 01:16:29,001 --> 01:16:32,000 AND ABOUT HALF IT 2022 01:16:32,001 --> 01:16:34,000 THESE MEDICAID CUTS AND THE -- 2023 01:16:34,001 --> 01:16:36,000 MEDICARE CUTS 2024 01:16:36,001 --> 01:16:37,000 TALKING ABOUT TODAY IS THE 2025 01:16:37,001 --> 01:16:39,000 MEDICARE ADVANTAGE PLAN. 2026 01:16:39,001 --> 01:16:41,000 I UNDERSTAND THERE WILL BE AN 2027 01:16:41,001 --> 01:16:43,000 AMENDMENT BY SENATOR HATCH, WHO 2028 01:16:43,001 --> 01:16:44,000 I'M SURE WILL TALK ABOUT HIS OWN AMENDMENT. 2029 01:16:44,001 --> 01:16:46,000 HE OF COURSE WAS PRESENT ON THE 2030 01:16:46,001 --> 01:16:47,000 FINANCE COMMITTEE, A L 2031 01:16:47,001 --> 01:16:48,000 MEMBER, WHEN MEDICARE ADVAN 2032 01:16:48,001 --> 01:16:51,000 WAS CREATED -- THAT THERE WILL 2033 01:16:51,001 --> 01:16:52,000 BE AN AMENDMENT TODAY TO SAY 2034 01:16:52,001 --> 01:16:54,000 SEND BACK TO THE FINANCE 2035 01:16:54,001 --> 01:16:57,000 COMMITTEE AND SAY DON'T CUT 2036 01:16:57,001 --> 01:16:59,000 MEDICARE ADVANTAGE. 2037 01:16:59,001 --> 01:17:01,000 MR. McCAIN: I LISTENED TO 2038 01:17:01,001 --> 01:17:02,000 SENATOR HATCH'S VERY IMPORTANT 2039 01:17:02,001 --> 01:17:05,000 STATEMENT LAST NIGHT, WHICH HE 2040 01:17:05,001 --> 01:17:07,000 WILL ADD TO TODAY. 2041 01:17:07,001 --> 01:17:08,000 HE WAS ABLE TO TAKE US DOWN 2042 01:17:08,001 --> 01:17:11,000 TRIP ON MEMORY LANE. 2043 01:17:11,001 --> 01:17:13,000 IN JUNE 2003 WHEN THE MEDICARE 2044 01:17:13,001 --> 01:17:15,000 MODERNIZATION ACT WAS BEFORE 2045 01:17:15,001 --> 01:17:17,000 SENATE, SEVERAL OUR COLLEAGUES, 2046 01:17:17,001 --> 01:17:18,000 INCLUDING SENATOR SCHUMER AND 2047 01:17:18,001 --> 01:17:21,000 KERRY, OFFERED A BIPARTISAN 2048 01:17:21,001 --> 01:17:22,000 AMENDMENT ON THE FLOOR TO 2049 01:17:22,001 --> 01:17:24,000 PROVIDE ADDITIONAL FUNDING FOR 2050 01:17:24,001 --> 01:17:26,000 BENEFITS UNDER THE MEDICARE 2051 01:17:26,001 --> 01:17:28,000 ADVANTAGE PROGRAM. 2052 01:17:28,001 --> 01:17:30,000 BUT AMNESIA IS NOT CONFINED TO 2053 01:17:30,001 --> 01:17:31,000 ONE SIDE OF THE AISLE AROUND 2054 01:17:31,001 --> 01:17:34,000 HERE. 2055 01:17:34,001 --> 01:17:36,000 BUT 2056 01:17:36,001 --> 01:17:37,000 FRIEND FROM 2057 01:17:37,001 --> 01:17:39,000 -- YOU KNOW, THIS DISCUSSION 2058 01:17:39,001 --> 01:17:42,000 ABOUT MEDICARE ADVANTAGE. 2059 01:17:42,001 --> 01:17:44,000 WE HAVE TO BETTER UNDERSTAND, 2060 01:17:44,001 --> 01:17:46,000 WHAT IS 2061 01:17:46,001 --> 01:17:50,000 IT SO 2062 01:17:50,001 --> 01:17:52,000 IS IT BECAUSE IT OFFERS SENIORS 2063 01:17:52,001 --> 01:17:53,000 A CHANCE TO GET ADDITIONAL 2064 01:17:53,001 --> 01:17:54,000 BENEFITS? 2065 01:17:54,001 --> 01:17:56,000 MAYBE YOU COULD JUST GIVE ME A 2066 01:17:56,001 --> 01:17:57,000 SHORT DEFINITION OF THAT BECAUSE 2067 01:17:57,001 --> 01:18:00,000 I THINK THE AMERICAN PEOPLE MAY 2068 01:18:00,001 --> 01:18:03,000 NOT BE TOTALLY CLEAR OF WHAT 2069 01:18:03,001 --> 01:18:06,000 WE'RE DISCUSSIN DISCUSSING HERE AND WHY 2070 01:18:06,001 --> 01:18:09,000 MILLION MEN'S -- 300,000 2071 01:18:09,001 --> 01:18:12,000 CITIZENS IN MY OWN STATE -- HAVE 2072 01:18:12,001 --> 01:18:14,000 CHOSEN MEDICARE AANTAGE AND 2073 01:18:14,001 --> 01:18:16,000 HAS PROMPTED, ACCORDING TO 2074 01:18:16,001 --> 01:18:19,000 BLOOMBERG, SENATOR CASEY OF 2075 01:18:19,001 --> 01:18:20,000 PENNSYLVANIA TO SAY, QUOTE, 2076 01:18:20,001 --> 01:18:22,000 "WE'RE NOT GOING TO BE ABLE TO 2077 01:18:22,001 --> 01:18:25,000 SAY, IF YOU LIKE WHAT YOU HAVE, 2078 01:18:25,001 --> 01:18:27,000 YOU CAN DEEP," SAID SENATOR BOB 2079 01:18:27,001 --> 01:18:28,000 CASEY, A PENNSYLVANIA DEMOCRAT. 2080 01:18:28,001 --> 01:18:29,000 THAT BASIC COMMITMENT THAT A LOT 2081 01:18:29,001 --> 01:18:32,000 OF US AROUND HERE HAVE MADE WILL 2082 01:18:32,001 --> 01:18:36,000 BE CALLED 2083 01:18:36,001 --> 01:18:39,000 THE QUESTION IS "DEEM SENATOR 2084 01:18:39,001 --> 01:18:41,000 SAYS MEDICARE ADVANTAGE CUTS 2085 01:18:41,001 --> 01:18:43,000 BREAK A PRESIDENT'S PLEDGE." 2086 01:18:43,001 --> 01:18:45,000 SO MAYBEF THE SENATOR FROM 2087 01:18:45,001 --> 01:18:46,000 TENNESSEE WOULD JUST GIVE ME A 2088 01:18:46,001 --> 01:18:48,000 BRIEF OUTLINE OF WHAT SENIORS 2089 01:18:48,001 --> 01:18:53,000 GET UNDER MEDICARE ADVANTAGE AND 2090 01:18:53,001 --> 01:18:55,000 WHY IT IS SO 2091 01:18:55,001 --> 01:18:58,000 SENIOR CITIZENS IN MY STAT 2092 01:18:58,001 --> 01:19:00,000 11 MILLION ALL OVER THE COUNTRY. 2093 01:19:00,001 --> 01:19:02,000 MR. ALEXANDER: I 2094 01:19:02,001 --> 01:19:03,000 THE SENATOR FROM ARIZONA IS 2095 01:19:03,001 --> 01:19:05,000 EXACTLY CORRECT. 2096 01:19:05,001 --> 01:19:08,000 IF SENATOR CASEY SAID THAT, HE'S 2097 01:19:08,001 --> 01:19:09,000 MERELY REPEATING WHAT THE 2098 01:19:09,001 --> 01:19:11,000 BUDGET OFFICE, WHEN HE SAID THAT 2099 01:19:11,001 --> 01:19:12,000 FULLY HALF THE BENEFITS OF 2100 01:19:12,001 --> 01:19:13,000 MEDICARE ADVANTAGE WOULD BE 2101 01:19:13,001 --> 01:19:15,000 LOST. 2102 01:19:15,001 --> 01:19:18,000 BUT IN ANSWER TO YOUR QUESTION, 2103 01:19:18,001 --> 01:19:20,000 THE MEDICARE ADVANTAGE IS AN 2104 01:19:20,001 --> 01:19:21,000 OPTION THAT 11 MILLION OF THE 40 2105 01:19:21,001 --> 01:19:22,000 MILLION SENIORS WHO ARE ON 2106 01:19:22,001 --> 01:19:26,000 MEDICARE HAV 2107 01:19:26,001 --> 01:19:27,000 AND THE REASON THEY CHOOSE IT IS 2108 01:19:27,001 --> 01:19:33,000 BECAUSE THE PLANS THAT ARE 2109 01:19:33,001 --> 01:19:36,000 OFFERED BY PRIVATE COMPANIES ARE 2110 01:19:36,001 --> 01:19:37,000 OFTEN IN RURAL COMMUNITIES, 2111 01:19:37,001 --> 01:19:39,000 LOWER-INCOME AMERICANS CHOOSE THESE. 2112 01:19:39,001 --> 01:19:41,000 THEY OFTEN CHOOSE THEM BECAUSE 2113 01:19:41,001 --> 01:19:42,000 THE PLANS GENERALLY OFFER THESE 2114 01:19:42,001 --> 01:19:45,000 BENEFITS: 2115 01:19:45,001 --> 01:19:47,000 DENTAL CARE, VISION CARE, 2116 01:19:47,001 --> 01:19:49,000 HEARING COVERAGE, REDUCED 2117 01:19:49,001 --> 01:19:53,000 HOSPITAL DEDUCTIBLES, LOWER 2118 01:19:53,001 --> 01:19:55,000 CO-PAYMENTS, LOWER PREMIUMS, 2119 01:19:55,001 --> 01:19:56,000 COORDINATED CHRONIC CARE 2120 01:19:56,001 --> 01:19:57,000 MANAGEMENT, AND PHYSICAL FITNESS 2121 01:19:57,001 --> 01:19:59,000 PROGRAMS. 2122 01:19:59,001 --> 01:20:01,000 SO THOSE ARE SOME OF THE 2123 01:20:01,001 --> 01:20:02,000 BENEFITS THAT THESE PLANS 2124 01:20:02,001 --> 01:20:04,000 GENERALLY OFFER SENIORS. 2125 01:20:04,001 --> 01:20:06,000 MR. McCAIN: WELL, I THANK MY FRIEND. 2126 01:20:06,001 --> 01:20:07,000 AND THE REASON I ASK IS YOU 2127 01:20:07,001 --> 01:20:09,000 MENTIONED THAT MEDICARE 2128 01:20:09,001 --> 01:20:11,000 ADVANTAGE ALLOWS SENIORS TO HAVE 2129 01:20:11,001 --> 01:20:17,000 DENTAL CARE, VISION CARE, 2130 01:20:17,001 --> 01:20:20,000 HEARING CARE, PHYSICAL -- 2131 01:20:20,001 --> 01:20:21,000 PHYSICAL FITNESS -- PHYSICAL 2132 01:20:21,001 --> 01:20:23,000 FITNESS. 2133 01:20:23,001 --> 01:20:26,000 YOU 2134 01:20:26,001 --> 01:20:30,000 THIS ALLOWS OUR SENIOR CITIZENS 2135 01:20:30,001 --> 01:20:32,000 TO HAVE DENTAL, VISION, 2136 01:20:32,001 --> 01:20:36,000 CARE, PHYSICAL 2137 01:20:36,001 --> 01:20:37,000 YOU KNOW, THAT'S A LITTLE 2138 01:20:37,001 --> 01:20:41,000 STRANGE BECAUSE, AS WAS POINTED 2139 01:20:41,001 --> 01:20:43,000 OUT TO ME, THAT'S EXACTLY WHAT 2140 01:20:43,001 --> 01:20:46,000 WE 2141 01:20:46,001 --> 01:20:50,000 STATES SENATE. 2142 01:20:50,001 --> 01:20:52,000 ABOUT 100 PACES FROM HERE, IF I 2143 01:20:52,001 --> 01:20:53,000 NEED SOME DOCTOR CARE 2144 01:20:53,001 --> 01:20:55,000 IMMEDIATELY, IF I NEED 2145 01:20:55,001 --> 01:21:00,000 VISION CARE, IF I NEED SOME 2146 01:21:00,001 --> 01:21:03,000 DENTAL CARE, NEC NEXT TO MY OFFICE 2147 01:21:03,001 --> 01:21:05,000 IN THE SENATE RUSSELL OFFICE 2148 01:21:05,001 --> 01:21:07,000 BUILDING -- AND I DON'T KNOW AT 2149 01:21:07,001 --> 01:21:09,000 WHAT COST -- I'D KE TO GET 2150 01:21:09,001 --> 01:21:10,000 ENTERED INTO THE RECORD HOW MANY 2151 01:21:10,001 --> 01:21:15,000 TENS OF MILONS OF DOLLARS IT 2152 01:21:15,001 --> 01:21:17,000 IS 2153 01:21:17,001 --> 01:21:19,000 SO -- SO, MY COLLEAGUES 2154 01:21:19,001 --> 01:21:21,000 YESTERDAY VOTED AGAINST KEEPING 2155 01:21:21,001 --> 01:21:24,000 THE 2156 01:21:24,001 --> 01:21:25,000 WHEN WE'VE GOT RIGHT HERE THE 2157 01:21:25,001 --> 01:21:28,000 BEST MEDICARE ADVANTAGE PROGRAM 2158 01:21:28,001 --> 01:21:32,000 THAT I'VE EVER HEARD OF IN THE WORLD: 2159 01:21:32,001 --> 01:21:35,000 FREE HEARING, FREE VISION, FREE 2160 01:21:35,001 --> 01:21:38,000 DENTAL, FREE -- AND EXPANDING A 2161 01:21:38,001 --> 01:21:40,000 GYMNASIUM IN A MANY MONTH-LONG 2162 01:21:40,001 --> 01:21:43,000 PROJECT AND I WILL GET THE COST, 2163 01:21:43,001 --> 01:21:47,000 ALTHOUGH IT MAY BE HARD TO DO. 2164 01:21:47,001 --> 01:21:48,000 SO LET ME GET 2165 01:21:48,001 --> 01:21:50,000 AGAIN, THE AMERICAN PEOPLE 2166 01:21:50,001 --> 01:21:53,000 SHOULD UNDERSTAND, WE JUST VOTED 2167 01:21:53,001 --> 01:21:55,000 TO CUT DRASTICALLY A PROGRAM 2168 01:21:55,001 --> 01:21:57,000 THAT SENIORS HAVE TAKEN 2169 01:21:57,001 --> 01:22:00,000 ADVANTAGE OF 2170 01:22:00,001 --> 01:22:02,000 ADDITIONAL 2171 01:22:02,001 --> 01:22:04,000 DENTAL, AND PHYSICAL FITNESS 2172 01:22:04,001 --> 01:22:07,000 CARE WHILE WE PRACTICE IT HERE 2173 01:22:07,001 --> 01:22:10,000 EVERY SINGLE DAY -- EVERY SINGLE 2174 01:22:10,001 --> 01:22:12,000 DAY THERE IS A PHYSICIAN ON DUTY 2175 01:22:12,001 --> 01:22:14,000 -- OR MORE THAN ONE -- NOT VERY 2176 01:22:14,001 --> 01:22:17,000 FAR FROM WHERE I SPEAK WHO IS 2177 01:22:17,001 --> 01:22:20,000 READY TO GIVE US INSTANT CARE. 2178 01:22:20,001 --> 01:22:22,000 IF HOSPITALIZATION IS NEEDED, 2179 01:22:22,001 --> 01:22:24,000 INSTANT TRANSPORTATION TO THE 2180 01:22:24,001 --> 01:22:26,000 BETHESDA NAVAL HOSPITAL WHERE WE 2181 01:22:26,001 --> 01:22:29,000 WILL GET FREE CARE. 2182 01:22:29,001 --> 01:22:33,000 AND, INCREDIBLY -- 2183 01:22:33,001 --> 01:22:34,000 THE SENATE, ON LARGELY PARTISAN 2184 01:22:34,001 --> 01:22:36,000 LINES, YESTERDAY VOTED AGAINST 2185 01:22:36,001 --> 01:22:39,000 SENIOR CITIZENS IN THIS COUNTRY, 2186 01:22:39,001 --> 01:22:40,000 MOST OF WHOM HAVE MADE A LOT 2187 01:22:40,001 --> 01:22:42,000 MORE INTO THE PROGRAM THAN WE HAVE. 2188 01:22:42,001 --> 01:22:44,000 WE'RE GOING TO DEPRIVE THEM OF 2189 01:22:44,001 --> 01:22:45,000 WHAT WE HAVE EVERY SINGLE DAY WE 2190 01:22:45,001 --> 01:22:46,000 ARE MEMBERS OF THE UNITED STATES 2191 01:22:46,001 --> 01:22:50,000 SENATE. 2192 01:22:50,001 --> 01:22:53,000 THAT, MY FRIENDS, IS AN 2193 01:22:53,001 --> 01:22:55,000 IN HYPOCRISY. THE SENATOR FROM PENNLVANIA 2194 01:22:55,001 --> 01:22:56,000 HAS IT RIGHT. 2195 01:22:56,001 --> 01:22:58,000 HE SAYS BECAUSE THE PRESIDENT 2196 01:22:58,001 --> 01:23:01,000 TIME AFTER TIME SAID TO THE 2197 01:23:01,001 --> 01:23:02,000 AMERICAN PEOPLE, IF YOU LIKE THE 2198 01:23:02,001 --> 01:23:04,000 INSURANCE POLICY YOU HAVE TODAY, 2199 01:23:04,001 --> 01:23:05,000 YOU CAN KEEP 2200 01:23:05,001 --> 01:23:09,000 HOW MANY HUNDREDS OF TIMES HAVE 2201 01:23:09,001 --> 01:23:11,000 WE SEEN HIM SAY THAT AT TOWN 2202 01:23:11,001 --> 01:23:13,000 HALL METTINGS AND HIS 2203 01:23:13,001 --> 01:23:14,000 ADMINISTRATION -- AT TOWN HALL 2204 01:23:14,001 --> 01:23:16,000 MEETINGS AND HIS ADMINISTRATION 2205 01:23:16,001 --> 01:23:17,000 MOUTH SPEOSES SAY THE SAME THING. 2206 01:23:17,001 --> 01:23:18,000 SENATOR CO-PAYSCY IS RIGHT WHEN 2207 01:23:18,001 --> 01:23:20,000 HE SAYS WE'RE NOT GOING TO BE 2208 01:23:20,001 --> 01:23:23,000 ABLE TO SAY, IF YOU LIKE WHAT 2209 01:23:23,001 --> 01:23:25,000 YOU HAVE, YOU CAN KEEP IT, SAID 2210 01:23:25,001 --> 01:23:26,000 SENATOR BOB CASEY, A 2211 01:23:26,001 --> 01:23:28,000 PENNSYLVANIA DEMOCRAT. 2212 01:23:28,001 --> 01:23:30,000 THAT COMTMENT A LOT OF US MADE 2213 01:23:30,001 --> 01:23:32,000 WILL BE CALLED INTO QUESTION. 2214 01:23:32,001 --> 01:23:34,000 I'D LIKE TO SAY A COUPLE OF WORDS. 2215 01:23:34,001 --> 01:23:35,000 I WILLE TALKING A LITTLE BIT 2216 01:23:35,001 --> 01:23:36,000 MORE ABOUT IT LATER. 2217 01:23:36,001 --> 01:23:37,000 EVERY TIME THE SENATOR FROM 2218 01:23:37,001 --> 01:23:40,000 MONTANA IS ON THE FLOOR AND 2219 01:23:40,001 --> 01:23:44,000 OTHERS, THEY TALK ABOUT THE FACT 2220 01:23:44,001 --> 01:23:48,000 THAT AARP NOW SUPPORTS THIS 2221 01:23:48,001 --> 01:23:50,000 BLATANT TRANSFER OF FUNDING FROM 2222 01:23:50,001 --> 01:23:54,000 THE MEDICARE PROGRAM, WHICH THE 2223 01:23:54,001 --> 01:23:56,000 SENIORS HAVE EARNED, INTO A 2224 01:23:56,001 --> 01:23:58,000 BRAND-NEW ENTITLEMENT -- $2.5 TRILLION ENTITLEMENT PROGRAM. 2225 01:23:58,001 --> 01:24:00,000 THAT'S WT 2226 01:24:00,001 --> 01:24:02,000 ABOUT. 2227 01:24:02,001 --> 01:24:05,000 SO JUST FOR YOUR INFORMATION, 2228 01:24:05,001 --> 01:24:06,000 AARP HAS RECEIVED $18 MILLION IN 2229 01:24:06,001 --> 01:24:08,000 STIMULUS MONEY. 2230 01:24:08,001 --> 01:24:12,000 NOW, THERE'S A JOB CREATOR FOR YOU. 2231 01:24:12,001 --> 01:24:16,000 THERE'S A JOB CREATOR FOR YOU. 2232 01:24:16,001 --> 01:24:17,000 AARP, WHICH HAS GIVEN ITS FULL 2233 01:24:17,001 --> 01:24:20,000 SUPPORT TO DEMOCRATIC HEALTH 2234 01:24:20,001 --> 01:24:21,000 CARE LEGISLATION, EVEN THOUGH 2235 01:24:21,001 --> 01:24:22,000 SENIORS REMAIN LARGELY OPPOSED, 2236 01:24:22,001 --> 01:24:26,000 RECEIVED AN $18 MILLION GRANT IN 2237 01:24:26,001 --> 01:24:29,000 THE ECONOMIC STIMULUS PACKAGE 2238 01:24:29,001 --> 01:24:32,000 HAS NOT CREATED ANY JOBS, 2239 01:24:32,001 --> 01:24:34,000 ACCORDING TO THE OBAMA 2240 01:24:34,001 --> 01:24:37,000 ADMINISTRATION'S RECOVERY.GOV WEB SITE. 2241 01:24:37,001 --> 01:24:38,000 THAT IS 2242 01:24:38,001 --> 01:24:39,000 BECAUSE EVERYTHING I'VE EVER 2243 01:24:39,001 --> 01:24:42,000 SEEN, THEY'VE CREATED MILLIONS 2244 01:24:42,001 --> 01:24:43,000 OF JOBS, INCLUDING IN THE NINTH CONGRESSIONAL DISTRICT OF 2245 01:24:43,001 --> 01:24:45,000 ARIZONA WHERE THEY SAID THEY 2246 01:24:45,001 --> 01:24:46,000 CREATE SOME THOUSANDS OF JOBS, 2247 01:24:46,001 --> 01:24:48,000 WHICH UNFORTUNATELY FOR ME WE 2248 01:24:48,001 --> 01:24:49,000 ONLY HAVE EIGHT CONGRESSIONAL DISTRICTS. 2249 01:24:49,001 --> 01:24:53,000 BUT THAT'S OKAY. 2250 01:24:53,001 --> 01:24:55,000 BUT THAT'S OFNLGT SO IN FEBRUARY 2251 01:24:55,001 --> 01:24:56,000 THE "POLITICO" REPORTED THAT 2252 01:24:56,001 --> 01:24:57,000 AARP WAS PUTTING PRESSURE ON 2253 01:24:57,001 --> 01:24:59,000 REPUBLICAN MEMBERS OF CONGRESS 2254 01:24:59,001 --> 01:25:02,000 TO SUPPORT THE STIMULUS PACKAGE. 2255 01:25:02,001 --> 01:25:04,000 SINCE THEN, AARP HAS MOVED ON TO 2256 01:25:04,001 --> 01:25:06,000 LOBBYING FOR PASSAGE OF HEALTH 2257 01:25:06,001 --> 01:25:07,000 CARE LEGISLATION, EVEN THOUGH 2258 01:25:07,001 --> 01:25:10,000 DEMOCRAT PROPOSALS HAVE CALLED 2259 01:25:10,001 --> 01:25:16,000 FOR SEVERAL HUNDRED BILLION 2260 01:25:16,001 --> 01:25:19,000 THRARS DOLLARS IN CUTS TO MEDICARE, A 2261 01:25:19,001 --> 01:25:21,000 PROGRAM THAT THEY OPPOSE WHEN 2262 01:25:21,001 --> 01:25:27,000 REPUBLICANS PROPOSE IT. 2263 01:25:27,001 --> 01:25:29,000 AARP 2264 01:25:29,001 --> 01:25:30,000 FINANCIAY B 2265 01:25:30,001 --> 01:25:33,000 LOSING CUTS TO MEDICARE 2266 01:25:33,001 --> 01:25:35,000 ADVANTAGE WILL BE FORCED TO BUY 2267 01:25:35,001 --> 01:25:38,000 MEDIGAP POLICIES, WHICH IS THE 2268 01:25:38,001 --> 01:25:40,000 MAIN SOURCE OF AARP REVENUE. 2269 01:25:40,001 --> 01:25:43,000 BARRY RAND, THE CHIEFXECUTIVE 2270 01:25:43,001 --> 01:25:48,000 OF AARP, WAS A BIG DONOR TO THE 2271 01:25:48,001 --> 01:25:50,000 OBAMA CAMPAIGN AND HAS RAINED 2272 01:25:50,001 --> 01:25:54,000 COZY RELATIONSHIP WITH THE ADMINISTRATION. 2273 01:25:54,001 --> 01:25:55,000 THAT'S SHOCKING NEWS. 2274 01:25:55,001 --> 01:25:58,000 SHOCKING NEWS. 2275 01:25:58,001 --> 01:26:03,000 SO, MY 2276 01:26:03,001 --> 01:26:05,000 THAT IN 2006 -- IN 200 6, THE 2277 01:26:05,001 --> 01:26:08,000 AARP RECEIVED $18 MILLION FROM 2278 01:26:08,001 --> 01:26:10,000 THE FEDERAL GOVERNMENT AND WE 2279 01:26:10,001 --> 01:26:11,000 ARE RESEARCHING ADDITIONAL 2280 01:26:11,001 --> 01:26:14,000 FEDERAL MONEYS THAT THEY GET. 2281 01:26:14,001 --> 01:26:17,000 BUT THE MT IMPORTANT THING IS 2282 01:26:17,001 --> 01:26:21,000 THAT, LET'S MAKE IT CLEAR. 2283 01:26:21,001 --> 01:26:23,000 AARP WILL 2284 01:26:23,001 --> 01:26:25,000 BENEFITS BECAUSE SENIORS WHO 2285 01:26:25,001 --> 01:26:28,000 HAVE THEIR CUTS IN MEDICARE 2286 01:26:28,001 --> 01:26:32,000 ADVANTAGE AND OTHER MEDICARE 2287 01:26:32,001 --> 01:26:34,000 PROGRAMS CAN BUY, 2288 01:26:34,001 --> 01:26:36,000 A MEDIGAP INSURANCE POLICY -- IN 2289 01:26:36,001 --> 01:26:37,000 OTHER WOR, TO COVER THE THINGS 2290 01:26:37,001 --> 01:26:39,000 THAT ARE BEING CUT BACK UNDER 2291 01:26:39,001 --> 01:26:42,000 THIS LEGISLATION -- AND IT COSTS 2292 01:26:42,001 --> 01:26:44,000 $175 A MONTH. 2293 01:26:44,001 --> 01:26:46,000 MEDICARE ADVANTAGE PREMIUMS, FOR 2294 01:26:46,001 --> 01:26:49,000 MOST SENIORS, ARE ZERO OR $35 A 2295 01:26:49,001 --> 01:26:51,000 MONTH. 2296 01:26:51,001 --> 01:26:53,000 SO IF THE MEDICARE ADVANTAGE 2297 01:26:53,001 --> 01:26:57,000 PLANS GO AWAY, PEOPLE WOULD HAVE 2298 01:26:57,001 --> 01:27:00,000 TO BUY MEDIGAP PLANS 2299 01:27:00,001 --> 01:27:02,000 YOU GOT IT, THE AARP. 2300 01:27:02,001 --> 01:27:05,000 AND SOME LOW-INCOME SENIORS 2301 01:27:05,001 --> 01:27:07,000 COULDN'T AFFORD $175 MONTH. 2302 01:27:07,001 --> 01:27:09,000 THAT'S WHY WHAT THE SENATOR 2303 01:27:09,001 --> 01:27:12,000 TENNESSEE HAS STATED -- IF WE 2304 01:27:12,001 --> 01:27:14,000 DRIVE PEOPLE OUT 2305 01:27:14,001 --> 01:27:15,000 ADVANTAGE, WE ARE 2306 01:27:15,001 --> 01:27:16,000 LOW-INCOME SENIORS ALL OVER THIS 2307 01:27:16,001 --> 01:27:17,000 COUNTRY. 2308 01:27:17,001 --> 01:27:19,000 WE ARE HARMING THEM. 2309 01:27:19,001 --> 01:27:22,000 WE ARE DOING THEM A DISSERVICE. 2310 01:27:22,001 --> 01:27:24,000 AND IF YOU THINK WITH 17% REAL 2311 01:27:24,001 --> 01:27:26,000 UNEMPLOYMENT IN MY STATE THAT 2312 01:27:26,001 --> 01:27:28,000 SENIORS WHO ARE UNEMPLOYED AND 2313 01:27:28,001 --> 01:27:32,000 DOWN ON THEIR LUCK ARE GOING TO 2314 01:27:32,001 --> 01:27:34,000 BE ABLE TO AFFORD THE AARP 2315 01:27:34,001 --> 01:27:36,000 MEDIGAP PROGRAM -- POLICY FOR 2316 01:27:36,001 --> 01:27:37,000 $175 A MONTH, THEN COME AND 2317 01:27:37,001 --> 01:27:38,000 VISIT MY STATE, AND I'LL TELL 2318 01:27:38,001 --> 01:27:41,000 YOU THEY CAN'T. 2319 01:27:41,001 --> 01:27:44,000 THEY CAN'T. 2320 01:27:44,001 --> 01:27:46,000 SO IT'S INTERESTING THE 2321 01:27:46,001 --> 01:27:48,000 CONVERSATION ABOUT HOW WE'RE -- 2322 01:27:48,001 --> 01:27:51,000 ABOUT HOW HIGH-INCOME SENIORS 2323 01:27:51,001 --> 01:27:52,000 AND HOW WE'RE GOING TO TAX 2324 01:27:52,001 --> 01:27:54,000 PEOPLE WITH CADILLAC PLANS AND 2325 01:27:54,001 --> 01:27:56,000 ALL OF THOSE THINGS, WHEN WE 2326 01:27:56,001 --> 01:27:58,000 REALLY WHAT WE'RE DOING -- WHAT 2327 01:27:58,001 --> 01:28:00,000 WE'RE REALLY DOING IS HARMING 2328 01:28:00,001 --> 01:28:05,000 THE LOWEST - 2329 01:28:05,001 --> 01:28:06,000 SENIORS IN RURAL AREAS 2330 01:28:06,001 --> 01:28:08,000 AMERICA. 2331 01:28:08,001 --> 01:28:09,000 MR. KYL: MY COLLEAGUE WAS 2332 01:28:09,001 --> 01:28:11,000 TALKING EARLIER MAKING THE POINT 2333 01:28:11,001 --> 01:28:13,000 THAT Y 2334 01:28:13,001 --> 01:28:14,000 OUT OF THE PROGRAM WITHOUT 2335 01:28:14,001 --> 01:28:15,000 HURTING 2336 01:28:15,001 --> 01:28:17,000 THOSE ON THE OTHER SIDE OF THE 2337 01:28:17,001 --> 01:28:18,000 AISLE SAID, WELL, WE THAT. 2338 01:28:18,001 --> 01:28:20,000 WE CAN CUT BY $120 BILLION AND 2339 01:28:20,001 --> 01:28:21,000 STILL WON'T HURT ANYBODY. 2340 01:28:21,001 --> 01:28:22,000 MY COLLEAGUE ASKED THE SENATOR 2341 01:28:22,001 --> 01:28:23,000 FROM TENNESSEE EXACTLY WHAT SOME 2342 01:28:23,001 --> 01:28:24,000 OF THE BENEFITS WERE AND 2343 01:28:24,001 --> 01:28:27,000 REPEATED THOSE. 2344 01:28:27,001 --> 01:28:30,000 SO I WENT BACK TO GET THE ACTUAL 2345 01:28:30,001 --> 01:28:32,000 STATISTICAL NUMBER HERE OF HOW 2346 01:28:32,001 --> 01:28:35,000 MUCH IT WILL ACTUALLY REDUCE 2347 01:28:35,001 --> 01:28:37,000 BENEFITS IN TERMS OF ACTUARIAL 2348 01:28:37,001 --> 01:28:38,000 VALUE, AND ACCORDING TO THE 2349 01:28:38,001 --> 01:28:41,000 CONGRESSIONAL BUDGET OSTLES IN 2350 01:28:41,001 --> 01:28:42,000 THE YEAR 2019 WHEN THIS IS FULLY 2351 01:28:42,001 --> 01:28:43,000 IMPLEMENTED, HERE'S THE 2352 01:28:43,001 --> 01:28:46,000 STATISTIC: 2353 01:28:46,001 --> 01:28:48,000 THE ACTUAL ACTUARIAL VALUE OF 2354 01:28:48,001 --> 01:28:51,000 THE REDUCTION IN BENEFITS UNDER 2355 01:28:51,001 --> 01:28:54,000 MEDICARE ADVANTAGE IS 64%. 2356 01:28:54,001 --> 01:28:58,000 IN DOLLAR NUMBERS, IT GOES FROM 2357 01:28:58,001 --> 01:28:59,000 MONTH. 2358 01:28:59,001 --> 01:29:01,000 IN OTHER WORDS, THE VERY THINGS 2359 01:29:01,001 --> 01:29:02,000 MY COLLEAGUE IS TALKING ABOUT -- 2360 01:29:02,001 --> 01:29:03,000 THE VISION CARE, THE DENTAL 2361 01:29:03,001 --> 01:29:04,000 CARE, ALL OF THOSE THINGS, AS 2362 01:29:04,001 --> 01:29:06,000 WELL -- 2363 01:29:06,001 --> 01:29:07,000 MR. McCAIN: THINGS THAT WE 2364 01:29:07,001 --> 01:29:09,000 ROUTINELY U 2365 01:29:09,001 --> 01:29:10,000 THE UNITED STATES SENATE. 2366 01:29:10,001 --> 01:29:12,000 I WOULD HOPE THAT THOSE WHO 2367 01:29:12,001 --> 01:29:14,000 VOTED TO HARM THE SENIORS IN 2368 01:29:14,001 --> 01:29:17,000 THIS COUNTRY AND NOT ALLOW THEM 2369 01:29:17,001 --> 01:29:19,000 TO HAVE DENTAL, VISION, OTHER 2370 01:29:19,001 --> 01:29:22,000 HEALTH CARE, WOULD UNILATERALLY 2371 01:29:22,001 --> 01:29:24,000 DISAVOW THE USE OF THE PHYSICIAN 2372 01:29:24,001 --> 01:29:26,000 CARE AND VISION CARE AND HEARING 2373 01:29:26,001 --> 01:29:28,000 CARE THAT'S AVAILABLE TO ALL OF 2374 01:29:28,001 --> 01:29:30,000 2US 4 HOURS A DAY RIGHT HERE -- 2375 01:29:30,001 --> 01:29:33,000 24 HOURS A DAY RIGHT HERE IN THE UNITED STATES 2376 01:29:33,001 --> 01:29:35,000 MR. KYL: JUST A LAST POINT. 2377 01:29:35,001 --> 01:29:36,000 I'D LIKE TO SAY THAT I HEAR MY 2378 01:29:36,001 --> 01:29:37,000 COLLEAGUE LOUD AND CLEAR AND I 2379 01:29:37,001 --> 01:29:38,000 HOPE THAT THE AMERICAN PEOPLE 2380 01:29:38,001 --> 01:29:41,000 DO, TOO. 2381 01:29:41,001 --> 01:29:42,000 BECAUSE YOU CAN'T CALL A120 2382 01:29:42,001 --> 01:29:43,000 BILLION CUT SOMETHING THAT 2383 01:29:43,001 --> 01:29:45,000 DOESN'T HURT PEOPLE AND 2384 01:29:45,001 --> 01:29:46,000 ESPECIALLY WHEN THE 2385 01:29:46,001 --> 01:29:48,000 CONGRESSIONAL BUDGET OFFICE 2386 01:29:48,001 --> 01:29:50,000 ITSELF SAYS, YES, THAT REDUCES 2387 01:29:50,001 --> 01:29:53,000 THESE VERY BENEFITS FROM A VALUE 2388 01:29:53,001 --> 01:29:54,000 OF $135 A MONTH DOWN TO $49 A 2389 01:29:54,001 --> 01:29:57,000 MONTH. 2390 01:29:57,001 --> 01:29:58,000 THAT IS -- THAT IS A 2391 01:29:58,001 --> 01:30:00,000 HUGE CUT IN THE VALUE OF THE 2392 01:30:00,001 --> 01:30:01,000 SERVICES THAT THEY RECEIVE UNDER 2393 01:30:01,001 --> 01:30:03,000 MEDICARE ADVANTAGE. 2394 01:30:03,001 --> 01:30:04,000 AND THAT'S WHAT WE ARE 2395 01:30:04,001 --> 01:30:05,000 PREVENT BY THIS AMENDMENT. 2396 01:30:05,001 --> 01:30:06,000 MR. McCAIN: COULD I JUST 2397 01:30:06,001 --> 01:30:08,000 MENTION ONE OTHER THING? 2398 01:30:08,001 --> 01:30:10,000 I'M NOT GOING TO SPEND THAT MUCH 2399 01:30:10,001 --> 01:30:12,000 MORE TIME ON AARP. 2400 01:30:12,001 --> 01:30:14,000 BUT THE REASON WHY I DO IS 2401 01:30:14,001 --> 01:30:16,000 BECAUSE EVERY TIME THE SENATOR 2402 01:30:16,001 --> 01:30:19,000 FROM MONTANA STANDS UP, HE TALKS 2403 01:30:19,001 --> 01:30:21,000 ABOUT THAT AARP HAS ENDORSED 2404 01:30:21,001 --> 01:30:22,000 THIS RIP-OFF OF THE AMERICAN 2405 01:30:22,001 --> 01:30:25,000 PEOPLE. 2406 01:30:25,001 --> 01:30:29,000 SO, LET ME JUST QUOTE AGAIN FROM 2407 01:30:29,001 --> 01:30:31,000 A BLOOMBERG ARTICLE ENTITLED 2408 01:30:31,001 --> 01:30:34,000 "AARP'S STEALTH FEES OFTEN STING 2409 01:30:34,001 --> 01:30:36,000 NIORS WITH COSTLIER INSURANCE." 2410 01:30:36,001 --> 01:30:37,000 AND I COAT FROM THE BLOOMBERG 2411 01:30:37,001 --> 01:30:38,000 ARTICLE -- AND I QUOTE FROM THE 2412 01:30:38,001 --> 01:30:40,000 BLOOMBERG ARTICLE. 2413 01:30:40,001 --> 01:30:44,000 ARTHUR LAPOS JOINED AARP BECAUSE 2414 01:30:44,001 --> 01:30:45,000 HE THOUGHT THE NONPROFIT SENIOR 2415 01:30:45,001 --> 01:30:46,000 CITIZEN ADVOCACY GROUP WOULD 2416 01:30:46,001 --> 01:30:47,000 MAKE HIS RETIREMENT YEARS 2417 01:30:47,001 --> 01:30:49,000 EASIER. 2418 01:30:49,001 --> 01:30:50,000 HE SIGNED UP FOR AN AUTO 2419 01:30:50,001 --> 01:30:51,000 INSURANCE POLICY ENDORSED BY 2420 01:30:51,001 --> 01:30:54,000 AARP BELIEVING THE ADVERTISING 2421 01:30:54,001 --> 01:30:55,000 THAT SAID HE WOULD SAVE MONEY. 2422 01:30:55,001 --> 01:30:59,000 HE DIDN'T. 2423 01:30:59,001 --> 01:31:01,000 WHEN LOPAS, 71, COMPARED HIS CAR 2424 01:31:01,001 --> 01:31:03,000 INSURANCE RATE WITH A 2425 01:31:03,001 --> 01:31:05,000 OTHER COMPANIES HE FOUND OUT HE 2426 01:31:05,001 --> 01:31:06,000 WAS PAYING TWICE THE AVERAGE. WHY? 2427 01:31:06,001 --> 01:31:07,000 ONE REASON HE LEARNED WAS 2428 01:31:07,001 --> 01:31:09,000 BECAUSE AARP WAS TAKING A CUT 2429 01:31:09,001 --> 01:31:10,000 OUT OF HIS PREMIUM BEFORE 2430 01:31:10,001 --> 01:31:12,000 SENDING THE MONEY TO HARTFORD 2431 01:31:12,001 --> 01:31:14,000 FINANCIAL SERVICES GROUP, THE 2432 01:31:14,001 --> 01:31:16,000 PROVIDER OF THE COVERAGE. 2433 01:31:16,001 --> 01:31:18,000 AARP USES THE ROYALTIES AND FEES 2434 01:31:18,001 --> 01:31:21,000 TO FUND ABOUT HALF THE EXPENSES 2435 01:31:21,001 --> 01:31:22,000 THAT PAY FOR ACTIVITIES SUCH AS 2436 01:31:22,001 --> 01:31:24,000 PUBLISHING 2437 01:31:24,001 --> 01:31:28,000 HEALTH CARE AND CONSUMER FRAUD 2438 01:31:28,001 --> 01:31:29,000 AS WELL 2439 01:31:29,001 --> 01:31:33,000 MILLION BOND DEBT THAT FUNDED 2440 01:31:33,001 --> 01:31:35,000 THE ASSOCIATION'S MARBL AND 2441 01:31:35,001 --> 01:31:38,000 BRASS-STUDDED WASHINGTON HEADQUARTERS. 2442 01:31:38,001 --> 01:31:41,000 IN ADDITION, AARP HOLDS CLIENTS' 2443 01:31:41,001 --> 01:31:44,000 INSURANCE PREMIUMS FOR AS LONG 2444 01:31:44,001 --> 01:31:47,000 AS A MONTH AND INVESTS THE MONEY 2445 01:31:47,001 --> 01:31:48,000 WHICH ADDED $40.4 MILLION TO 2446 01:31:48,001 --> 01:31:50,000 REVENUE IN 2007. 2447 01:31:50,001 --> 01:31:52,000 DURING THE PAST DECADE, 2448 01:31:52,001 --> 01:31:54,000 ROYALTIES AND FEES HAVE MADE UP 2449 01:31:54,001 --> 01:31:58,000 AN INCREASING PERCENTAGE OF 2450 01:31:58,001 --> 01:32:02,000 AARP'S INCOME, RISING TO 43% OF 2451 01:32:02,001 --> 01:32:06,000 ITS $1.17 BILLION IN REVENUE IN 2452 01:32:06,001 --> 01:32:08,000 2007 FROM 11% IN 1999, ACCORDING 2453 01:32:08,001 --> 01:32:11,000 TO AARP DATA." 2454 01:32:11,001 --> 01:32:13,000 THIS IS A BLOOMBERG ARTICLE. 2455 01:32:13,001 --> 01:32:14,000 THIS ISN'T FROM THE REPUBLICAN 2456 01:32:14,001 --> 01:32:16,000 POLICY COMMITTEE. 2457 01:32:16,001 --> 01:32:18,000 SO THE POINTS WHO GAINS? 2458 01:32:18,001 --> 01:32:20,000 WHO GAINS FROM THIS LEGISLATION? 2459 01:32:20,001 --> 01:32:21,000 WHO'S GOING TO MAKE HUNDREDS OF 2460 01:32:21,001 --> 01:32:23,000 MILLIONS DOLLARS MORE BECAUSE 2461 01:32:23,001 --> 01:32:26,000 THEY PROVIDE THE MEDIGAP 2462 01:32:26,001 --> 01:32:27,000 POLICIES THAT PEOPLE WILL BE 2463 01:32:27,001 --> 01:32:31,000 DEPRIVED OF WHEN WE KILL OFF 2464 01:32:31,001 --> 01:32:34,000 MEDICARE ADVANTAGE? AARP. 2465 01:32:34,001 --> 01:32:35,000 MR. KYL: -- 2466 01:32:35,001 --> 01:32:37,000 MR. ALEXANDER: I SEE THE 2467 01:32:37,001 --> 01:32:38,000 SENATOR FROM TEXAS, THE SENATOR 2468 01:32:38,001 --> 01:32:39,000 FROM IDAHO AND THE SENATOR FROM 2469 01:32:39,001 --> 01:32:41,000 WYOMING HAVE COME TOHE FLOOR 2470 01:32:41,001 --> 01:32:42,000 IN ADDITION TO THE SPONSOR OF 2471 01:32:42,001 --> 01:32:44,000 THE AMENDMENT, SENATOR HATCH. 2472 01:32:44,001 --> 01:32:47,000 I'M SURE THEY ARE PREPARED TO 2473 01:32:47,001 --> 01:32:48,000 REFLECT ON WHO'S HURT BY THESE 2474 01:32:48,001 --> 01:32:50,000 CUTS. 2475 01:32:50,001 --> 01:32:54,000 THE ONLY THING I WOULD EMPHASIZE 2476 01:32:54,001 --> 01:32:55,000 WITH WHAT YOU HAVE SAID IS THAT 2477 01:32:55,001 --> 01:32:57,000 DISPROPORTIONATELY LOW-INCOME 2478 01:32:57,001 --> 01:32:58,000 AMERICANS IN TEXAS AND IN IDAHO 2479 01:32:58,001 --> 01:33:00,000 AND IN TENNESSEE AND IN WYOMING 2480 01:33:00,001 --> 01:33:02,000 AND IN UTAH ARE HURT. 2481 01:33:02,001 --> 01:33:06,000 ONLY A THIRD OF ELIGIBLE WHITE 2482 01:33:06,001 --> 01:33:09,000 SENIORS WHO DON'T HAVE MEDICAID 2483 01:33:09,001 --> 01:33:10,000 OR EMPLOYER-BASED INSURANCE ARE 2484 01:33:10,001 --> 01:33:12,000 ENROLLED IN MEDICARE ADVANTAGE. 2485 01:33:12,001 --> 01:33:15,000 BUT THE NUMBER INCREASES TO 40% 2486 01:33:15,001 --> 01:33:17,000 FOR AFRICAN-AMERICANS AND 53% FOR 2487 01:33:17,001 --> 01:33:20,000 MR. McCAIN: COULD I ASK THE 2488 01:33:20,001 --> 01:33:21,000 SENATOR AGAIN, HE DESCRIBED THE 2489 01:33:21,001 --> 01:33:22,000 BENEFITS PROVIDED UNDER THE 2490 01:33:22,001 --> 01:33:24,000 MEDICARE ADVANTAGE PROGRAM THAT 2491 01:33:24,001 --> 01:33:29,000 SENIORS CAN HAVE IF THEY WANT; RIGHT? 2492 01:33:29,001 --> 01:33:31,000 ARE THOSE SAME ABILITY -- 2493 01:33:31,001 --> 01:33:33,000 DENT, VISION, HEARING AND 2494 01:33:33,001 --> 01:33:35,000 FITNESS CARE --HAT AVAILABLE 2495 01:33:35,001 --> 01:33:36,000 UNDER REGULAR MEDICARE TODAY? 2496 01:33:36,001 --> 01:33:37,000 MR. ALEXANDER: MY 2497 01:33:37,001 --> 01:33:39,000 UNDERSTANDING IS THE ANSWER IS 2498 01:33:39,001 --> 01:33:42,000 NO TO THAT. 2499 01:33:42,001 --> 01:33:43,000 THAT'S THE REASON 11 MILLION 2500 01:33:43,001 --> 01:33:44,000 AMERICANS CHOOSE MEDICARE 2501 01:33:44,001 --> 01:33:45,000 ADVANTAGE IS BECAUSE THESE 2502 01:33:45,001 --> 01:33:47,000 BENEFITS ARE NOT AVAILABLE UNDER 2503 01:33:47,001 --> 01:33:48,000 THE ORIGINAL MEDICARE. 2504 01:33:48,001 --> 01:33:50,000 MR. McCAIN: IN 2505 01:33:50,001 --> 01:33:52,000 ARE 27,000 ENROLLEES WHO WILL 2506 01:33:52,001 --> 01:33:55,000 SEE A 24% DECREASE. 2507 01:33:55,001 --> 01:33:58,000 IN CONNECTICUT, THERE'S 94,000 2508 01:33:58,001 --> 01:33:59,000 ENROLLEES WHO WILL SEE A 14% DECREASE. 2509 01:33:59,001 --> 01:34:01,000 BY THE WAY, SOME SPECIAL DEALS 2510 01:34:01,001 --> 01:34:05,000 HAVE BEEN CUT FOR THREE STATES, 2511 01:34:05,001 --> 01:34:09,000 I UNDERSTAND: OREGON, NEW YORK, 2512 01:34:09,001 --> 01:34:11,000 WE'RE GOING TO TRY TO FIX THAT. 2513 01:34:11,001 --> 01:34:15,000 THERE'S NO REASON WHY ONE STATE 2514 01:34:15,001 --> 01:34:16,000 SHOULD BE SHIELDED ANYMORE THAN 2515 01:34:16,001 --> 01:34:17,000 ANOTHER FROM THESE DRACONIAN 2516 01:34:17,001 --> 01:34:18,000 MEASURES. 2517 01:34:18,001 --> 01:34:20,000 WE'RE GOING TO TRY TO FIX THAT. 2518 01:34:20,001 --> 01:34:22,000 BUT THE REASON WHY I BRING UP 2519 01:34:22,001 --> 01:34:24,000 THIS ISSUE, PRESENT-DAY MEDICARE 2520 01:34:24,001 --> 01:34:25,000 BENEFICIARIES DON'T HAVE VISION. 2521 01:34:25,001 --> 01:34:27,000 THEY DON'T HAVE DENTAL CARE. 2522 01:34:27,001 --> 01:34:28,000 THEY DON'T HAVE FITNESS. 2523 01:34:28,001 --> 01:34:31,000 YET, WE HERE IN THE UNITED 2524 01:34:31,001 --> 01:34:33,000 STATES SENATE 2525 01:34:33,001 --> 01:34:35,000 SINGLE DAY. 2526 01:34:35,001 --> 01:34:39,000 SO YESTERDAY WHAT WE DID WAS WE 2527 01:34:39,001 --> 01:34:41,000 VOTED TO DEPRIVE SENIORS FROM 2528 01:34:41,001 --> 01:34:43,000 THE ABILITY TO HAVE THE SAME 2529 01:34:43,001 --> 01:34:44,000 PRIVILEGES THAT WE ENJOY EVERY 2530 01:34:44,001 --> 01:34:45,000 SINGLE DAY IN THE UNITED STATES 2531 01:34:45,001 --> 01:34:47,000 SENATE. 2532 01:34:47,001 --> 01:34:50,000 I WOULD ARGUE THAT'S AN EXERCISE 2533 01:34:50,001 --> 01:34:53,000 IN HYPOCRISY. 2534 01:34:53,001 --> 01:34:55,000 MRS. HUTCHISON: 2535 01:34:55,001 --> 01:34:56,000 WE'RE OPERATING UNDER A C 2536 01:34:56,001 --> 01:34:58,000 MANAGED BY SENATOR McCAIN, AND 2537 01:34:58,001 --> 01:35:00,000 SO THE REPUBLICAN SENATORS ARE 2538 01:35:00,001 --> 01:35:02,000 FREE TO ENGAGE IN A DISCUSSION. 2539 01:35:02,001 --> 01:35:04,000 MRS. HUT 2540 01:35:04,001 --> 01:35:06,000 APPRECIATE WHAT THE SENATORS 2541 01:35:06,001 --> 01:35:08,000 HAVE BEEN TALKING ABOUT, BECAUSE 2542 01:35:08,001 --> 01:35:11,000 WHAT YOU'RE SAYING, SENATOR 2543 01:35:11,001 --> 01:35:13,000 McCAIN, IS THAT TSE SENIORS 2544 01:35:13,001 --> 01:35:17,000 WHO ARE LOW-INCOME HAVE AN 2545 01:35:17,001 --> 01:35:18,000 AFFORDABLE OPTION, AND IT'S LESS 2546 01:35:18,001 --> 01:35:22,000 EXPENSIVE THAN THE AARP OPTION 2547 01:35:22,001 --> 01:35:24,000 THAT WOULD GIVE THEM THIS EXTRA 2548 01:35:24,001 --> 01:35:26,000 CARE: THE EYE CARE, THE DENTAL 2549 01:35:26,001 --> 01:35:28,000 CARE, THE HEARING AIDS. 2550 01:35:28,001 --> 01:35:31,000 IT'S AN 2551 01:35:31,001 --> 01:35:33,000 IN TEXAS, WE 2552 01:35:33,001 --> 01:35:35,000 SENIORS ENROLLED IN MEDICARE 2553 01:35:35,001 --> 01:35:36,000 ADVANTAGE, AND ONE OF THE GREAT 2554 01:35:36,001 --> 01:35:38,000 THINGS ABOUT MEDICARE ADVANTAGE 2555 01:35:38,001 --> 01:35:40,000 IS THAT IT IS AVAILABLE IN RURAL 2556 01:35:40,001 --> 01:35:42,000 AREAS AND IT GIVES THEM CHOICES 2557 01:35:42,001 --> 01:35:48,000 THAT THEY MIGHT NOT BE ABLE 2558 01:35:48,001 --> 01:35:49,000 AFFORD WITH OTHER PROGRAMS THAT 2559 01:35:49,001 --> 01:35:50,000 ARE MEDIGAP. 2560 01:35:50,001 --> 01:35:52,000 THIS ONE IS AFFORDABLE. 2561 01:35:52,001 --> 01:35:57,000 AND THAT'S WHY WE'RE FIGHTING SO 2562 01:35:57,001 --> 01:35:58,000 HARD TO RESTORE T CUTS TO 2563 01:35:58,001 --> 01:36:01,000 MEDICARE ADVANTAGE. 2564 01:36:01,001 --> 01:36:02,000 MEDICARE ADVANTAGE COSTS ABOUT 2565 01:36:02,001 --> 01:36:03,000 14% MORE THAN 2566 01:36:03,001 --> 01:36:05,000 MEDICARE BECAUSE IT PROVIDES A 2567 01:36:05,001 --> 01:36:07,000 WIDE RANGE OF THESE EXTRA 2568 01:36:07,001 --> 01:36:10,000 BENEFITS THAT WE HAVE DISCUSSED: 2569 01:36:10,001 --> 01:36:12,000 DENTAL, EYE CARE, HEARING AIDS, 2570 01:36:12,001 --> 01:36:13,000 AND IN MANY CASES IT PAYS 2571 01:36:13,001 --> 01:36:15,000 PROVIDERS MORE. 2572 01:36:15,001 --> 01:36:17,000 REPUBLICANS, OF COURSE, ARE OPEN 2573 01:36:17,001 --> 01:36:19,000 TO DISCUSSING HOW TO IMPROVE THE 2574 01:36:19,001 --> 01:36:21,000 MEDICARE ADVANTAGE PAYMENT FORMULA. 2575 01:36:21,001 --> 01:36:23,000 WE WANT TO BE MORE EFFICIENT 2576 01:36:23,001 --> 01:36:25,000 WITH TAXPAYER DOLLARS. 2577 01:36:25,001 --> 01:36:27,000 BUT DO WE WANT TO DO THAT IN THE 2578 01:36:27,001 --> 01:36:29,000 CONTEXT OF CREATING A MASSIVE 2579 01:36:29,001 --> 01:36:31,000 NEW ENTITLEMENT PROGRAM AND ASK 2580 01:36:31,001 --> 01:36:34,000 MEDICARE TO PAY FOR IT? 2581 01:36:34,001 --> 01:36:37,000 OR TO CUT LIFESAVING 2582 01:36:37,001 --> 01:36:41,000 FOR SENIORS? 2583 01:36:41,001 --> 01:36:43,000 IS THAT WHAT WE WANT TO DO? 2584 01:36:43,001 --> 01:36:44,000 SENATOR CRAPO? 2585 01:36:44,001 --> 01:36:46,000 MR. CRAPO: THANK YOU. 2586 01:36:46,001 --> 01:36:48,000 MR. PRESIDENT, THAT'S THE CASE. 2587 01:36:48,001 --> 01:36:49,000 I'D LIKE TO POINT OUT WHEN WE 2588 01:36:49,001 --> 01:36:51,000 HAD THE FINANCE 2589 01:36:51,001 --> 01:36:53,000 MARKUP, I ASKED THE C.B.O. 2590 01:36:53,001 --> 01:36:54,000 DIRECTOR ELMENDORF DIRECTLY 2591 01:36:54,001 --> 01:36:55,000 WHETHER THE PROVISIONS IN THE 2592 01:36:55,001 --> 01:36:58,000 BILL, WHICH ARE STILL IN THE 2593 01:36:58,001 --> 01:37:00,000 BILL, WOULD REDUCE THE 2594 01:37:00,001 --> 01:37:01,000 THAT MEDICARE RECIPIENTS RECEIVE. 2595 01:37:01,001 --> 01:37:03,000 AND HIS RESPONSE WAS FOR THOSE 2596 01:37:03,001 --> 01:37:05,000 WHO WOULD BE ENROLLED OTHERWISE 2597 01:37:05,001 --> 01:37:07,000 UNDER THE 2598 01:37:07,001 --> 01:37:09,000 THERE'S BEEN A LOT OF TALK HERE, 2599 01:37:09,001 --> 01:37:11,000 WELL, WE'RE NOT CUTTING MEDICARE 2600 01:37:11,001 --> 01:37:12,000 BENEFITS OR WE ARE, OR IT'S THIS 2601 01:37:12,001 --> 01:37:13,000 OR THAT. 2602 01:37:13,001 --> 01:37:15,000 THE BOTTOM LINE IS THE C.B.O. 2603 01:37:15,001 --> 01:37:16,000 DIRECTOR SAID IT DIRECTLY, YES, 2604 01:37:16,001 --> 01:37:18,000 WE'RE CUTTING BENEFITS. 2605 01:37:18,001 --> 01:37:19,000 I'D LIKE TO ASK THE SPONSOR OF 2606 01:37:19,001 --> 01:37:20,000 THIS AMENDMENT A QUESTION, 2607 01:37:20,001 --> 01:37:22,000 BECAUSE I KNOW THERE ARE SOME 2608 01:37:22,001 --> 01:37:23,000 WHO ARE SAYING THE REASON WE'RE 2609 01:37:23,001 --> 01:37:27,000 CUTTING MEDICARE ADVANTAGE IS 2610 01:37:27,001 --> 01:37:28,000 THAT IT'S SO EXPENSIVE, AND WE 2611 01:37:28,001 --> 01:37:32,000 SHOULD BE CUTTING MEDICARE AND 2612 01:37:32,001 --> 01:37:35,000 CONTROLLING ITS 2613 01:37:35,001 --> 01:37:36,000 LIKE 14% MORE EXPENSIVE THAN 2614 01:37:36,001 --> 01:37:38,000 FEE-FOR-SERVICE MEDICARE. 2615 01:37:38,001 --> 01:37:39,000 SOME PEOPLE SAY, IF YOU'RE 2616 01:37:39,001 --> 01:37:41,000 DEFENDING MEDICARE ADVANTAGE, 2617 01:37:41,001 --> 01:37:42,000 YOU'RE DEFENDING OVERPAYMENTS IN HEALTH CARE PLANS. 2618 01:37:42,001 --> 01:37:45,000 WOULD THE SENATOR FROM UTAH LIKE 2619 01:37:45,001 --> 01:37:46,000 TO RESPOND TO THAT CRITICISM 2620 01:37:46,001 --> 01:37:47,000 THAT SOME ARE MAKING? 2621 01:37:47,001 --> 01:37:48,000 MR. HATCH: I'D BE DELIGHTED TO 2622 01:37:48,001 --> 01:37:50,000 DO THAT. 2623 01:37:50,001 --> 01:37:51,000 TO BE CLEAR, THE SO-CALLED 2624 01:37:51,001 --> 01:37:54,000 OVERPAYMENTS TO MEDICARE 2625 01:37:54,001 --> 01:37:56,000 ADVANTAGE PLANS DO NOT GO TO THE PLANS. 2626 01:37:56,001 --> 01:38:01,000 AS A 2627 01:38:01,001 --> 01:38:02,000 THE SENIORS IN THE FORM OF BENEFITS. 2628 01:38:02,001 --> 01:38:04,000 THAT'S A PRETTY IMPORTANT THING 2629 01:38:04,001 --> 01:38:07,000 THAT A LOT OF PEOPLE MISS. 2630 01:38:07,001 --> 01:38:08,000 75% OF THE ADDITIONAL PAYMENTS 2631 01:38:08,001 --> 01:38:10,000 TO MICARE ADVANTAGE PLANS ARE 2632 01:38:10,001 --> 01:38:13,000 USED TO PROVIDE SENIORS WITH 2633 01:38:13,001 --> 01:38:15,000 EXTRA BENEFITS, INCLUDING 2634 01:38:15,001 --> 01:38:17,000 CHRONIC CARE MANAGEMENT. 2635 01:38:17,001 --> 01:38:18,000 YOU WOULD THINK YOU'D WANT TO DO 2636 01:38:18,001 --> 01:38:21,000 THAT. 2637 01:38:21,001 --> 01:38:25,000 HEARING AIDS, EYEGLASSES. 2638 01:38:25,001 --> 01:38:26,000 THE OTHER 25% OF ANY EXTRA 2639 01:38:26,001 --> 01:38:27,000 PAYMENTS ARE RETURNED TO THE 2640 01:38:27,001 --> 01:38:29,000 FEDERAL GOVERNMENT. 2641 01:38:29,001 --> 01:38:32,000 I MEAN, I CAN'T IMAGINE WHY 2642 01:38:32,001 --> 01:38:33,000 ANYBODY WOULDN THAT. 2643 01:38:33,001 --> 01:38:34,000 MRS. HUTCHIS 2644 01:38:34,001 --> 01:38:38,000 I WOU 2645 01:38:38,001 --> 01:38:39,000 SENATOR FROM UTAH: LET ME ASK 2646 01:38:39,001 --> 01:38:40,000 YOU TO ALSO RESPOND TO THE 2647 01:38:40,001 --> 01:38:42,000 ARGUMENTS THAT CLAIM THAT THE 2648 01:38:42,001 --> 01:38:47,000 GOVERNMENT REALLY CAN'T AFFD 2649 01:38:47,001 --> 01:38:49,000 NOW TO CONTINUE 2650 01:38:49,001 --> 01:38:51,000 PRIVATE PLANS AND THAT THE 2651 01:38:51,001 --> 01:38:53,000 MEDICARE TRUST FUND IS GOING BROKE. 2652 01:38:53,001 --> 01:38:54,000 OF COURSE WE'RE TRYING -- WE 2653 01:38:54,001 --> 01:38:56,000 TRIED ACTUALLY SEVERAL YEARS 2654 01:38:56,001 --> 01:38:58,000 TO SHORE UP THE MEDICARE 2655 01:38:58,001 --> 01:39:02,000 PROGRAM, TRYING TO DO IT IN A 2656 01:39:02,001 --> 01:39:04,000 RESPONSIBLE WAY, NOT CUTTING OUT 2657 01:39:04,001 --> 01:39:06,000 TH MEDICARE BENEFITS THAT THESE 2658 01:39:06,001 --> 01:39:07,000 SENIORS 2659 01:39:07,001 --> 01:39:09,000 AFFORDABLE 2660 01:39:09,001 --> 01:39:10,000 BUT WHAT DO YOU SAY TO THAT? 2661 01:39:10,001 --> 01:39:12,000 MR. HATCH: YOU POINTED OUT THE 2662 01:39:12,001 --> 01:39:13,000 MEDICARE TRUST FUND IS GOING 2663 01:39:13,001 --> 01:39:14,000 YET, WHAT DO WE HAVE FROM THE 2664 01:39:14,001 --> 01:39:18,000 OTHER SIDE? 2665 01:39:18,001 --> 01:39:20,000 TAKE ALMOST $500 BILLION OUT OF 2666 01:39:20,001 --> 01:39:22,000 NOW,O TRUST ME, 2667 01:39:22,001 --> 01:39:26,000 CONCERNED ABOUT THE SOLVENCY OF 2668 01:39:26,001 --> 01:39:28,000 MR. McCAIN: IT'S MY 2669 01:39:28,001 --> 01:39:29,000 UNDERSTANDING THAT 2670 01:39:29,001 --> 01:39:31,000 S ACTUALLY SEEN MEDICARE 2671 01:39:31,001 --> 01:39:33,000 ADVANTAGE PATIENTS, HE AND 2672 01:39:33,001 --> 01:39:34,000 DR. COBURN ARE PROBABLY THE 2673 01:39:34,001 --> 01:39:36,000 TWO. 2674 01:39:36,001 --> 01:39:37,000 AND MAYBE WE COULD GIVE HIM THE 2675 01:39:37,001 --> 01:39:40,000 BENEFIT -- GIVE US THE BENEFIT 2676 01:39:40,001 --> 01:39:41,000 OF HIS EXPERIENCE AND ALSO NOT 2677 01:39:41,001 --> 01:39:42,000 ONLY BENEFIT OF HIS EXPERIENCE, 2678 01:39:42,001 --> 01:39:45,000 BUT I'M SURE HE'S GOING TO TELL 2679 01:39:45,001 --> 01:39:47,000 US WHAT'S THE IMPACT GOING TO BE 2680 01:39:47,001 --> 01:39:51,000 ON THESE -- ON THE LOW-INCOME 2681 01:39:51,001 --> 01:39:52,000 SENIORS FROM HIS 2682 01:39:52,001 --> 01:39:55,000 MR. BARRASSO: I AGREE WITH THE 2683 01:39:55,001 --> 01:39:56,000 SENATOR FROM ARIZONA THAT PEOPLE 2684 01:39:56,001 --> 01:39:59,000 CHOOSE TO BE ON MEDICARE ADVANTAGE. 2685 01:39:59,001 --> 01:40:00,000 11 MILLION PEOPLE HAVE CHOSEN TO 2686 01:40:00,001 --> 01:40:03,000 BE ON MEDICARE ADVANTAGE BECAUSE 2687 01:40:03,001 --> 01:40:05,000 IT'S A WISE CHOICE TO MAKE, 2688 01:40:05,001 --> 01:40:06,000 BECAUSE THEY GET BETTER 2689 01:40:06,001 --> 01:40:07,000 BENEFITS. 2690 01:40:07,001 --> 01:40:08,000 THEY GET DENTAL CARE. 2691 01:40:08,001 --> 01:40:09,000 THEY GET THE VISION CARE. 2692 01:40:09,001 --> 01:40:12,000 THEY GET THE HEARING. 2693 01:40:12,001 --> 01:40:13,000 THEY GET THE 2694 01:40:13,001 --> 01:40:15,000 MR. McCAIN: AS WE DO. 2695 01:40:15,001 --> 01:40:18,000 MR. BARRASSO: JUST AS WE DO. 2696 01:40:18,001 --> 01:40:19,000 IT 2697 01:40:19,001 --> 01:40:20,000 COORDINATED CARE. 2698 01:40:20,001 --> 01:40:23,000 MR. McCAIN: I DON'T THINK THEY 2699 01:40:23,001 --> 01:40:25,000 HAVE AS NICE A GYMNASIUM AS 2700 01:40:25,001 --> 01:40:26,000 WE'RE GOING TO GET. 2701 01:40:26,001 --> 01:40:28,000 MR. BARRASSO: IT'S ALSO NO 2702 01:40:28,001 --> 01:40:29,000 SURPRISE THAT WHEN PEOPLE READ 2703 01:40:29,001 --> 01:40:30,000 ABOUT IT AND LEARN ABOUT IT THAT 2704 01:40:30,001 --> 01:40:31,000 THEY WOULD WANT TO BE ON 2705 01:40:31,001 --> 01:40:33,000 MEDICARE ADVANTAGE. 2706 01:40:33,001 --> 01:40:35,000 WHAT THE SENATOR FROM UTAH HAS 2707 01:40:35,001 --> 01:40:36,000 SAID AND THE SPONSOR OF THIS 2708 01:40:36,001 --> 01:40:37,000 AMENDMENT, THE MONEY THAT GOES 2709 01:40:37,001 --> 01:40:38,000 INTO THIS PROGRAM IS FOR THE 2710 01:40:38,001 --> 01:40:41,000 BENEFIT OF THE SENIORS. 2711 01:40:41,001 --> 01:40:42,000 IT'S FOR SERVICES FOR THE 2712 01:40:42,001 --> 01:40:44,000 SENIORS ON MEDICARE. 2713 01:40:44,001 --> 01:40:49,000 THIS IS -- TO ME, THIS WHOLE 2714 01:40:49,001 --> 01:40:50,000 BILL BASICALLY GUTS MEDICARE, 2715 01:40:50,001 --> 01:40:52,000 RAIDS MEDICARE TO START A WHOLE 2716 01:40:52,001 --> 01:40:53,000 NEW PROGRAM. 2717 01:40:53,001 --> 01:40:55,000 TODAY, AS THE SENATOR FROM 2718 01:40:55,001 --> 01:40:57,000 ARIZONA HAS MENTIONED, IN THESE 2719 01:40:57,001 --> 01:40:59,000 ARTICLE, TODAY'S ASSOCIATED 2720 01:40:59,001 --> 01:41:02,000 PRESS AND "USA TODAY" "SENATE 2721 01:41:02,001 --> 01:41:04,000 DEMOCRATS CLOSED RANKS THURSDAY 2722 01:41:04,001 --> 01:41:07,000 BEHIND $460 BILLION IN 2723 01:41:07,001 --> 01:41:09,000 POLITICALLY RISKY MEDICARE CUTS 2724 01:41:09,001 --> 01:41:10,000 AT THE HEART 2725 01:41:10,001 --> 01:41:12,000 LEGISLATION." 2726 01:41:12,001 --> 01:41:14,000 IT GOES ON TO SAY "APPROVAL 2727 01:41:14,001 --> 01:41:15,000 WOULD HAVE STRIPPED OUT MONEY TO 2728 01:41:15,001 --> 01:41:19,000 PAY FOR EXPANDING COVERAGE TO 2729 01:41:19,001 --> 01:41:21,000 TENS OF MILLIONS OF UNINSURED AMERICANS." 2730 01:41:21,001 --> 01:41:23,000 THEY'RE GOING TO TAKE $460 2731 01:41:23,001 --> 01:41:25,000 BILLION, THIS SAYS, AWAY FROM 2732 01:41:25,001 --> 01:41:26,000 OUR SENIORS WHO DEPEND UPON IT 2733 01:41:26,001 --> 01:41:28,000 FOR THEIR MEDICARE AND START A 2734 01:41:28,001 --> 01:41:30,000 WHOLE NEW GOVERNMENT PROGRAM. 2735 01:41:30,001 --> 01:41:32,000 IT SAYS -- "WASHINGTON TIMES," 2736 01:41:32,001 --> 01:41:35,000 FRONT-PAGE STORY, HEADLINES, 2737 01:41:35,001 --> 01:41:37,000 "DEMOCRATS WIN CUTS OF $400 2738 01:41:37,001 --> 01:41:38,000 BILLION TO MEDICARE." 2739 01:41:38,001 --> 01:41:39,000 McCAIN PUSHED FOR ANOTHER WAY 2740 01:41:39,001 --> 01:41:40,000 TO PAY. 2741 01:41:40,001 --> 01:41:42,000 SO I LOOK AT THIS AND SAY THIS 2742 01:41:42,001 --> 01:41:43,000 IS NOT FAIR TO OUR SENIORS, NOT 2743 01:41:43,001 --> 01:41:46,000 FAIR TO THE PATIENTS THAT I HAVE 2744 01:41:46,001 --> 01:41:48,000 TAKEN CARE OF FOR 25 YEARS IN 2745 01:41:48,001 --> 01:41:52,000 WYOMING, TAKEN CARE OF FAMILIES, 2746 01:41:52,001 --> 01:41:53,000 TAKEN CARE OF FOLKS WHEN GRANDMA 2747 01:41:53,001 --> 01:41:55,000 BREAKS HER HIP AND WHAT WE NEED 2748 01:41:55,001 --> 01:41:56,000 TO DO FOR OUR PATIENTS. 2749 01:41:56,001 --> 01:41:57,000 THESE ARE CHOICES THAT PEOPLE 2750 01:41:57,001 --> 01:41:58,000 HAVE MADE. 2751 01:41:58,001 --> 01:41:59,000 11 MILLION AMERICANS HAVE CLO 2752 01:41:59,001 --> 01:42:01,000 MEDICARE ADVANTAGE BECAUSE THERE 2753 01:42:01,001 --> 01:42:02,000 IS AN ADVANTAGE TO THEM FOR THE 2754 01:42:02,001 --> 01:42:04,000 HEALTH CARE THEY GET. 2755 01:42:04,001 --> 01:42:06,000 THE ADDITIONAL SERVICES, THE 2756 01:42:06,001 --> 01:42:07,000 COORDINATED CARE, THE PREVENTIVE 2757 01:42:07,001 --> 01:42:09,000 CARE. 2758 01:42:09,001 --> 01:42:10,000 ANYONE WHO LOOKS AT THIS AND 2759 01:42:10,001 --> 01:42:12,000 STUDIES IT SAYS I WANT TO SIGN 2760 01:42:12,001 --> 01:42:14,000 UP FOR THIS. 2761 01:42:14,001 --> 01:42:15,000 IT'S 2762 01:42:15,001 --> 01:42:16,000 AREAS, WONDERFUL IN BIG CITIES. 2763 01:42:16,001 --> 01:42:17,000 THIS HAS HELPED A LOT OF PEOPLE 2764 01:42:17,001 --> 01:42:18,000 IN THE COUNTRY. 2765 01:42:18,001 --> 01:42:19,000 SO IT'S NOT SURPRISING THAT ONE 2766 01:42:19,001 --> 01:42:21,000 OUT OF FOUR PEOPLE IN THE 2767 01:42:21,001 --> 01:42:22,000 COUNTRY ON MEDICARE HAVE CHOSEN 2768 01:42:22,001 --> 01:42:23,000 MEDICARE ADVANTAGE. 2769 01:42:23,001 --> 01:42:25,000 BUT YET WHAT WE'RE SEEING HERE 2770 01:42:25,001 --> 01:42:26,000 IS THE DEMOCRATS WANT TO GET 2771 01:42:26,001 --> 01:42:28,000 OF MEDICARE 2772 01:42:28,001 --> 01:42:31,000 MR. McCAIN: SO LET ME GET THIS STRAIGHT. 2773 01:42:31,001 --> 01:42:35,000 SO BASICALLY BY REMOVING THE 2774 01:42:35,001 --> 01:42:37,000 CHCES THAT SENIORS HAVE AS A 2775 01:42:37,001 --> 01:42:40,000 PART OF MEDICARE ADVANTAGE -- 2776 01:42:40,001 --> 01:42:41,000 DENTAL, VISION, HEARING, 2777 01:42:41,001 --> 01:42:43,000 FITN 2778 01:42:43,001 --> 01:42:45,000 TAKING AWAY FROM THEM WHAT WE 2779 01:42:45,001 --> 01:42:47,000 OURSELVES ENJOY EVERY SINGLE DAY 2780 01:42:47,001 --> 01:42:49,000 HERE IN THE UNITED STATES SENATE? 2781 01:42:49,001 --> 01:42:50,000 MR. BARRASSO: WE ARE TAKING IT 2782 01:42:50,001 --> 01:42:51,000 AWAY FROM SENIORS, AND WE'RE 2783 01:42:51,001 --> 01:42:53,000 USING ALL OF THAT MONEY TO START 2784 01:42:53,001 --> 01:42:54,000 A NEW GOVERNMENT PROGRAM WHEN WE 2785 01:42:54,001 --> 01:42:57,000 KNOW THAT MEDICARE ITSELF IS 2786 01:42:57,001 --> 01:42:59,000 GOING TO GO BROKE BY THE YEAR -- MR. HATCH: I THINK WE OUGHT TO 2787 01:42:59,001 --> 01:43:00,000 BE LISTENING TO ONE OF THE ONLY 2788 01:43:00,001 --> 01:43:02,000 TWO DOCTORS IN THE UNITED STATES 2789 01:43:02,001 --> 01:43:03,000 SENATE WHO REALLY KNOWS, WHO'S 2790 01:43:03,001 --> 01:43:05,000 BEEN ON THE GROUND, WHO'S MET 2791 01:43:05,001 --> 01:43:07,000 WITH THE PEOPLE, WHO UNDERSTANDS 2792 01:43:07,001 --> 01:43:09,000 WHAT THIS MEANSO SENIOR CITIZENS. 2793 01:43:09,001 --> 01:43:10,000 A QUARTER OF WHOM ARE ON 2794 01:43:10,001 --> 01:43:11,000 MEDICARE ADVANTAGE. 2795 01:43:11,001 --> 01:43:13,000 AND IN THE END, I BELIEVE WE 2796 01:43:13,001 --> 01:43:14,000 ACTUALLY NOT ONLY HELP THE 2797 01:43:14,001 --> 01:43:17,000 SENIORS TO BE MORE HEALT 2798 01:43:17,001 --> 01:43:18,000 WE SAVE A LOT OF MONEY IN THE END. 2799 01:43:18,001 --> 01:43:20,000 TRUST ME, I'M DEEPLY CONCERNED 2800 01:43:20,001 --> 01:43:22,000 ABOUT THE SOLVENCY OF THE MEDICARERUST FUND. 2801 01:43:22,001 --> 01:43:24,000 AS YOU KNOW, WE'VE BEEN SOUNDING 2802 01:43:24,001 --> 01:43:26,000 THAT ALARM FOR YEARS, FOR YEARS. 2803 01:43:26,001 --> 01:43:30,000 THAT'S WHY IT'S SO SHOCKING THAT 2804 01:43:30,001 --> 01:43:31,000 WE AREEBATING A 2805 01:43:31,001 --> 01:43:33,000 HEALTH REFORM BILL THAT DOES 2806 01:43:33,001 --> 01:43:34,000 ALMOST NOTHING TO MAKE SURE THAT 2807 01:43:34,001 --> 01:43:36,000 MEDICARE IS SOUND. 2808 01:43:36,001 --> 01:43:41,000 IN FACT, DOES A LOT OF THINGS TO 2809 01:43:41,001 --> 01:43:42,000 MAKE IT U 2810 01:43:42,001 --> 01:43:44,000 NOTHING TO MAKE SURE THAT 2811 01:43:44,001 --> 01:43:46,000 MEDICARE IS AROUND FOR FUTURE GENERATIONS. 2812 01:43:46,001 --> 01:43:47,000 INSTEAD WE'RE ST CREATING 2813 01:43:47,001 --> 01:43:49,000 ANOTHER FEDERAL ENTITLEMENT 2814 01:43:49,001 --> 01:43:53,000 PROGRAM THAT WE CANNOT AFFORD 2815 01:43:53,001 --> 01:43:55,000 WHILE MEDICARE'S $38 TRILLION IN 2816 01:43:55,001 --> 01:43:57,000 UNFUNDED LIABILITIES. A SENATOR: A LOT OF PEOPLE 2817 01:43:57,001 --> 01:44:00,000 TRYING TO DEFEND THESE CUTS ARE 2818 01:44:00,001 --> 01:44:03,000 SAYING THESE EXPERT COSTS IN THE 2819 01:44:03,001 --> 01:44:05,000 GOING 2820 01:44:05,001 --> 01:44:06,000 COMPANIES PROFITS BIGGER AND TO 2821 01:44:06,001 --> 01:44:08,000 HELP LARGE C.E.O. SALARIES AND 2822 01:44:08,001 --> 01:44:09,000 SO FORTH. 2823 01:44:09,001 --> 01:44:11,000 MR. CRAPO: BUT NOTHING COULD 2824 01:44:11,001 --> 01:44:12,000 BE FURTHER FROM THE TRUTH. 2825 01:44:12,001 --> 01:44:14,000 THE REALITY IS, AS THE SENATOR 2826 01:44:14,001 --> 01:44:16,000 FROM UTAH HAS INDICATED, THAT 2827 01:44:16,001 --> 01:44:18,000 75% OF THIS 14% EXTRA PAYMENT 2828 01:44:18,001 --> 01:44:19,000 GOES TO -- IN THESE PLANS GO TO 2829 01:44:19,001 --> 01:44:20,000 PROVIDE THE SENIORS WITH THE 2830 01:44:20,001 --> 01:44:22,000 EXTRA BENEFITS THAT WE ARE 2831 01:44:22,001 --> 01:44:24,000 TALKING ABOUT HERE. 2832 01:44:24,001 --> 01:44:25,000 AND THEN 25% IS RETURNED TO THE 2833 01:44:25,001 --> 01:44:27,000 FEDERAL 2834 01:44:27,001 --> 01:44:28,000 NOT TO INSURANCE COMPANIES. 2835 01:44:28,001 --> 01:44:30,000 NOT TO C.E.O.'S. 2836 01:44:30,001 --> 01:44:31,000 AND I HAVE A CHART HERE. 2837 01:44:31,001 --> 01:44:32,000 WE'RE GOING TO MAKE THIS INTO A 2838 01:44:32,001 --> 01:44:33,000 BIGGER ONE. 2839 01:44:33,001 --> 01:44:34,000 BUT WHEN THOSE WHO SUPPORT THIS 2840 01:44:34,001 --> 01:44:36,000 PROGRAM SAY THAT WE ARE NOT 2841 01:44:36,001 --> 01:44:39,000 CUTTING MEDICARE BENEFITS, THIS 2842 01:44:39,001 --> 01:44:40,000 CHART -- I APOLOGIZE, IT'S A 2843 01:44:40,001 --> 01:44:41,000 LITTLE BIT SMALL -- BUT THIS IS 2844 01:44:41,001 --> 01:44:43,000 A CHART OF THE UNITED STATES AND 2845 01:44:43,001 --> 01:44:45,000 IT SHOWS YOU WHAT'S HAPPENING TO 2846 01:44:45,001 --> 01:44:48,000 THE 2847 01:44:48,001 --> 01:44:51,000 ADVANTAGE 2848 01:44:51,001 --> 01:44:52,000 THE DARK RED IS MORE THAN 350% 2849 01:44:52,001 --> 01:44:54,000 REDUCTION OF THE PEOPLE IN -- 2850 01:44:54,001 --> 01:44:58,000 MORE THAN 50% REDUCTION OF THE 2851 01:44:58,001 --> 01:45:00,000 PEOP IN KNOWS DARK RED STATES. 2852 01:45:00,001 --> 01:45:01,000 THE MEDIUM COLORS IS A 25% 2853 01:45:01,001 --> 01:45:02,000 REDUCTION. 2854 01:45:02,001 --> 01:45:04,000 THE ONLY STATES WITHOUT A 2855 01:45:04,001 --> 01:45:06,000 REDUCTION ARE THE WHITE ONES. THREE OR FOUR STATES THAT ARE 2856 01:45:06,001 --> 01:45:08,000 NOT SEEING DEEP CUTS IN MEDICARE 2857 01:45:08,001 --> 01:45:11,000 ADVANTAGE BENEFITS. 2858 01:45:11,001 --> 01:45:12,000 AND THOSE WHO SAY, LIKE THE 2859 01:45:12,001 --> 01:45:14,000 PRESIDENT SAID WAS ONE OF HIS 2860 01:45:14,001 --> 01:45:15,000 GOALS, THAT IF YOU LIKE WHAT YOU 2861 01:45:15,001 --> 01:45:16,000 HAVE, YOU CAN KEEP IT, NOTF 2862 01:45:16,001 --> 01:45:18,000 YOU LIVE IN ONE OF THE STATES 2863 01:45:18,001 --> 01:45:20,000 THAT'S NOT IN WHITE ON THIS 2864 01:45:20,001 --> 01:45:23,000 CHART. 2865 01:45:23,001 --> 01:45:25,000 BECAUSE YOUR BENEFITS WILL BE 2866 01:45:25,001 --> 01:45:26,000 CUT. MR. ALEXANDER: I WONDER IF I 2867 01:45:26,001 --> 01:45:27,000 MIGHT ASK THE SENATOR FROM IDAHO 2868 01:45:27,001 --> 01:45:29,000 TO GO BACK OVER A POINT HE MADE 2869 01:45:29,001 --> 01:45:30,000 JUST A 2870 01:45:30,001 --> 01:45:32,000 WENT OVER IT QUICKLY BUT IT IS 2871 01:45:32,001 --> 01:45:34,000 SUCH AN IMPORTANT POINT AND IT 2872 01:45:34,001 --> 01:45:36,000 IS THE ONE REFLECTED BY THE 2873 01:45:36,001 --> 01:45:37,000 CHART BEHIND HIM AND BY WHAT 2874 01:45:37,001 --> 01:45:38,000 JUST SAID. 2875 01:45:38,001 --> 01:45:42,000 REPEATEDLY WE'RE TOLD THAT 2876 01:45:42,001 --> 01:45:45,000 SENIORS WON'T LOSE BENEFITS TO 2877 01:45:45,001 --> 01:45:46,000 BE CUT NEARLY A HALF TRILLION IN 2878 01:45:46,001 --> 01:45:47,000 MEDICAID. 2879 01:45:47,001 --> 01:45:48,000 SO IF YOU COULD TAKE A MOMENT -- 2880 01:45:48,001 --> 01:45:50,000 I BELIEVE YOU WERE IN THE 2881 01:45:50,001 --> 01:45:51,000 FINANCE COMMITTEE MARKUP WHERE 2882 01:45:51,001 --> 01:45:54,000 THE BILL WAS BEING WRITTEN THAT 2883 01:45:54,001 --> 01:45:55,000 WAS OFFERED BY THE DISTINGUISHED 2884 01:45:55,001 --> 01:45:56,000 FINANCE COMMITTEE CHAIRMAN. 2885 01:45:56,001 --> 01:45:58,000 AND I BELIEVE YOU WERE TALKING 2886 01:45:58,001 --> 01:46:00,000 TO THE HEAD OF THE CONGRESSIONAL 2887 01:46:00,001 --> 01:46:01,000 BUDGET OFFICE, WHO IS OFTEN 2888 01:46:01,001 --> 01:46:03,000 CITED BY OUR FRIENDS ON THE 2889 01:46:03,001 --> 01:46:05,000 OTHER SIDE AS THE NONPARTISAN 2890 01:46:05,001 --> 01:46:06,000 THORITY FOR EXACTLY WHAT THE 2891 01:46:06,001 --> 01:46:08,000 BILL DOES. 2892 01:46:08,001 --> 01:46:10,000 AND I BELIEVE YOU ASKED HIM 2893 01:46:10,001 --> 01:46:12,000 WHETHER BENEFITS OF MEDICARE 2894 01:46:12,001 --> 01:46:14,000 ADVANTAGE SIFT RECIPIENTS WOULD BE CUT. 2895 01:46:14,001 --> 01:46:16,000 WOULD YOU DESCRIBE TT IN A 2896 01:46:16,001 --> 01:46:19,000 LITTLE MORE DETAIL SO PEOPLE 2897 01:46:19,001 --> 01:46:21,000 UNDERSTAND 2898 01:46:21,001 --> 01:46:22,000 MR. CRAPO: YES, I WOULD. 2899 01:46:22,001 --> 01:46:23,000 THIS CHART SHOWS THE LAST TWO 2900 01:46:23,001 --> 01:46:25,000 SENTENCES OF OUR COLLOQUY WHEN 2901 01:46:25,001 --> 01:46:27,000 WE WERE IN THE FINANCE COMMITTEE. 2902 01:46:27,001 --> 01:46:30,000 BUT IT WENT WENT ON FOR SOMETIME. 2903 01:46:30,001 --> 01:46:32,000 I WAS ASKING THE DIRECTOR OF 2904 01:46:32,001 --> 01:46:33,000 C.B.O. WHETHER THE CUTS TO 2905 01:46:33,001 --> 01:46:35,000 MEDICARE ADVANTAGE THAT ARE IN 2906 01:46:35,001 --> 01:46:37,000 THE BILL WOULD REDUCE BEFITS 2907 01:46:37,001 --> 01:46:40,000 TO SENIOR CITIZENS. 2908 01:46:40,001 --> 01:46:41,000 AND HE SAID, YES. 2909 01:46:41,001 --> 01:46:43,000 AND THE REASON HE HAD THIS 2910 01:46:43,001 --> 01:46:44,000 PHRASE THAT SAID "FOR THOSE WHO 2911 01:46:44,001 --> 01:46:47,000 WOULD BE ENROLLED OTHERWISE 2912 01:46:47,001 --> 01:46:50,000 UNDER CURRENT LAW" -- THE REASON 2913 01:46:50,001 --> 01:46:51,000 HE PREFACED 2914 01:46:51,001 --> 01:46:52,000 REST OF WHAT HE SAID WAS THAT 2915 01:46:52,001 --> 01:46:54,000 FOR FUTURE SENIORS, IT'S NOT 2916 01:46:54,001 --> 01:46:56,000 GOING TO BE A VIABLE OPTION. 2917 01:46:56,001 --> 01:46:58,000 SO THEY IN THE FUTURE, THOSE WHO 2918 01:46:58,001 --> 01:47:00,000 ARE NOT ON IT NOW, WON'T HAVE A 2919 01:47:00,001 --> 01:47:02,000 REALLY SIGNIFICANT, VIABLE 2920 01:47:02,001 --> 01:47:04,000 OPTION TO GET ON IT BECAUSE IT'S 2921 01:47:04,001 --> 01:47:05,000 GOING TO BE GUTTED. 2922 01:47:05,001 --> 01:47:07,000 SO WHAT HE WAS SAYING FOR THOSE 2923 01:47:07,001 --> 01:47:08,000 75% -- BY THE WAY, MEDICARE 2924 01:47:08,001 --> 01:47:10,000 ADVANTAGE IS THE MOST POPULAR 2925 01:47:10,001 --> 01:47:12,000 PART OF MEDICARE IN AMERICA TODAY. 2926 01:47:12,001 --> 01:47:14,000 THE FASTEST OF-GROWING PART OF 2927 01:47:14,001 --> 01:47:15,000 MEDICARE BECAUSE IT IS SO 2928 01:47:15,001 --> 01:47:16,000 POPULAR, BECAUSE IT PROVIDES 2929 01:47:16,001 --> 01:47:18,000 THESE ADDITIONAL BIFORTS THAT 2930 01:47:18,001 --> 01:47:19,000 SENIORS HAVE TO PAY SO 2931 01:47:19,001 --> 01:47:20,000 SIGNIFICANTLY FOR TO GET IN 2932 01:47:20,001 --> 01:47:22,000 SUPPLEMENTAL INSURANCE THAT AARP 2933 01:47:22,001 --> 01:47:23,000 IS GOING TO 2934 01:47:23,001 --> 01:47:25,000 AND WHAT THE C.B.O. DIRECTOR 2935 01:47:25,001 --> 01:47:27,000 SAID WAS THAT FOR THE FUTURE, 2936 01:47:27,001 --> 01:47:28,000 THOSE WHO AREN'T ALREADY ON IT 2937 01:47:28,001 --> 01:47:29,000 DON'T GET IT. 2938 01:47:29,001 --> 01:47:30,000 MR. McCAIN: COULD THE SENATOR 2939 01:47:30,001 --> 01:47:32,000 FROM TEXAS AND I GO BACK A 2940 01:47:32,001 --> 01:47:35,000 SECOND TO ONE OF THE THINGS I 2941 01:47:35,001 --> 01:47:38,000 MENTIONED EARLIER, BECAUSE IN 2942 01:47:38,001 --> 01:47:39,000 TEXAS, I ASK HOW MUCH ARE UNDER 2943 01:47:39,001 --> 01:47:43,000 MEDICARE CARE? 2944 01:47:43,001 --> 01:47:45,000 HUTCH 500,000 OF MY CONSTITUENTS. 2945 01:47:45,001 --> 01:47:46,000 MR. McCAIN: 500,000 SENIOR 2946 01:47:46,001 --> 01:47:47,000 CITIZENS IN YOUR STATE. 2947 01:47:47,001 --> 01:47:50,000 THERE IS NO -- QUOTE -- 2948 01:47:50,001 --> 01:47:52,000 "SHIELDINSHIELDING." 2949 01:47:52,001 --> 01:47:55,000 ACCORDING TO THIS BLOOMBERG 2950 01:47:55,001 --> 01:47:56,000 ARTICLE, IT SAYS "SENATORS'S 2951 01:47:56,001 --> 01:47:58,000 SENATORS CHARLES SCHUMER, BILL 2952 01:47:58,001 --> 01:48:02,000 NELSON OF FLORIDA AND RON WYDEN 2953 01:48:02,001 --> 01:48:06,000 OF 2954 01:48:06,001 --> 01:48:09,000 SECURED SPECIAL PROVISIONS CUTS." 2955 01:48:09,001 --> 01:48:11,000 CASEY -- THAT'S SENATOR CASEY 2956 01:48:11,001 --> 01:48:13,000 SAYS HE 2957 01:48:13,001 --> 01:48:15,000 COMPARABLE PROTECTIONS FOR HIS STATE." 2958 01:48:15,001 --> 01:48:17,000 SURPRISINGLY ENOUGH. 2959 01:48:17,001 --> 01:48:19,000 "WHERE MORE THAN ONE-THIRD OF 2960 01:48:19,001 --> 01:48:21,000 MEDICARE BENEFICIARIES 2961 01:48:21,001 --> 01:48:22,000 PARTICIPATE IN MEDICARE 2962 01:48:22,001 --> 01:48:24,000 ADVANTAGE." 2963 01:48:24,001 --> 01:48:25,000 QUOTE -- "IT IS THE KIND OF 2964 01:48:25,001 --> 01:48:27,000 THING THAT WILL LIKELY BE 2965 01:48:27,001 --> 01:48:28,000 ADDRESSED ON 2966 01:48:28,001 --> 01:48:29,000 "I EAGERLY LOOK FORWARD TO 2967 01:48:29,001 --> 01:48:31,000 WORKING ON THE OTHER SIDE OF THE 2968 01:48:31,001 --> 01:48:32,000 AISLE WITH ALL THE MEMBERS FROM 2969 01:48:32,001 --> 01:48:35,000 THOSE STATES WITH THE EXCEPTION 2970 01:48:35,001 --> 01:48:37,000 OF NEW YORK, FLORIDA, AND OREGON 2971 01:48:37,001 --> 01:48:39,000 WHO HAVE EARNED SPECIAL 2972 01:48:39,001 --> 01:48:40,000 SHIELDING FROM THESE CUTS. 2973 01:48:40,001 --> 01:48:43,000 I LOOK FORWARD TO WORKING WITH 2974 01:48:43,001 --> 01:48:44,000 THEM AND LET'S FIX IT FOR ALL OF US. 2975 01:48:44,001 --> 01:48:45,000 RIGHT, SENATOR? 2976 01:48:45,001 --> 01:48:46,000 MR. HATCH: THAT'S RIGHT. 2977 01:48:46,001 --> 01:48:47,000 GO AHEAD. 2978 01:48:47,001 --> 01:48:48,000 MRS. HUTCHISON: I WOULD JUST 2979 01:48:48,001 --> 01:48:50,000 SAY TO THE SENATOR 2980 01:48:50,001 --> 01:48:53,000 I WAS WONDERING IF EVERY STATE 2981 01:48:53,001 --> 01:48:56,000 COULD HAVE THE SAME 2982 01:48:56,001 --> 01:48:58,000 WHY NOT HAVE EVERY STA 2983 01:48:58,001 --> 01:49:00,000 THIS SHIELDING FOR THEIR 2984 01:49:00,001 --> 01:49:01,000 MEDICARE ADVANTAGE? 2985 01:49:01,001 --> 01:49:04,000 THAT IS 11 MILLION PEOPLE IN 2986 01:49:04,001 --> 01:49:07,000 THIS COUNTRY WHO 2987 01:49:07,001 --> 01:49:08,000 HELPED BY A FAIR ASSESSMENT ALL 2988 01:49:08,001 --> 01:49:12,000 OVER THE 2989 01:49:12,001 --> 01:49:13,000 BUT MEET ME JUST POINT OUT ONE 2990 01:49:13,001 --> 01:49:14,000 -- BUT LET ME JUST POINT OUT ONE 2991 01:49:14,001 --> 01:49:15,000 OTHE 2992 01:49:15,001 --> 01:49:17,000 THE WAY THEY HAVE BEEN SHIELDED 2993 01:49:17,001 --> 01:49:19,000 IS GRANDFATHERING. 2994 01:49:19,001 --> 01:49:21,000 CANE INAND 2995 01:49:21,001 --> 01:49:22,000 -- AND MAY I ASK, WAS THAT 2996 01:49:22,001 --> 01:49:23,000 SHIELDING DONE ON THE FLOOR OF 2997 01:49:23,001 --> 01:49:24,000 THE SENATE IN OPEN DEBATE AND 2998 01:49:24,001 --> 01:49:25,000 DISCUSSION OF THE ISSUE? 2999 01:49:25,001 --> 01:49:27,000 MR. HATCH: OH, NO. 3000 01:49:27,001 --> 01:49:28,000 MRS. HUTCHISON: OH, 3001 01:49:28,001 --> 01:49:29,000 NOW AMISSIONLY 3002 01:49:29,001 --> 01:49:30,000 MR. McCAIN: ITY IT WAS DONE IN 3003 01:49:30,001 --> 01:49:32,000 AN OFFICE HERE WHERE WE STILL 3004 01:49:32,001 --> 01:49:33,000 AWAIT THE WHITE SMOKE. 3005 01:49:33,001 --> 01:49:34,000 MRS. HUTCHISON: THE WHITE SMOKE. 3006 01:49:34,001 --> 01:49:35,000 THAT'S CORRECT. 3007 01:49:35,001 --> 01:49:38,000 BUTHEN THE QUESTION ARISES, 3008 01:49:38,001 --> 01:49:40,000 WELL WHAT ABOUT FUTURE MEME SAY, 3009 01:49:40,001 --> 01:49:41,000 THAT'S WHAT I CAN AFFORD, IT IS 3010 01:49:41,001 --> 01:49:43,000 WHAT I WANT TO HAVE. 3011 01:49:43,001 --> 01:49:44,000 OH, BUT GRANDFATHERING DOESN'T 3012 01:49:44,001 --> 01:49:46,000 INCLUDE ANYONE THAT MIGHT WANT 3013 01:49:46,001 --> 01:49:47,000 TO JOIN IN THE FUTURE. 3014 01:49:47,001 --> 01:49:49,000 IT'S ONLY THE PEOPLE WHO ARE 3015 01:49:49,001 --> 01:49:51,000 ALREADY IN THE SYSTEM, AND 3016 01:49:51,001 --> 01:49:52,000 FOREEVER HOW LONG THEY LAST AND 3017 01:49:52,001 --> 01:49:54,000 LIVE, THAT'S GREAT. 3018 01:49:54,001 --> 01:49:56,000 BUT WHAT ABOUT THE FUTURE? 3019 01:49:56,001 --> 01:49:57,000 SO THIS IS A GREAT 3020 01:49:57,001 --> 01:49:59,000 IT IS AFFORDABLE FOR THE 3021 01:49:59,001 --> 01:50:01,000 LOWER-INCOME PEOPLE. 3022 01:50:01,001 --> 01:50:04,000 IT'S ONLY FOR THREE STATES NOW 3023 01:50:04,001 --> 01:50:07,000 BUT I'D LIKE TO SEE US HAVE ALL 3024 01:50:07,001 --> 01:50:10,000 THE SAME CAPABITIES FOR OUR CONSTITUENTS. 3025 01:50:10,001 --> 01:50:12,000 BUT WHAT ABOUT OUR FUTURE 3026 01:50:12,001 --> 01:50:13,000 CONSTITUENTS? 3027 01:50:13,001 --> 01:50:15,000 MR. GREGG: WOULD THE SENATOR 3028 01:50:15,001 --> 01:50:16,000 ELD ON THAT POINT? 3029 01:50:16,001 --> 01:50:18,000 I THINK THE SENATOR FROM ARIZONA 3030 01:50:18,001 --> 01:50:20,000 HAS RAISED AN EXTRAORDINARY POINT. 3031 01:50:20,001 --> 01:50:22,000 BECAUSE IF THIS IS SUCH A GRUED 3032 01:50:22,001 --> 01:50:23,000 PROGRAM FOR THESE FOUR STATES, 3033 01:50:23,001 --> 01:50:25,000 WHY ISN'T IT SUCH A GOOD PROGRAM 3034 01:50:25,001 --> 01:50:26,000 FOR EVERYBODY? 3035 01:50:26,001 --> 01:50:28,000 THE SENATOR IS THE EXPERT AROUND 3036 01:50:28,001 --> 01:50:29,000 HERE ON EARMARKS. 3037 01:50:29,001 --> 01:50:30,000 IS THIS NOT A CLASSIC EARMARK? 3038 01:50:30,001 --> 01:50:31,000 AND DIDN'T WE HEAR FM THE 3039 01:50:31,001 --> 01:50:33,000 OTHER SIDE OF THE AISLE HOW WE 3040 01:50:33,001 --> 01:50:34,000 WERE GOI TO HAVE AN OPEN GOVERNMENT, HOW WE W 3041 01:50:34,001 --> 01:50:36,000 GOING TO HAVE THIS TYPE OF 3042 01:50:36,001 --> 01:50:37,000 EXERCISE OCCUR WITHIN MAJOR 3043 01:50:37,001 --> 01:50:39,000 BILLS, THAT BILLS WEREN'T GOING 3044 01:50:39,001 --> 01:50:41,000 TO BE LOADED UP WITH SPECIAL 3045 01:50:41,001 --> 01:50:42,000 INTEREST EARMARKS, ASSISTING ONE 3046 01:50:42,001 --> 01:50:46,000 MEMBER OR ANOTHER? 3047 01:50:46,001 --> 01:50:48,000 AS THE EXPERT ON THE ISSUE OF 3048 01:50:48,001 --> 01:50:49,000 EARMARKS -- 3049 01:50:49,001 --> 01:50:51,000 MR. McCAIN: I'D SAY THIS IS 3050 01:50:51,001 --> 01:50:53,000 PROBABLY 3051 01:50:53,001 --> 01:50:54,000 PROTECTIONISM THAT WE SEE IN THE 3052 01:50:54,001 --> 01:50:56,000 EARMARKING AND BENEFITS THAT WE 3053 01:50:56,001 --> 01:50:57,000 SEE IN THE EARMARKING PROCESS. 3054 01:50:57,001 --> 01:50:58,000 BUT ALSO I WOULD 3055 01:50:58,001 --> 01:51:00,000 SENATOR FROM NEW HAMPSHIRE, AS 3056 01:51:00,001 --> 01:51:01,000 WE'VE ALL DISCUSSED SEVERAL 3057 01:51:01,001 --> 01:51:05,000 TIMES, IN OCTOBER OF LAST YEAR 3058 01:51:05,001 --> 01:51:07,000 -- A YEAR AGO LAST OCTOBER, THE 3059 01:51:07,001 --> 01:51:10,000 THEN-CANDIDATE FOR PRESIDENT 3060 01:51:10,001 --> 01:51:16,000 SAID, IT'S GOING TO BE ON C 3061 01:51:16,001 --> 01:51:19,000 SPAFNONC-SPAN. 3062 01:51:19,001 --> 01:51:21,000 THE C-SPAN CAMERAS ARE STILL 3063 01:51:21,001 --> 01:51:23,000 WAITING TO FILM THESE NEGOTIATIONS. 3064 01:51:23,001 --> 01:51:24,000 SO ALL AMERICANS CAN SEE WHO IS 3065 01:51:24,001 --> 01:51:25,000 ON THE SIDE OF THE 3066 01:51:25,001 --> 01:51:27,000 PHARMACEUTICAL COMPANIES AND 3067 01:51:27,001 --> 01:51:28,000 WHO'S ON THE SIDE OF THE 3068 01:51:28,001 --> 01:51:29,000 AMERICAN 3069 01:51:29,001 --> 01:51:32,000 C-SPAN, KEEP WAITING. 3070 01:51:32,001 --> 01:51:33,000 WE'RE GOING TO TRY GET YOU IN. 3071 01:51:33,001 --> 01:51:34,000 MR. GREGG: IF I COULD ASK ONE 3072 01:51:34,001 --> 01:51:36,000 MORE QUESTION. 3073 01:51:36,001 --> 01:51:37,000 I CAME OVER BECAUSE I WANTED TO 3074 01:51:37,001 --> 01:51:39,000 PARTICIPATE A LITTLE BIT BECAUSE 3075 01:51:39,001 --> 01:51:40,000 I THINK IT'S BEEN SUCH AN 3076 01:51:40,001 --> 01:51:41,000 EXCELLENT AND INFORMATIVE 3077 01:51:41,001 --> 01:51:42,000 DEBATE. 3078 01:51:42,001 --> 01:51:43,000 BUT I'VE BEEN LOOKING AT THE 3079 01:51:43,001 --> 01:51:46,000 NUMBERS HERE. 3080 01:51:46,001 --> 01:51:50,000 AND I KNOW THE NUMBERS ARE BIG, 3081 01:51:50,001 --> 01:51:51,000 PERIOD, ALMOST $500 BILLION IN 3082 01:51:51,001 --> 01:51:53,000 REDUCTIONS IN MEDICARE SPENDING. 3083 01:51:53,001 --> 01:51:55,000 BUT I THINK THE POINT WE NEED TO 3084 01:51:55,001 --> 01:51:56,000 MAKE IS THAT IT DOESN'T END THERE. 3085 01:51:56,001 --> 01:51:57,000 IT DOESN'T END THERE. 3086 01:51:57,001 --> 01:52:00,000 THOSE MEDICARE SPENDING 3087 01:52:00,001 --> 01:52:01,000 REDUCTIONS, THEY GO ON INTO THE 3088 01:52:01,001 --> 01:52:03,000 NEXT 3089 01:52:03,001 --> 01:52:06,000 AND OVER THE FIRST TWO DECADES 3090 01:52:06,001 --> 01:52:09,000 OF THIS BILL, MEDICARE SPENDING 3091 01:52:09,001 --> 01:52:12,000 REDUCTIONS WILL ACCOUNT FOR $3 3092 01:52:12,001 --> 01:52:14,000 ILLION -- $3 TRILLION. 3093 01:52:14,001 --> 01:52:15,000 MR. McCAIN: AND ISN'T -- 3094 01:52:15,001 --> 01:52:17,000 MR 3095 01:52:17,001 --> 01:52:18,000 ARGUE AGAINST WHAT THE SENATOR 3096 01:52:18,001 --> 01:52:19,000 FROM IDAHO SAID, WHICH IS THAT 3097 01:52:19,001 --> 01:52:21,000 THIS TRANSLATES 3098 01:52:21,001 --> 01:52:23,000 REDUCTIONS IN MEDICARE SPENDING? 3099 01:52:23,001 --> 01:52:24,000 MR. McCAI 3100 01:52:24,001 --> 01:52:27,000 IMPORTANT POINT HERE IN THIS 3101 01:52:27,001 --> 01:52:29,000 DISCUSSION IS THIS MASSIVE MONEY 3102 01:52:29,001 --> 01:52:32,000 TH 3103 01:52:32,001 --> 01:52:36,000 NOT BEING USED TO SAVE MEDICARE? 3104 01:52:36,001 --> 01:52:37,000 IT IS CREATING A 3105 01:52:37,001 --> 01:52:38,000 ENTITLEMENT PROGRAM. 3106 01:52:38,001 --> 01:52:40,000 SO HERE WE ARE WITH MEDICARE 3107 01:52:40,001 --> 01:52:42,000 GOING BROKE IN SEVEN YEARS. 3108 01:52:42,001 --> 01:52:44,000 WE'RE TAKING MONEY OUT OF IT IN 3109 01:52:44,001 --> 01:52:46,000 ORDER TO CREATE NEW PROGRAM. 3110 01:52:46,001 --> 01:52:47,000 THAT'S -- THAT'S WHAT THE CRIME 3111 01:52:47,001 --> 01:52:48,000 IS BEING COMMITTED HERE. 3112 01:52:48,001 --> 01:52:50,000 MR. GREGG: THE SENATOR IS ABSOLUTELY RIGHT. 3113 01:52:50,001 --> 01:52:51,000 THE NEW PROGRAM BY THE WAY WILL 3114 01:52:51,001 --> 01:52:53,000 NOT BE SOLVED EITHER. 3115 01:52:53,001 --> 01:52:54,000 SO WE'RE COMPOUNDING THE 3116 01:52:54,001 --> 01:52:57,000 INSOLVENCY OF THE FUTURE TH 3117 01:52:57,001 --> 01:52:59,000 WE'RE PASSING CHILDREN. 3118 01:52:59,001 --> 01:53:00,000 MR. HATCH: WE'RE TAKING 3119 01:53:00,001 --> 01:53:02,000 A-BILLION OUT OF A PROGRAM 3120 01:53:02,001 --> 01:53:05,000 THAT'S GOING TO BE INSOLVED 3121 01:53:05,001 --> 01:53:07,000 BEFORE 3122 01:53:07,001 --> 01:53:08,000 MR. GREGG: $3 TRILLION -- MR. HATCH: BEFORE THE END OF 3123 01:53:08,001 --> 01:53:10,000 THIS PROGRAM. 3124 01:53:10,001 --> 01:53:12,000 AND WE'RE GIVING TO ANOTHER 3125 01:53:12,001 --> 01:53:13,000 PROGRAM THAT'S ALREADY INSOLVENT. 3126 01:53:13,001 --> 01:53:14,000 MR. GREGG: TAXPAYER BE 3127 01:53:14,001 --> 01:53:15,000 INSOLVENT. 3128 01:53:15,001 --> 01:53:18,000 MR. HATCH: IT IS ALMOST INSANE WHAT THEY'RE DOING. 3129 01:53:18,001 --> 01:53:21,000 AMERICAN PEOPLE ARE HAVING SUCH 3130 01:53:21,001 --> 01:53:24,000 A DIFFICULT TIME, WHY WE HAVE 3131 01:53:24,001 --> 01:53:26,000 %, YOU KNOW, UNEMPLOYED, HAVE 3132 01:53:26,001 --> 01:53:27,000 THE UNDEREMPLOYMENT IS 17% IN 3133 01:53:27,001 --> 01:53:29,000 THIS COUNTRY. 3134 01:53:29,001 --> 01:53:30,000 THOSE ARE PEOPLE WHO TRY TO GET 3135 01:53:30,001 --> 01:53:31,000 PA-TIME JOBS BECAUSE THEY 3136 01:53:31,001 --> 01:53:34,000 CAN'T GET FULL-TIME JOBS. 3137 01:53:34,001 --> 01:53:36,000 THAT'S WT THE REAL PERCENTAGE IS. 3138 01:53:36,001 --> 01:53:38,000 AND THEY -- AND THEY -- 3139 01:53:38,001 --> 01:53:39,000 -- YOU KNOW, THIS WHOLE PROGRAM 3140 01:53:39,001 --> 01:53:41,000 IS ABOUT HELPING LOW-INCOME 3141 01:53:41,001 --> 01:53:42,000 PEOPLE AND MINORITIES. 3142 01:53:42,001 --> 01:53:43,000 WHEN YOU STOP AND THINK ABOUT 3143 01:53:43,001 --> 01:53:46,000 IT, TH 3144 01:53:46,001 --> 01:53:48,000 ADVANTAGE IS ABOUT. 3145 01:53:48,001 --> 01:53:51,000 THEY CAN'T AFFORD THESE -- AS 3146 01:53:51,001 --> 01:53:52,000 THE DISTINGUISHED SENATOR FROM 3147 01:53:52,001 --> 01:53:55,000 ARIZONA HAS SAID, THEY CAN'T 3148 01:53:55,001 --> 01:53:57,000 AFFORD THESE SUPPLEMENTAL 3149 01:53:57,001 --> 01:54:00,000 POLI 3150 01:54:00,001 --> 01:54:01,000 MAKE A LOT OF MONEY OFF IF THEY 3151 01:54:01,001 --> 01:54:02,000 CAN -- IF THEY CAN -- IF THEY 3152 01:54:02,001 --> 01:54:04,000 CAN KILL THIS PROGRAM. 3153 01:54:04,001 --> 01:54:06,000 THERE ARE A LOT OF GAPS IN 3154 01:54:06,001 --> 01:54:08,000 TRADITIONAL MEDICARE BENEFITS, 3155 01:54:08,001 --> 01:54:10,000 INCLUDING 3156 01:54:10,001 --> 01:54:12,000 NO OUT-OF-POCKET LIMITS. 3157 01:54:12,001 --> 01:54:15,000 THAT'S ABOUT 89% OF SENIORS HAVE 3158 01:54:15,001 --> 01:54:17,000 SOME 3159 01:54:17,001 --> 01:54:18,000 COVERAGE ON TOP OF MEDICARE. 3160 01:54:18,001 --> 01:54:20,000 FOR MANY LOW-INCOME AMERICANS 3161 01:54:20,001 --> 01:54:22,000 AND MINORITIES, MEDICARE 3162 01:54:22,001 --> 01:54:25,000 ADVANTAGE IS THE ONLY WAY THAT 3163 01:54:25,001 --> 01:54:29,000 THEY CAN AFFORD THE SUPPLEMENTAL COVERAGE. 3164 01:54:29,001 --> 01:54:30,000 I WANT TO COMPLIMENT AL ALL OF MY 3165 01:54:30,001 --> 01:54:32,000 COLLEAGUES HERE ON THE FLOOR -- 3166 01:54:32,001 --> 01:54:33,000 THE DISTINGUISHED SENATOR FROM 3167 01:54:33,001 --> 01:54:36,000 ARIZONA, THE DISTINGUISHED 3168 01:54:36,001 --> 01:54:37,000 SENATOR FROM IDAHO, THE 3169 01:54:37,001 --> 01:54:40,000 DISTINGUISHED SENATOR FROM 3170 01:54:40,001 --> 01:54:44,000 TEXAS, OUR OWN DOCTOR AND ONE OF 3171 01:54:44,001 --> 01:54:45,000 ONLY TWO IN THE SENATE, SENATOR 3172 01:54:45,001 --> 01:54:47,000 BARRASSO FROM WYOMING, OF COURSE 3173 01:54:47,001 --> 01:54:49,000 OUR LEADER IN THE SENATE BOTH 3174 01:54:49,001 --> 01:54:51,000 THE BUDGET COMMITTEE, SENATOR 3175 01:54:51,001 --> 01:54:54,000 GREGG, AND OF COURSE SENATOR ALEXANDRIA. 3176 01:54:54,001 --> 01:54:55,000 YOU GUYS HAVE REALLY SUMMED THIS 3177 01:54:55,001 --> 01:54:57,000 UP. 3178 01:54:57,001 --> 01:54:58,000 MR. McCAIN: WE'VE HAD SPIRITED 3179 01:54:58,001 --> 01:55:00,000 DEBATE AND DISCUSSION ON THE FLOOR. 3180 01:55:00,001 --> 01:55:02,000 IT IS CLEAR THAT THE MAJORITY OF 3181 01:55:02,001 --> 01:55:04,000 THE AMERICAN PEOPLE DO NOT 3182 01:55:04,001 --> 01:55:05,000 SUPPORT THE PROPOSAL THAT IS 3183 01:55:05,001 --> 01:55:07,000 BEFORE US. 3184 01:55:07,001 --> 01:55:09,000 SO -- AND THEY DON'T 3185 01:55:09,001 --> 01:55:11,000 MEETINGS IN PRIVATE, MOSTLY IN 3186 01:55:11,001 --> 01:55:14,000 SECRET, C 3187 01:55:14,001 --> 01:55:15,000 AGAIN, I RENEW OUR OFFER TO THE 3188 01:55:15,001 --> 01:55:17,000 DEMOCRATS AND TO THE 3189 01:55:17,001 --> 01:55:18,000 ADMINISTRATION: 3190 01:55:18,001 --> 01:55:21,000 LET'S GET TOGETHER IN A ROOM 3191 01:55:21,001 --> 01:55:25,000 WITH THE C-SPAN 3192 01:55:25,001 --> 01:55:28,000 OTHER OUTLET 3193 01:55:28,001 --> 01:55:32,000 AND DO SOME SERIOUS NEGOTIATIONS 3194 01:55:32,001 --> 01:55:34,000 WHICH THERE ARE MANY, AND LET'S 3195 01:55:34,001 --> 01:55:35,000 SAVE MEDICARE, AND LET'S FIX THE 3196 01:55:35,001 --> 01:55:36,000 SYSTEM IN THE WAY THE AMERICAN 3197 01:55:36,001 --> 01:55:38,000 PEOPLE WANT US TO DO IN 3198 01:55:38,001 --> 01:55:39,000 BIPARTISAN FASHION, NOT BEHIND 3199 01:55:39,001 --> 01:55:41,000 CLOSED DOORS BUT SO THAT THE 3200 01:55:41,001 --> 01:55:44,000 AMERICAN PEOPLE CAN SEE US WORK TOGETHER FOR A CHANGE. 3201 01:55:44,001 --> 01:55:46,000 AND I THANK ALL OF M 3202 01:55:46,001 --> 01:55:47,000 FOR THEIR MANY CONTRIBUTIONS. 3203 01:55:47,001 --> 01:55:48,000 WE'RE READY TO TALK. 3204 01:55:48,001 --> 01:55:51,000 WE'RE READY TO TALK. 3205 01:55:51,001 --> 01:55:52,000 BUT WE WON'T BE 3206 01:55:52,001 --> 01:55:55,000 MRS. HUTCHISON: MR. PRESIDENT, 3207 01:55:55,001 --> 01:55:57,000 I WOULD JUST LIKE TO RETURN TO A 3208 01:55:57,001 --> 01:56:02,000 POIN 3209 01:56:02,001 --> 01:56:03,000 ABOUT THE PRESIDENT PROMISING IT, 3210 01:56:03,001 --> 01:56:04,000 IT BEING UNDERSTOOD BY EVERYONE 3211 01:56:04,001 --> 01:56:06,000 THAT IF YOU LIKE WHAT YOU HAVE, 3212 01:56:06,001 --> 01:56:08,000 YOU CAN KEEP IT. 3213 01:56:08,001 --> 01:56:10,000 BUT ON MEDICARE ADVANTAGE, ONCE 3214 01:56:10,001 --> 01:56:11,000 AGAIN THE C.M.S. HAS ESTIMATED 3215 01:56:11,001 --> 01:56:13,000 -- AND I WOULD ASK THE 3216 01:56:13,001 --> 01:56:16,000 DISTINGUISHED SENATOR FROM UTAH 3217 01:56:16,001 --> 01:56:19,000 TO VERIFY -- THAT ENROLLMENT IN 3218 01:56:19,001 --> 01:56:23,000 MEDICAREDVANTAGE WILL DECREASE 3219 01:56:23,001 --> 01:56:24,000 BY 64% UNDER THIS BILL. 3220 01:56:24,001 --> 01:56:25,000 MR. HATCH: A LOT OF SENIORS 3221 01:56:25,001 --> 01:56:26,000 ARE GOING TO BE VERY BADLY HURT 3222 01:56:26,001 --> 01:56:29,000 BY THIS. 3223 01:56:29,001 --> 01:56:30,000 MRS. HUTCHISON: 8.5 MILLION 3224 01:56:30,001 --> 01:56:31,000 SENIORS. 3225 01:56:31,001 --> 01:56:32,000 MR. HATCH: A LOT ARE 3226 01:56:32,001 --> 01:56:34,000 MINORIES, BY THE WAY, AS WELL. 3227 01:56:34,001 --> 01:56:37,000 THIS IS AMAZING TO ME HOW WE GOT 3228 01:56:37,001 --> 01:56:38,000 THROUGH ALL KINDS OF DEMAGOGUING 3229 01:56:38,001 --> 01:56:39,000 ABOUT LOW-INCOME PEOPL AND 3230 01:56:39,001 --> 01:56:40,000 MINORITIES AND YET THEY'RE GOING 3231 01:56:40,001 --> 01:56:43,000 TO TAKE ONE OF THE MOST 3232 01:56:43,001 --> 01:56:45,000 IMPORTANT BENEFITS AWAY FROM 3233 01:56:45,001 --> 01:56:47,000 THEM, AND THAT BENEFIT IS 3234 01:56:47,001 --> 01:56:48,000 MENTIONED IN THE MEDICARE 3235 01:56:48,001 --> 01:56:50,000 HANDBOOK FOR 2010. 3236 01:56:50,001 --> 01:56:51,000 AND THEY ACT LIKE IT'S NOT PART 3237 01:56:51,001 --> 01:56:52,000 OF MEDICARE. 3238 01:56:52,001 --> 01:56:53,000 I CAN'T BELIEVE SOME OF THE 3239 01:56:53,001 --> 01:56:54,000 ARGUMENTS THAT HAVE COME FROM 3240 01:56:54,001 --> 01:56:55,000 THE OTHER SIDE. 3241 01:56:55,001 --> 01:56:58,000 MR. McCAIN: CAN I ASK THE 3242 01:56:58,001 --> 01:57:03,000 SENATOR FROM NEW HAMPSHIRE 3243 01:57:03,001 --> 01:57:05,000 HAPPENS -- WHAT HAPPENS 3244 01:57:05,001 --> 01:57:06,000 SENIOR MEMBER ON THE BUDGET 3245 01:57:06,001 --> 01:57:07,000 COMMITTEE, A PERSON THAT IS 3246 01:57:07,001 --> 01:57:08,000 WELL-PHONE FOR HIS KNOWLEDGE OF 3247 01:57:08,001 --> 01:57:11,000 THE COMIRKS OF THE BUDGETARY 3248 01:57:11,001 --> 01:57:12,000 SITUATION IN AMERICA -- WHAT 3249 01:57:12,001 --> 01:57:13,000 HAPPENS, WHAT HAPPENS, I ASK THE 3250 01:57:13,001 --> 01:57:16,000 SENATOR FROM NEW HAMPSHIRE, IF 3251 01:57:16,001 --> 01:57:17,000 WE PASS THIS MASSIVE 3252 01:57:17,001 --> 01:57:18,000 WHAT HAPPENS TO AMERICA'S 3253 01:57:18,001 --> 01:57:19,000 ECONOMY? 3254 01:57:19,001 --> 01:57:20,000 MR. GREGG: WELL, MY VIEW IS THIS: 3255 01:57:20,001 --> 01:57:22,000 FIRST OFF WE KNOW A COUPLE OF 3256 01:57:22,001 --> 01:57:25,000 FACTS. 3257 01:57:25,001 --> 01:57:27,000 THAT WE GROW THE GOVERNMENT 3258 01:57:27,001 --> 01:57:28,000 $2.5 TRILLION OVER A TEN-YEAR 3259 01:57:28,001 --> 01:57:30,000 PERIOD WHEN THIS BILL IS FULLY 3260 01:57:30,001 --> 01:57:31,000 IMPLEMENTED. 3261 01:57:31,001 --> 01:57:32,000 WE ALSO KNOW THAT THE TAX 3262 01:57:32,001 --> 01:57:34,000 INCREASES DURING THAT PERIOD 3263 01:57:34,001 --> 01:57:36,000 WILL BE APPROXI 3264 01:57:36,001 --> 01:57:37,000 TRILLION, TAX TAX INCREASES AND 3265 01:57:37,001 --> 01:57:39,000 FEES. 3266 01:57:39,001 --> 01:57:41,000 AND THEY AREN'T GOING TO FALL ON THE WLTY. 3267 01:57:41,001 --> 01:57:42,000 THEY ARE GOING TO FALL O 3268 01:57:42,001 --> 01:57:43,000 SMALL BUSINESS PERSON TRYING TO 3269 01:57:43,001 --> 01:57:46,000 CREATE THE 3270 01:57:46,001 --> 01:57:50,000 WE ALSO KNOW THAT THERE WILL BE 3271 01:57:50,001 --> 01:57:51,000 AN ENTIRE SEED CHANGE IN THE WAY 3272 01:57:51,001 --> 01:57:53,000 PEOPLE GET THEIR HEALTH CARE. THE GOVERNMENT WILL BE STEPPING 3273 01:57:53,001 --> 01:57:54,000 IN BETWEEN YOU AND YOUR DOCTOR 3274 01:57:54,001 --> 01:57:56,000 AND BASICALLY MAKIN A DECISION 3275 01:57:56,001 --> 01:57:57,000 TO WHAT YOUR DOCTOR CAN TELL 3276 01:57:57,001 --> 01:57:59,000 YOU WHAT YOU CAN 3277 01:57:59,001 --> 01:58:00,000 CARE, WHAT THE PROVIDER GROUP 3278 01:58:00,001 --> 01:58:02,000 CAN TELL YOU YOU CAN HAVE FOR 3279 01:58:02,001 --> 01:58:03,000 HEALTH CARE. 3280 01:58:03,001 --> 01:58:04,000 SOMETHING ELSE HASN'T BEEN 3281 01:58:04,001 --> 01:58:05,000 DISCUSSED MUCH, WHICH IS T 3282 01:58:05,001 --> 01:58:07,000 INNOVATION IN HEALTH CARE WHICH 3283 01:58:07,001 --> 01:58:09,000 HAS DONE SO MUCH TO MAKE AMERICA 3284 01:58:09,001 --> 01:58:10,000 THE BEST PLACE TO GET HEALTH 3285 01:58:10,001 --> 01:58:14,000 CARE IN THE WORLD, WHICH HAS PUT 3286 01:58:14,001 --> 01:58:16,000 US ON THE CUTTING EDGE OF DRUGS, 3287 01:58:16,001 --> 01:58:17,000 WHICH WHO IS IMPROVED THE LIVES 3288 01:58:17,001 --> 01:58:18,000 OF NOT ONLY THOSE IN THE UNI 3289 01:58:18,001 --> 01:58:19,000 STATES 3290 01:58:19,001 --> 01:58:20,000 IT WILL BE SIGNIFICANTLY CHILLED 3291 01:58:20,001 --> 01:58:22,000 BUS THERE WILL NOT BE AN 3292 01:58:22,001 --> 01:58:23,000 INTEREST IN INVESTING CAPITAL IN 3293 01:58:23,001 --> 01:58:26,000 A MARKET THAT IS SO CONTROLLED 3294 01:58:26,001 --> 01:58:28,000 BY THE GOVERNMENT. 3295 01:58:28,001 --> 01:58:31,000 IN THE END, IT'S FAIRLY OBVIOUS 3296 01:58:31,001 --> 01:58:33,000 THAT ANYBODY WHO'S BEEN AROUND 3297 01:58:33,001 --> 01:58:34,000 THIS PLACE, THERE AREN'T GOING 3298 01:58:34,001 --> 01:58:36,000 TO BE $3 TRILLION OF REDUCTIONS 3299 01:58:36,001 --> 01:58:37,000 IN MEDICARE 3300 01:58:37,001 --> 01:58:38,000 NEXT 20 YEARS. 3301 01:58:38,001 --> 01:58:40,000 AND THERE AREN'T GOING TO BE 3302 01:58:40,001 --> 01:58:41,000 $500 BILLION IN THE 3303 01:58:41,001 --> 01:58:45,000 YEARS. 3304 01:58:45,001 --> 01:58:46,000 AND SO ALL OF THAT SPENDING IS 3305 01:58:46,001 --> 01:58:48,000 GOING TO FALL ON THE BACKS OF 3306 01:58:48,001 --> 01:58:49,000 OUR CHILDREN IN THE FORM OF 3307 01:58:49,001 --> 01:58:51,000 DEBT. 3308 01:58:51,001 --> 01:58:54,000 AND WE ALREADY HAVE A NATION 3309 01:58:54,001 --> 01:58:56,000 THAT IS ON AN UNSUSTAINABLE PATH 3310 01:58:56,001 --> 01:58:57,000 UNDER THE PRESENT BUDGET 3311 01:58:57,001 --> 01:59:00,000 SCENARIO WITHOUT THIS HEALTH 3312 01:59:00,001 --> 01:59:01,000 CARE BILL. 3313 01:59:01,001 --> 01:59:03,000 OUR DEFICITS ARE $1 TRILLION A 3314 01:59:03,001 --> 01:59:04,000 YEAR, ON AVERAGE, FOR THE NEXT 3315 01:59:04,001 --> 01:59:05,000 TEN YEARS, THAT'S WITHOUT THIS 3316 01:59:05,001 --> 01:59:09,000 BILL. 3317 01:59:09,001 --> 01:59:11,000 OUR PUBLIC DEBT GOES FROM 35% OF 3318 01:59:11,001 --> 01:59:12,000 THE GROSS NATIONAL PRODUCT TO 3319 01:59:12,001 --> 01:59:13,000 85% OF THE GROSS NATIONAL 3320 01:59:13,001 --> 01:59:14,000 PRODUCT. 3321 01:59:14,001 --> 01:59:15,000 WE BECOME INSOLVED AT THE END OF 3322 01:59:15,001 --> 01:59:17,000 THIS DECADE. 3323 01:59:17,001 --> 01:59:20,000 NOT THIS DECADE BUT THE DECADE 3324 01:59:20,001 --> 01:59:21,000 STARTING TODAY, TEN YEARS FROM TODAY. 3325 01:59:21,001 --> 01:59:24,000 MR. HATCH: SENATOR, WOULD YOU YIELD ON THAT? 3326 01:59:24,001 --> 01:59:25,000 MR. GREGG: AND THAT'S ALL 3327 01:59:25,001 --> 01:59:26,000 AGGRAVATED DRAMATICALLY BY 3328 01:59:26,001 --> 01:59:27,000 EXODING THE SIZE OF THE 3329 01:59:27,001 --> 01:59:28,000 GOVERNMENT UNDER THIS BILL 3330 01:59:28,001 --> 01:59:29,000 RATHER THAN TAKING THE 3331 01:59:29,001 --> 01:59:31,000 STEP-BY-STEP APPROACH THAT HAS 3332 01:59:31,001 --> 01:59:33,000 BEEN APPROACHED BY OUR SIDE TO 3333 01:59:33,001 --> 01:59:36,000 REFORM HEALTH CARE AND MAKE IT 3334 01:59:36,001 --> 01:59:37,000 MORE EFFECTIVE AND MAKE IT 3335 01:59:37,001 --> 01:59:39,000 DELIVER MORE SERVICES TO MORE 3336 01:59:39,001 --> 01:59:40,000 PEOPLE AT A BETTER COST THE. 3337 01:59:40,001 --> 01:59:42,000 THERE IS NOTHING IN THIS BILL -- 3338 01:59:42,001 --> 01:59:43,000 I HAVE HEARD PEOPLE ON THE OTHER 3339 01:59:43,001 --> 01:59:46,000 SI 3340 01:59:46,001 --> 01:59:47,000 TIMES GET UP AND SAY, THE C.B.O. SAYS THIS BILL REDUCES THE 3341 01:59:47,001 --> 01:59:48,000 HEALTH CARE SPENDING OF THE 3342 01:59:48,001 --> 01:59:49,000 FEDERAL GOVERNMENT. 3343 01:59:49,001 --> 01:59:50,000 JUST THE OPPOSITE. 3344 01:59:50,001 --> 01:59:52,000 JUST -- 3345 01:59:52,001 --> 01:59:54,000 THE C.B.O. LETTER SPECIFICALLY 3346 01:59:54,001 --> 01:59:56,000 SAID THAT 3347 01:59:56,001 --> 01:59:57,000 FEDERAL GOVERNMENT OF HEALTH 3348 01:59:57,001 --> 01:59:59,000 CARE GO UP, GO UP, UNDER THIS 3349 01:59:59,001 --> 02:00:01,000 BILL. 3350 02:00:01,001 --> 02:00:04,000 IN THE TEN-YEAR PERIOD. 3351 02:00:04,001 --> 02:00:05,000 AND 3352 02:00:05,001 --> 02:00:06,000 DOWN THE COST OF HEALTH CARE. 3353 02:00:06,001 --> 02:00:07,000 IT DOES EXPLODE THE SIZE OF 3354 02:00:07,001 --> 02:00:09,000 GOVERNMENT. 3355 02:00:09,001 --> 02:00:10,000 IT DOES PUT THE GOVERNMENT INTO 3356 02:00:10,001 --> 02:00:12,000 THE BUSINESS OF MAN 3357 02:00:12,001 --> 02:00:14,000 HEALTH CARE. 3358 02:00:14,001 --> 02:00:15,000 AND, AS A RESULT, I THINK IT'S 3359 02:00:15,001 --> 02:00:17,000 GOING TO REDUCE THE QUALITY OF 3360 02:00:17,001 --> 02:00:18,000 LIFE OF OUR 3361 02:00:18,001 --> 02:00:19,000 HATCH WILL THE SENATOR YIELD ON 3362 02:00:19,001 --> 02:00:22,000 THAT POINT? 3363 02:00:22,001 --> 02:00:23,000 MR. GREGG: I DON'T HAVE THE FLOOR. 3364 02:00:23,001 --> 02:00:25,000 MR. McCAIN: GO AHEAD. 3365 02:00:25,001 --> 02:00:26,000 MR. HATCH: OKAY. 3366 02:00:26,001 --> 02:00:27,000 WELL, THE SENATOR HAS POINTED 3367 02:00:27,001 --> 02:00:31,000 OUT THAT YOU REALLY DON'T 3368 02:00:31,001 --> 02:00:32,000 BELIEVE THEY CAN AFFORD ALL 3369 02:00:32,001 --> 02:00:33,000 THESE PROGRAMS. 3370 02:00:33,001 --> 02:00:34,000 YOU DO 3371 02:00:34,001 --> 02:00:37,000 YOU'RE NOT SUGGESTING THIS IS A 3372 02:00:37,001 --> 02:00:39,000 GAME, ARE YOU? 3373 02:00:39,001 --> 02:00:41,000 MR. GREGG: I -- I AM SUGGESTING 3374 02:00:41,001 --> 02:00:42,000 THAT IT IS VERY DIFFICULT UNDER 3375 02:00:42,001 --> 02:00:46,000 ANY SCENARIO TO BELIEVE THAT 3376 02:00:46,001 --> 02:00:47,000 THIS CONGRESS IS GOING TO DO 3377 02:00:47,001 --> 02:00:49,000 ANYTHING OTHER THAN SPEND THE 3378 02:00:49,001 --> 02:00:50,000 MONEY THAT IS PUT IN THIS BILL. 3379 02:00:50,001 --> 02:00:52,000 IT'S CERTAINLY NOT GOING TO END 3380 02:00:52,001 --> 02:00:53,000 UP MAKING THE REDUCTIONS IN 3381 02:00:53,001 --> 02:00:54,000 MEDICARE THAT IT PROPOSES IN 3382 02:00:54,001 --> 02:00:55,000 THIS BILL. 3383 02:00:55,001 --> 02:00:56,000 IF IT DOES MAKE THOSE 3384 02:00:56,001 --> 02:00:59,000 REDUCTIONS, THOUGH, I THINK THE 3385 02:00:59,001 --> 02:01:00,000 SENATOR FROM UTAH HAS BEEN 3386 02:01:00,001 --> 02:01:03,000 ABSOLUTELY RIGHT IN SAYING THOSE 3387 02:01:03,001 --> 02:01:05,000 REDUCTIONS SHOULD GO TO MAKING 3388 02:01:05,001 --> 02:01:06,000 THE MEDICARE SYSTEM SOLVENT. 3389 02:01:06,001 --> 02:01:08,000 THEY SHOULDN'T GO TO CREATING A 3390 02:01:08,001 --> 02:01:10,000 BRAND-NEW ENTITLEMENT. 3391 02:01:10,001 --> 02:01:11,000 MR. McIN McCAIN: ON THAT POINT, I 3392 02:01:11,001 --> 02:01:14,000 THINK SENATOR CRAPO WOULD LIKE 3393 02:01:14,001 --> 02:01:15,000 EXACTLY TO EMPHASIZE SENATOR 3394 02:01:15,001 --> 02:01:17,000 GREGG'S POINT. 3395 02:01:17,001 --> 02:01:18,000 MR. CRAPO: YEAH, I'D LIKE TO 3396 02:01:18,001 --> 02:01:20,000 ENGAGE -- MAKE A COMMENT OR TWO 3397 02:01:20,001 --> 02:01:21,000 AND THEN ENGAGE AGAIN WITH THE 3398 02:01:21,001 --> 02:01:23,000 CHAIRMAN -- OR THE RANKING 3399 02:01:23,001 --> 02:01:25,000 MEMBER OF THE BUDGET COMMITTEE. 3400 02:01:25,001 --> 02:01:26,000 THE COST CURVE DOWN, AND, 3401 02:01:26,001 --> 02:01:28,000 FRANKLY, WHEN YOU TALK TO AMERICANS ABOUT WHAT THEY WANT 3402 02:01:28,001 --> 02:01:29,000 IN HEALTH CARE REFORM, THE VAST 3403 02:01:29,001 --> 02:01:31,000 MAJORITY OF THEM SAY THE REASON 3404 02:01:31,001 --> 02:01:32,000 WE NEED HEALTH CARE REFORM IS 3405 02:01:32,001 --> 02:01:33,000 BECAUSE OF THE SKYROCKETING 3406 02:01:33,001 --> 02:01:34,000 COSTS OF HEALTH CARE AND HEALTH 3407 02:01:34,001 --> 02:01:36,000 CARE INSURANCE. 3408 02:01:36,001 --> 02:01:37,000 AND THOSE WHO ARE PROMOTING THIS 3409 02:01:37,001 --> 02:01:38,000 BILL SAY THAT THEY ARE BENDING 3410 02:01:38,001 --> 02:01:41,000 THAT COST CURVE DOWN. 3411 02:01:41,001 --> 02:01:42,000 MY QUESTION IS: THIS COST CURVE 3412 02:01:42,001 --> 02:01:44,000 ARE THEY TALKING ABOUT? 3413 02:01:44,001 --> 02:01:45,000 IS IT THE SIZE OF GOVERNMENT? 3414 02:01:45,001 --> 02:01:47,000 ARE THEY BENDING THE SIZE OF 3415 02:01:47,001 --> 02:01:48,000 GOVERNMENT GROWTH DOWN? 3416 02:01:48,001 --> 02:01:49,000 NO, AS THE SENATOR FROM NEW 3417 02:01:49,001 --> 02:01:53,000 HAMPSHIRE SAID, THEY'RE GROWING 3418 02:01:53,001 --> 02:01:54,000 GOVERNMENT BY $2.5 TRILLION FOR 3419 02:01:54,001 --> 02:01:56,000 THE FIRST TRUE TEN-YEAR PERIOD 3420 02:01:56,001 --> 02:01:58,000 OF THE BILL. 3421 02:01:58,001 --> 02:02:00,000 ARE THEY DRIVING PERSONAL HEALTH 3422 02:02:00,001 --> 02:02:02,000 CARE COSTS DOWN? NO. 3423 02:02:02,001 --> 02:02:04,000 THE C.B.O. REPORT THAT WE 3424 02:02:04,001 --> 02:02:05,000 RECENTLY GOT SAID THAT 30% OF 3425 02:02:05,001 --> 02:02:06,000 AMERICANS WILL SEE THEIR HEALTH 3426 02:02:06,001 --> 02:02:08,000 INSURANCE GO UP. 3427 02:02:08,001 --> 02:02:10,000 AND THE OTHER 70% WILL, AT BEST, 3428 02:02:10,001 --> 02:02:12,000 SEE IT STAY JUST ABOUT WHAT IT 3429 02:02:12,001 --> 02:02:13,000 IS TODAY, RISING AT THE SAME 3430 02:02:13,001 --> 02:02:14,000 LEVEL AS IT IS TODAY. 3431 02:02:14,001 --> 02:02:15,000 AR 3432 02:02:15,001 --> 02:02:16,000 FEDERAL DEFICIT? 3433 02:02:16,001 --> 02:02:17,000 WELL, THE CHAIRMAN OF THE BUDGET 3434 02:02:17,001 --> 02:02:20,000 COMMITTEE HAS JUST INDICATED TO 3435 02:02:20,001 --> 02:02:21,000 US THAT WE'RE GOI 3436 02:02:21,001 --> 02:02:23,000 SKYROCKETING DEFICITS, AND THOSE 3437 02:02:23,001 --> 02:02:25,000 WHO CLAIM THAT THIS BILL'S GOING 3438 02:02:25,001 --> 02:02:26,000 TO REDUCE THE DEFICIT CAN SAY SO 3439 02:02:26,001 --> 02:02:28,000 ONLY IF THEY TAKE INTO ACCOUNT 3440 02:02:28,001 --> 02:02:30,000 ALL OF THEIR BUDGET GIMMICKS, 3441 02:02:30,001 --> 02:02:32,000 LIKE NOT COUNTING THE FIRST FOUR 3442 02:02:32,001 --> 02:02:33,000 YEARS OF THE SPENDING, OR THE 3443 02:02:33,001 --> 02:02:34,000 HUNDREDS OF BILLIONS OF DOLLARS 3444 02:02:34,001 --> 02:02:36,000 IN TAXES THAT ARE GOING TO BE 3445 02:02:36,001 --> 02:02:37,000 IMPOSED ON THE AMERICAN PEOPLE, 3446 02:02:37,001 --> 02:02:38,000 ARE OR THE MEDICARE CUTS THAT 3447 02:02:38,001 --> 02:02:39,000 WE'VE BEEN TALKING. 3448 02:02:39,001 --> 02:02:40,000 YOU CAN TAKE ANY ONE OF THOSE 3449 02:02:40,001 --> 02:02:42,000 THREE OUT OF THIS BILL AND IT 3450 02:02:42,001 --> 02:02:43,000 DRIVES THE DEFICIT UP IN THE 3451 02:02:43,001 --> 02:02:45,000 SKYROCKETING FASHION. 3452 02:02:45,001 --> 02:02:47,000 IS THAT NOT CORRECT, SENATOR? 3453 02:02:47,001 --> 02:02:48,000 MR. McCAIN: AND AS THE SENATOR 3454 02:02:48,001 --> 02:02:49,000 FROM -- HAS THE SENATOR FROM NEW 3455 02:02:49,001 --> 02:02:50,000 HAMPSHIRE EVER HEARD OF 3456 02:02:50,001 --> 02:02:53,000 LEGISLATION WHERE YOU PAY IN THE 3457 02:02:53,001 --> 02:02:54,000 FIRST FOUR YEARS BEFORE A SINGLE 3458 02:02:54,001 --> 02:02:56,000 BENEFIT COMES ABOUT? 3459 02:02:56,001 --> 02:02:57,000 YOU KNOW, NOWADAYS, I SEE THESE 3460 02:02:57,001 --> 02:02:58,000 ADVERTISEMENTS THAT YOU CAN BUY 3461 02:02:58,001 --> 02:03:01,000 A CAR AND YOU DON'T HAVE TO MAKE 3462 02:03:01,001 --> 02:03:02,000 A PAYMENT FOR A YEAR AND THEN 3463 02:03:02,001 --> 02:03:03,000 YOU START MAKING PAYMENTS. 3464 02:03:03,001 --> 02:03:05,000 ON THIS DEAL, IT'S THE REVERSE. 3465 02:03:05,001 --> 02:03:06,000 YOU MAKE PAYMENTS AND THEN 3466 02:03:06,001 --> 02:03:08,000 PERHAPS YOU GET THE BENEFITS 3467 02:03:08,001 --> 02:03:09,000 AFTER SOME YEARS. 3468 02:03:09,001 --> 02:03:14,000 AND THE SENATOR FROM TENNESSEE I 3469 02:03:14,001 --> 02:03:15,000 THINK WOULD LIKE TO COMMENT TOO. 3470 02:03:15,001 --> 02:03:17,000 MR. ALEXANDER 3471 02:03:17,001 --> 02:03:18,000 COMMENT TO THE SENATOR FROM NEW HAMPSHIRE TOO. 3472 02:03:18,001 --> 02:03:20,000 THE PRESIDENT OF THE UNITED 3473 02:03:20,001 --> 02:03:21,000 STATES SAID 3474 02:03:21,001 --> 02:03:25,000 WEEKS AGO THAT I THOUGHT WAS 3475 02:03:25,001 --> 02:03:27,000 PROFOUND AND THAT I AGREE WITH, WHICH -- HE SAID THAT THIS 3476 02:03:27,001 --> 02:03:29,000 DEBATE IS NOT JUST ABOUT HEALTH 3477 02:03:29,001 --> 02:03:31,000 CARE, IT'S ABOUT THE ROLE OF THE 3478 02:03:31,001 --> 02:03:32,000 FEDERAL GOVERNMENT IN THE 3479 02:03:32,001 --> 02:03:34,000 EVERYDAY LIVES OF THE AMERICAN PEOPLE. 3480 02:03:34,001 --> 02:03:36,000 AND I BELIEVE HE'S EXACTLY RIGHT 3481 02:03:36,001 --> 02:03:38,000 ABOU THAT, WHICH IS WHY SO MANY 3482 02:03:38,001 --> 02:03:39,000 AMERICANS ARE TURNING AGAINST 3483 02:03:39,001 --> 02:03:42,000 THIS BILL. WOULD THE SENATOR FROM NEW 3484 02:03:42,001 --> 02:03:43,000 HAMPSHIRE AGREE THAT -- THAT THE 3485 02:03:43,001 --> 02:03:48,000 PRESIDENT WAS CORRECT, THAT THIS 3486 02:03:48,001 --> 02:03:49,000 DEBATE IS ABOUT, IN MY WORDS NOW 3487 02:03:49,001 --> 02:03:52,000 NOW, WASHINGTON TAKEOVERS, MORE 3488 02:03:52,001 --> 02:03:53,000 TAXES, MORE SPENDING, MORE DEBT, 3489 02:03:53,001 --> 02:03:54,000 TAKING OVER CAR COMPANIES? 3490 02:03:54,001 --> 02:03:55,000 THIS -- IT'S NOT JUST ABOUT 3491 02:03:55,001 --> 02:03:56,000 HEALTH CARE. 3492 02:03:56,001 --> 02:03:58,000 THE ENORMOUS INTEREST ACROSS THE 3493 02:03:58,001 --> 02:04:00,000 COUNTRY IN THESE VOTES COMES 3494 02:04:00,001 --> 02:04:01,000 FROM A MUCH 3495 02:04:01,001 --> 02:04:02,000 JUST THIS HEALTH CARE BILL. 3496 02:04:02,001 --> 02:04:03,000 MR. GREGG: WELL, I THINK THE 3497 02:04:03,001 --> 02:04:06,000 SENATOR FROM TENNESSEE IS ONCE 3498 02:04:06,001 --> 02:04:07,000 AGAIN -- HAS ONCE AGAIN HIT THE 3499 02:04:07,001 --> 02:04:08,000 NAIL ON THE HEAD. 3500 02:04:08,001 --> 02:04:09,000 AND I -- AND I READY THE 3501 02:04:09,001 --> 02:04:10,000 PRESIDENT'S FORTHRIGHTNESS, 3502 02:04:10,001 --> 02:04:12,000 BECAUSE THE PRESIDENT HAS SAID 3503 02:04:12,001 --> 02:04:14,000 VERY SIMPLY, HE BELIEVES THAT 3504 02:04:14,001 --> 02:04:15,000 PROSPERITY COMES FROM GROWING 3505 02:04:15,001 --> 02:04:16,000 THE GOVERNMENT. 3506 02:04:16,001 --> 02:04:18,000 AND WHEN THIS BILL PASSES, WE 3507 02:04:18,001 --> 02:04:19,000 WILL SEE THE LARGEST GROWTH IN 3508 02:04:19,001 --> 02:04:21,000 GOVERNMENT IN THE HISTORY OF OUR COUNTRY. 3509 02:04:21,001 --> 02:04:23,000 THIS IS GOING TO BE 16% OF OUR 3510 02:04:23,001 --> 02:04:24,000 ECONOMY BASICALLY MANAGED BY THE 3511 02:04:24,001 --> 02:04:26,000 FEDERAL GOVERNMENT. 3512 02:04:26,001 --> 02:04:28,000 AND YOU'RE GOING TO SEE THE 3513 02:04:28,001 --> 02:04:30,000 GOVERNMENT EXPLODE IN SIZE. 3514 02:04:30,001 --> 02:04:31,000 DOES THAT LEAD TO PROSPERITY? 3515 02:04:31,001 --> 02:04:33,000 I DON'T HAPPEN TO THINK IT DOES. 3516 02:04:33,001 --> 02:04:34,000 IT CERTAINLY DOESN'T LEAD TO 3517 02:04:34,001 --> 02:04:35,000 PROSPERITY IF ALONG WITH THAT 3518 02:04:35,001 --> 02:04:36,000 MASSIVE EXPANSION IN THE SIZE OF 3519 02:04:36,001 --> 02:04:37,000 GOVERNMENT, YOU'RE GOING TO SEE 3520 02:04:37,001 --> 02:04:38,000 YOUR D 3521 02:04:38,001 --> 02:04:39,000 U'RE GOING TO SEE THE DEFICITS 3522 02:04:39,001 --> 02:04:41,000 GO UP SIGNIFICANTLY. 3523 02:04:41,001 --> 02:04:42,000 OR YOU'RE GOING TO SEE YOUR TAX 3524 02:04:42,001 --> 02:04:44,000 BURDEN GO UP SIGNIFICANTLY, 3525 02:04:44,001 --> 02:04:45,000 WHICH REDUCES PRODUCTIVITY. 3526 02:04:45,001 --> 02:04:47,000 OR IF YOU'RE GOING TO TAKE A 3527 02:04:47,001 --> 02:04:49,000 LARGE SEGMENT OF OUR SOCIETY -- 3528 02:04:49,001 --> 02:04:52,000 OUR SENIORS, 35 MILLION A DAY, 3529 02:04:52,001 --> 02:04:53,000 70 MILLION BY THE YEAR 2019 -- 3530 02:04:53,001 --> 02:04:56,000 AND SAY TO THEM, THEY'RE NOT GOING TO HAVE THE ABILITY TO 3531 02:04:56,001 --> 02:04:57,000 HAVE A SOLVENT MEDICARE SYSTEM 3532 02:04:57,001 --> 02:04:58,000 BECAUSE THE WAY THAT SYSTEM 3533 02:04:58,001 --> 02:04:59,000 MIGHT HAVE BEEN MADE MORE 3534 02:04:59,001 --> 02:05:01,000 SOLVENT IS NOW BE USED TO CREATE 3535 02:05:01,001 --> 02:05:02,000 A BRAND-NEW ENTITLEMENT, A 3536 02:05:02,001 --> 02:05:04,000 MASSIVE NEW ENTITLEMENT FOR A 3537 02:05:04,001 --> 02:05:05,000 WHOLE GROUP OF PEOPLE WHO NEVER 3538 02:05:05,001 --> 02:05:06,000 PAID INTO THE INSURANCE POLICY 3539 02:05:06,001 --> 02:05:07,000 AND NEVER PAID INTO THE MEDICARE 3540 02:05:07,001 --> 02:05:10,000 INSURANCE FUND. 3541 02:05:10,001 --> 02:05:11,000 SO I -- I THINK THE SENATOR'S 3542 02:05:11,001 --> 02:05:12,000 HAS TOUCHED T BASE. 3543 02:05:12,001 --> 02:05:13,000 YOU KNOW, WE'VE SEEN 3544 02:05:13,001 --> 02:05:16,000 AUTOMOBILES, WE'VE SEEN FINANCIAL INSTITUTIONS, WE'VE 3545 02:05:16,001 --> 02:05:17,000 SEEN THE STUDENT LOANS AND NOW 3546 02:05:17,001 --> 02:05:18,000 WE'RE SEEING HEALTH CARE ALL 3547 02:05:18,001 --> 02:05:20,000 TAKEN OVER BY THE GOVERNMENT. 3548 02:05:20,001 --> 02:05:21,000 PARTIALLY TAKEN OVER BY THE 3549 02:05:21,001 --> 02:05:23,000 GOVERNMENT. 3550 02:05:23,001 --> 02:05:24,000 AND, CLEARLY, THE GOAL IS, AS 3551 02:05:24,001 --> 02:05:25,000 THE PRESIDENT SAID, EXPAND THE 3552 02:05:25,001 --> 02:05:26,000 SIZE OF THE GOVERNMENT, YOU 3553 02:05:26,001 --> 02:05:28,000 CREATE PROSPERITY. 3554 02:05:28,001 --> 02:05:29,000 USE THE EUROPEAN MODEL. 3555 02:05:29,001 --> 02:05:30,000 I DON'T HAPPEN TO BE ATTRACTED 3556 02:05:30,001 --> 02:05:31,000 TO THE EUROPEAN MODEL. 3557 02:05:31,001 --> 02:05:33,000 I THINK THE AMERICAN MODEL WORKS 3558 02:05:33,001 --> 02:05:35,000 BETTERMENT WHERE Y HAVE A 3559 02:05:35,001 --> 02:05:37,000 GOVERNMENT THAT YOU CAN AFFORD 3560 02:05:37,001 --> 02:05:39,000 AND YOU GIVE ENTREPRENEURS A 3561 02:05:39,001 --> 02:05:42,000 CHANCE TO GO OUT AND TAKE 3562 02:05:42,001 --> 02:05:45,000 -- RISKS AND CREATE JOBS. 3563 02:05:45,001 --> 02:05:46,000 MR. McCAIN: SENATOR HUTCHISON CONCLUDES. 3564 02:05:46,001 --> 02:05:47,000 MRS. HUTCHISON: MR. PRESIDENT, 3565 02:05:47,001 --> 02:05:49,000 WE'VE BEEN TALKING ABOUT 3566 02:05:49,001 --> 02:05:51,000 MEDICARE ADVANTAGE AND LOSING 3567 02:05:51,001 --> 02:05:52,000 THIS GREAT OPTION FOR OUR 3568 02:05:52,001 --> 02:05:57,000 LOWER-INCOME SENIORS IS SO IMPORTANT. 3569 02:05:57,001 --> 02:06:00,000 I WAS REMINDED THAT LOOKING HOSPITALS, WE HAVEN'T EVEN 3570 02:06:00,001 --> 02:06:01,000 TALKED ABOUT THE $135 BILLION 3571 02:06:01,001 --> 02:06:03,000 THAT WOULD BE TAKEN OUT OF 3572 02:06:03,001 --> 02:06:06,000 HOSPITALS IN THIS AMENDMENT -- I 3573 02:06:06,001 --> 02:06:07,000 MEAN, THI IN THIS BILL, AND THAT IS 3574 02:06:07,001 --> 02:06:09,000 THE CARE PROVIDERS. 3575 02:06:09,001 --> 02:06:14,000 SO WE' 3576 02:06:14,001 --> 02:06:16,000 AWAY THEIR OPTIONS, AND EYE CARE 3577 02:06:16,001 --> 02:06:19,000 AND DENTAL CARE AND HEARING 3578 02:06:19,001 --> 02:06:20,000 AIDS 3579 02:06:20,001 --> 02:06:21,000 SENIORS NEED, BUT ALSO 3580 02:06:21,001 --> 02:06:23,000 UNDERCUTTING THE HOSPITALS THAT 3581 02:06:23,001 --> 02:06:25,000 READ IT THEM STHAT THE CARE IN 3582 02:06:25,001 --> 02:06:26,000 THE HOSPITALS THEMSELVES WOULD 3583 02:06:26,001 --> 02:06:29,000 ALSO HAVE TO BE CUT BACK. 3584 02:06:29,001 --> 02:06:33,000 MR. PRESIDENT, IT JUST DOES NOT 3585 02:06:33,001 --> 02:06:37,000 PASS COMMON SENSE 3586 02:06:37,001 --> 02:06:38,000 MEDICARE IN ORDER TO CREATE A 3587 02:06:38,001 --> 02:06:40,000 NEW, BIG ENTITLEMENT PROGRAM. 3588 02:06:40,001 --> 02:06:42,000 WE'VE ALL THAT SAID M 3589 02:06:42,001 --> 02:06:44,000 ON LIFE SUPPORT ANYWAY, THAT 3590 02:06:44,001 --> 02:06:45,000 EVERYONE UNDERSTANDS 3591 02:06:45,001 --> 02:06:50,000 YOU TAKE HALF A TRILLION DOLLARS 3592 02:06:50,001 --> 02:06:52,000 OUT OF A PROGRAM THAT IS WORKING 3593 02:06:52,001 --> 02:06:53,000 FOR SENIORS, THAT GIVES OPTIONS 3594 02:06:53,001 --> 02:06:55,000 TO SENIORS, LIKE MEDICARE 3595 02:06:55,001 --> 02:06:58,000 ADVANTAGE, AND YOU TAKE AWAY 3596 02:06:58,001 --> 02:07:02,000 THEIR CARE TO PAY FOR ANOTHER 3597 02:07:02,001 --> 02:07:03,000 ENTITLEMENT PROGRAM THAT 3598 02:07:03,001 --> 02:07:06,000 SPECIFICALLY DESIGNED FOR THEM. 3599 02:07:06,001 --> 02:07:08,000 MR. PRESIDENT, I WANT TO THANK 3600 02:07:08,001 --> 02:07:09,000 THE SENATOR FROM ARIZONA, AND I 3601 02:07:09,001 --> 02:07:13,000 WOULD ASK HIM TO -- TO FINISH 3602 02:07:13,001 --> 02:07:15,000 THE COMMENT ON -- ON 3603 02:07:15,001 --> 02:07:16,000 HAPPENING TO THIS BILL IN THIS 3604 02:07:16,001 --> 02:07:18,000 COUNTRY TO OUR SENIORS AND WE 3605 02:07:18,001 --> 02:07:19,000 NEED TO STOP IT. 3606 02:07:19,001 --> 02:07:20,000 MR. McCAIN McCAIN: I THANK MY COLLEAGUES. 3607 02:07:20,001 --> 02:07:23,000 ITS BEEN A LOT OF 3608 02:07:23,001 --> 02:07:24,000 I YI 3609 02:07:24,001 --> 02:07:25,000 MR. BROWN: MR. PRESIDENT? 3610 02:07:25,001 --> 02:07:26,000 MR. PRESIDENT? 3611 02:07:26,001 --> 02:07:27,000 MR. PRESIDENT? 3612 02:07:27,001 --> 02:07:28,000 THE PRESIDING OFFICER: THE 3613 02:07:28,001 --> 02:07:29,000 SENATOR FROM OHIO. MR. BROWN: YEAH. 3614 02:07:29,001 --> 02:07:32,000 MR. PRESIDENT, I ASK UNANIMOUS 3615 02:07:32,001 --> 02:07:33,000 CONSENT TO -- 3616 02:07:33,001 --> 02:07:42,000 THE PRESIDING OFFICER: THE 3617 02:07:42,001 --> 02:07:48,000 SENATOR FR 3618 02:07:48,001 --> 02:07:49,000 MR. BAUCUS: 3619 02:07:49,001 --> 02:07:50,000 CONSENT THAT WE EXTEND FOR 3620 02:07:50,001 --> 02:07:51,000 ADDITIONAL HOUR THE PERIOD FOR 3621 02:07:51,001 --> 02:07:52,000 DEBATE ONLY. 3622 02:07:52,001 --> 02:07:53,000 THE PRESIDING OFFICER: WITHOUT 3623 02:07:53,001 --> 02:07:54,000 OBJECTION. 3624 02:07:54,001 --> 02:07:56,000 MR. BAUCUS: THERE'S MORE TO IT. 3625 02:07:56,001 --> 02:07:58,000 WITH NO FURTHER AMENDMENTS OR 3626 02:07:58,001 --> 02:07:59,000 MOTIONS IN ORDER DURING THE HOUR 3627 02:07:59,001 --> 02:08:01,000 AND THAT THE TIME BE EQUALLY 3628 02:08:01,001 --> 02:08:02,000 DIVIDE BETWEEN THE TWO SIDES, 3629 02:08:02,001 --> 02:08:04,000 WITH THE REPUBLICANS CONTROLLING 3630 02:08:04,001 --> 02:08:05,000 THE FIRST 30 MINUTES, THE 3631 02:08:05,001 --> 02:08:08,000 MAJORITYONTROLLING THE SECOND 3632 02:08:08,001 --> 02:08:09,000 30 MINUTES. 3633 02:08:09,001 --> 02:08:11,000 THE PRESIDING OFFICER: WITHOUT 3634 02:08:11,001 --> 02:08:12,000 OBJECTION. 3635 02:08:12,001 --> 02:08:13,000 MR. BAUCUS: BUT THERE ARE THREE 3636 02:08:13,001 --> 02:08:14,000 MINUTES REMAINING ON THE FIRST 3637 02:08:14,001 --> 02:08:15,000 BLOCK ON THE MAJORITY SIDE. 3638 02:08:15,001 --> 02:08:17,000 THE PRESIDING OFFICER: 2 MINUTES 3639 02:08:17,001 --> 02:08:18,000 AND 20 SECONDS. 3640 02:08:18,001 --> 02:08:19,000 MR. BAUCUS: THAT'S CLOSE ENOUGH. 3641 02:08:19,001 --> 02:08:21,000 MR. PRESIDENT, I ASK CONSENT 3642 02:08:21,001 --> 02:08:23,000 THAT SARAH FELD OF SENATOR 3643 02:08:23,001 --> 02:08:24,000 HARKIN'S STAFF BE GRANTED FLOOR 3644 02:08:24,001 --> 02:08:25,000 PRIVILEGES FOR THE DURATION OF 3645 02:08:25,001 --> 02:08:26,000 TODAY'S SESSION. 3646 02:08:26,001 --> 02:08:27,000 THE PRESIDING OFFICER: WITHOUT 3647 02:08:27,001 --> 02:08:28,000 OBJECTION. 3648 02:08:28,001 --> 02:08:29,000 MR. BROWN: MR. PRESIDENT? THE PRESIDING OFFICER: THE 3649 02:08:29,001 --> 02:08:31,000 MR. BROWN: MR. PRESIDENT, I ASK 3650 02:08:31,001 --> 02:08:32,000 UNANIMOUS CONSENT TO BEDDED AS 3651 02:08:32,001 --> 02:08:35,000 A COSPONSOR TO THE COBURN 3652 02:08:35,001 --> 02:08:39,000 AMENDMENT NUMBER 278 REQUIRING 3653 02:08:39,001 --> 02:08:42,000 ALL MEMBERS OF CONGRESS -- 2789 REQUIRING ALL MEMBERS OF 3654 02:08:42,001 --> 02:08:44,000 CONGRESS TO ENROLL IN THE NEW PUBLIC INSURANCE OPTION. 3655 02:08:44,001 --> 02:08:45,000 I WANTED TO ADD MY NAME TO 3656 02:08:45,001 --> 02:08:46,000 SENATOR COBURN'S AMENDMENT. 3657 02:08:46,001 --> 02:08:48,000 17 YEARS AGO WHEN I FIRST RAN 3658 02:08:48,001 --> 02:08:50,000 FOR CONGRESS, I PROMISED I'D PAY 3659 02:08:50,001 --> 02:08:51,000 MY OWN HEALTH INSURANCE UNTIL 3660 02:08:51,001 --> 02:08:52,000 CONGRESS PASSED HEALTH INSURANCE 3661 02:08:52,001 --> 02:08:53,000 FOR EVERYONE. 3662 02:08:53,001 --> 02:08:55,000 I LOOK FORWARD -- I'VE PAID IT 3663 02:08:55,001 --> 02:08:57,000 OUT OF MY POCKET SINCE THEN. 3664 02:08:57,001 --> 02:08:58,000 I LOOK 3665 02:08:58,001 --> 02:09:00,000 EAGERNESS TO JOIN THE PUBLIC 3666 02:09:00,001 --> 02:09:01,000 OPTION COME AS SOON AVAILABLE. 3667 02:09:01,001 --> 02:09:02,000 THANK YOU, MR. PRESIDENT. 3668 02:09:02,001 --> 02:09:12,000 THE PRESIDING OFFICER: WITHOUT 3669 02:09:12,001 --> 02:09:14,000 OBJECTION. 3670 02:09:14,001 --> 02:09:16,000 THINK I'LL USE MY THREE 3671 02:09:16,001 --> 02:09:17,000 JUST TO SAY THIS. MR. PRESIDENT? 3672 02:09:17,001 --> 02:09:18,000 THE PRESIDING OFFICER: THE 3673 02:09:18,001 --> 02:09:20,000 SENATOR FROM MONTANA. 3674 02:09:20,001 --> 02:09:21,000 MR. BAUCUS: 2 MINUTES AND 20 SECONDS. 3675 02:09:21,001 --> 02:09:22,000 THE PRESIDING OFFICER: 15 3676 02:09:22,001 --> 02:09:23,000 SECONDS. 3677 02:09:23,001 --> 02:09:27,000 MR. BAUCUS: OKAY. 3678 02:09:27,001 --> 02:09:29,000 WELL 3679 02:09:29,001 --> 02:09:30,000 I JUST WANT TO MAKE A PRETTY 3680 02:09:30,001 --> 02:09:31,000 BASIC POINT. 3681 02:09:31,001 --> 02:09:32,000 THE SENATOR FROM ARIZONA TALKS 3682 02:09:32,001 --> 02:09:34,000 ABOUT, GEE, ALL THESE MEDICARE 3683 02:09:34,001 --> 02:09:37,000 ADVANTAGE PLANS HAVE DENTAL AND 3684 02:09:37,001 --> 02:09:39,000 VISION COVERAGE AND -- AND HE 3685 02:09:39,001 --> 02:09:40,000 GOES ON TO SAY, SO DO MEMBERS OF 3686 02:09:40,001 --> 02:09:43,000 CONGRESS. 3687 02:09:43,001 --> 02:09:44,000 WELL, THE FACT IS, THAT'S NOT 3688 02:09:44,001 --> 02:09:47,000 AUTOMATICALLY TRUE. 3689 02:09:47,001 --> 02:09:50,000 THE FACT IS THAT THE MEMBERS OF 3690 02:09:50,001 --> 02:09:52,000 CONGRESS CHOOSE AMONG VARIOUS 3691 02:09:52,001 --> 02:09:54,000 PRIVATE PLANS. 3692 02:09:54,001 --> 02:09:56,000 SOME PLANS OFFER DENTAL AND VISION. 3693 02:09:56,001 --> 02:09:58,000 SOME DON'T. 3694 02:09:58,001 --> 02:10:00,000 AETNA IS A COMPANY THAT MEMBERS 3695 02:10:00,001 --> 02:10:04,000 OF CONGRESS CAN CHOOSE FROM 3696 02:10:04,001 --> 02:10:05,000 UNDER FEHBP AND HUMANA IS 3697 02:10:05,001 --> 02:10:06,000 ANOTHER ONE THAT MEMBERS OF 3698 02:10:06,001 --> 02:10:07,000 CONGRESS CAN CHOOSE FROM. 3699 02:10:07,001 --> 02:10:09,000 THOSE COMPANIES DO PROVIDE 3700 02:10:09,001 --> 02:10:12,000 DENTAL AND VISION COVERAGE, BUT 3701 02:10:12,001 --> 02:10:13,000 THERE ARE OTHERS, I THINK 3702 02:10:13,001 --> 02:10:16,000 BLUECROSS BLUESHIELD DOES NOT 3703 02:10:16,001 --> 02:10:18,000 PROVIDE DENTAL AND VISION VERAGE. 3704 02:10:18,001 --> 02:10:20,000 AND I MAKE THAT POINT BECAUSE 3705 02:10:20,001 --> 02:10:22,000 THIS IS EXACTLY WHAT WE'RE 3706 02:10:22,001 --> 02:10:23,000 TRYING TO SET UP IN THESE 3707 02:10:23,001 --> 02:10:24,000 EXCHANGES, THAT IS, PEOPLE CAN 3708 02:10:24,001 --> 02:10:27,000 PARTICIPATE IN THE EXCHANGES, 3709 02:10:27,001 --> 02:10:29,000 THEY CAN -- WHERE THEY WOULD BUY 3710 02:10:29,001 --> 02:10:30,000 PRIVATE COVERAGE AND THEY COULD 3711 02:10:30,001 --> 02:10:33,000 CHOOSE AMONG VARIOUS PRIVATE 3712 02:10:33,001 --> 02:10:34,000 PLANS WHICH COVERAGE THEY WANT. 3713 02:10:34,001 --> 02:10:36,000 DO THEY WANT A PLAN THAT COVERS 3714 02:10:36,001 --> 02:10:38,000 DENTAL AND VISION OR NOT. 3715 02:10:38,001 --> 02:10:40,000 IT'S EXACTLY WHAT WE'RE TRYIN 3716 02:10:40,001 --> 02:10:41,000 TO DO ON THE EXCHANGE. 3717 02:10:41,001 --> 02:10:44,000 AND AS IS THE CASE FOR MEMBERS 3718 02:10:44,001 --> 02:10:46,000 OF CONGRESS. 3719 02:10:46,001 --> 02:10:47,000 AND IT'S -- AND MEDICARE ADVANTAGE ANS DO PROVIDE 3720 02:10:47,001 --> 02:10:49,000 DENTAL AND VISION. 3721 02:10:49,001 --> 02:10:51,000 THAT'S -- I THINK THAT'S 3722 02:10:51,001 --> 02:10:52,000 I SEE MY TIME'S EXPIRED. 3723 02:10:52,001 --> 02:10:57,000 AT THE APPROPRIATE TIME, I WOULD 3724 02:10:57,001 --> 02:10:59,000 LIKE TO 3725 02:10:59,001 --> 02:11:01,000 EXPLAIN WHY WHAT WE DO IN THIS 3726 02:11:01,001 --> 02:11:06,000 BILL I THINK MAKES EMINENT 3727 02:11:06,001 --> 02:11:07,000 SENSE. 3728 02:11:07,001 --> 02:11:08,000 A SENATOR: MR. PRESIDENT? THE PRESIDING OFFICER: THE 3729 02:11:08,001 --> 02:11:10,000 SENATOR FROM IOWA. 3730 02:11:10,001 --> 02:11:11,000 MR. GRASSLEY: I WOULD YIELD 3731 02:11:11,001 --> 02:11:14,000 MYSELF SUCH TIME AS I MIGHT TAKE, AND I DON'T THINK I'M 3732 02:11:14,001 --> 02:11:15,000 GOING TO SPEAK MORE THAN SIX OR 3733 02:11:15,001 --> 02:11:19,000 SEVEN MINUTES, FOR THE BENEFIT 3734 02:11:19,001 --> 02:11:23,000 OF MY 3735 02:11:23,001 --> 02:11:24,000 SOME OF THIS TIME. 3736 02:11:24,001 --> 02:11:26,000 I WANT TO TELL MY COLLEAGUES WHY 3737 02:11:26,001 --> 02:11:27,000 I'M SUPPORTING THE HATCH 3738 02:11:27,001 --> 02:11:29,000 AMENDMENT. 3739 02:11:29,001 --> 02:11:32,000 IN MY HOME STATE OF IOWA, THERE 3740 02:11:32,001 --> 02:11:34,000 ARE 64,000 SENIORS ENROLLED IN 3741 02:11:34,001 --> 02:11:36,000 MEDICARE ADVANTAGE. 3742 02:11:36,001 --> 02:11:40,000 THESE ARE SENIORS THAT HAVE COME 3743 02:11:40,001 --> 02:11:41,000 TO RELY 3744 02:11:41,001 --> 02:11:44,000 PARTICULARLY ADDITIONAL BENEFITS 3745 02:11:44,001 --> 02:11:46,000 THAT MEDICARE ADVANTAGE PROVIDES 3746 02:11:46,001 --> 02:11:48,000 AS OPPOSED TO TRADITIONAL 3747 02:11:48,001 --> 02:11:49,000 MEDICARE. 3748 02:11:49,001 --> 02:11:50,000 YESTERDAY, I CAME TO THE FLOOR 3749 02:11:50,001 --> 02:11:53,000 TO POINT OUT THAT MY COLLEAGUES 3750 02:11:53,001 --> 02:11:56,000 ON THE OTHER SIDE OF THE AISLE 3751 02:11:56,001 --> 02:11:59,000 ARE PLAYING WORD GAMES TO COVER 3752 02:11:59,001 --> 02:12:03,000 UP THE FACT THAT THEY ARE 3753 02:12:03,001 --> 02:12:07,000 RAIDING MEDICARE, CUTTING 3754 02:12:07,001 --> 02:12:09,000 BENEFITS BY 64% FOR THESE 3755 02:12:09,001 --> 02:12:12,000 11 MILLION SENIORS THAT HAVE 3756 02:12:12,001 --> 02:12:14,000 CHOSEN VOLUNTARILY TO GO ON 3757 02:12:14,001 --> 02:12:18,000 MEDICARE ADVANTAGE AS OPPOSED TO 3758 02:12:18,001 --> 02:12:21,000 TRADITIONAL MEDICARE. 3759 02:12:21,001 --> 02:12:23,000 SO LET ME REPEAT, THIS BILL CUTS 3760 02:12:23,001 --> 02:12:28,000 MEDICARE BENEFITS, OR LET'S SAY 3761 02:12:28,001 --> 02:12:33,000 RAIDS MEDICARE, BY 64% FOR 11 MILLION MICARE 3762 02:12:33,001 --> 02:12:34,000 BENEFICIARIES 3763 02:12:34,001 --> 02:12:35,000 MY FRIENDS ON THE OTHER SIDE OF 3764 02:12:35,001 --> 02:12:37,000 THE AISLE KEEP SAYING THAT 3765 02:12:37,001 --> 02:12:39,000 THEY'RE NOT CUTTING, AND THEY 3766 02:12:39,001 --> 02:12:41,000 USE THESE WORDS -- THEY'RE NOT 3767 02:12:41,001 --> 02:12:44,000 CUTTING GUARANTEED BENEFITS. 3768 02:12:44,001 --> 02:12:46,000 BUT THIS ISN'T EVEN THE CASE, 3769 02:12:46,001 --> 02:12:49,000 BECAUSE WE HAVE THIS NEW 3770 02:12:49,001 --> 02:12:51,000 INDEPENDENT MEDICARE ADVISORY 3771 02:12:51,001 --> 02:12:55,000 BOARD THAT'S SET UP IN THIS LEGISLATION. 3772 02:12:55,001 --> 02:12:59,000 IT'S GIVEN VERY SPECIFIC 3773 02:12:59,001 --> 02:13:02,000 AUTHORITY TO CUT PAYMENTS TO MEDICARE PART-D. 3774 02:13:02,001 --> 02:13:07,000 THIS WILL RESULT IN HIGHER COSTS 3775 02:13:07,001 --> 02:13:09,000 AND LESS GUARANTEED BENEFITS FOR 3776 02:13:09,001 --> 02:13:10,000 MEDICARE BENEFICIARIES ENROLLED 3777 02:13:10,001 --> 02:13:11,000 IN MEDICARE PART-D. 3778 02:13:11,001 --> 02:13:13,000 BUT I WANT TO LEAVE THAT DEBATE 3779 02:13:13,001 --> 02:13:14,000 FOR LATER. 3780 02:13:14,001 --> 02:13:16,000 I WANT TO VISIT WITH MY 3781 02:13:16,001 --> 02:13:21,000 COLLEAES NOW JUST ABOUT 3782 02:13:21,001 --> 02:13:23,000 MEDICARE ADVANTAGE. 3783 02:13:23,001 --> 02:13:28,000 64,000 S 3784 02:13:28,001 --> 02:13:32,000 11 MILLION SENIORS NATIONWIDE 3785 02:13:32,001 --> 02:13:33,000 DON'T CARE ABOUT THE 3786 02:13:33,001 --> 02:13:35,000 GOBBLEDYGOOK TYPE WORDS WE USE 3787 02:13:35,001 --> 02:13:36,000 HERE IN TOWN, AS LEGAL AS THEY 3788 02:13:36,001 --> 02:13:39,000 ARE, GUARANTEED BENEFITS ON THE 3789 02:13:39,001 --> 02:13:40,000 ONE HAND AND THE WORDS 3790 02:13:40,001 --> 02:13:41,000 "ADDITIONAL BENEFIT" ON THE 3791 02:13:41,001 --> 02:13:45,000 OTHER HAND. 3792 02:13:45,001 --> 02:13:46,000 IN OTHER WORDS, "GUARANTEED 3793 02:13:46,001 --> 02:13:49,000 BENEFITS," OR, AS THE OTHER SIDE 3794 02:13:49,001 --> 02:13:50,000 WANTS US TO 3795 02:13:50,001 --> 02:13:52,000 SOMEHOW ADDITIONAL BENEFITS 3796 02:13:52,001 --> 02:13:55,000 PROVIDED UNDER MEDICARE. 3797 02:13:55,001 --> 02:13:56,000 SO I SAY THAT'S WASHINGTON 3798 02:13:56,001 --> 02:13:58,000 NONSENSE AND I WANT TO BRING A 3799 02:13:58,001 --> 02:14:02,000 LITTLE BIT OF MIDWESTERN 3800 02:14:02,001 --> 02:14:03,000 COMMONSENSE TO THIS DEBATE. 3801 02:14:03,001 --> 02:14:06,000 BECAUSE OUR CONSTITUENTS JUST 3802 02:14:06,001 --> 02:14:09,000 WANT TO KNOW THAT CONGRESS ISN'T 3803 02:14:09,001 --> 02:14:11,000 CUTTING MEDICARE BENEFITS THAT 3804 02:14:11,001 --> 02:14:12,000 THEY HAVE COME TO RELY UPON, AND 3805 02:14:12,001 --> 02:14:15,000 THAT WOULD INCLUDE UNDER 3806 02:14:15,001 --> 02:14:17,000 MEDICARE ADVANTAGE. 3807 02:14:17,001 --> 02:14:20,000 DENTAL CARE, EYEGLASSES, HEARING 3808 02:14:20,001 --> 02:14:21,000 AIDS AND OTHER ADDITIONAL 3809 02:14:21,001 --> 02:14:24,000 BENEFITS PROVIDED BY THIS 3810 02:14:24,001 --> 02:14:26,000 PROGRAM THAT THEY VOLUNTARILY 3811 02:14:26,001 --> 02:14:27,000 CHOOSE MEDICARE ADVANTAGE. 3812 02:14:27,001 --> 02:14:31,000 NOW, I KNOW THAT TO BE THE CASE 3813 02:14:31,001 --> 02:14:34,000 BECAUSE I JUST HAVE -- I HAVE AT 3814 02:14:34,001 --> 02:14:35,000 LEAST A THOUSAND LETTERS 3815 02:14:35,001 --> 02:14:36,000 RECEIVED LAST SUMMER -- SINCE 3816 02:14:36,001 --> 02:14:39,000 LAST SUMMER ON THIS POINT. 3817 02:14:39,001 --> 02:14:42,000 BUT I JUST WANT TO READ ONE FROM 3818 02:14:42,001 --> 02:14:45,000 MISS GALARDO OF IOWA CITY, IOWA. 3819 02:14:45,001 --> 02:14:46,000 "I AM WRITING TO URGE YOU TO 3820 02:14:46,001 --> 02:14:48,000 OPPOSE CUTS TO MEDICARE ADVANTAGE. 3821 02:14:48,001 --> 02:14:50,000 THIS PLAN WAS A GREAT HELP TO ME 3822 02:14:50,001 --> 02:14:53,000 WHEN MY LATE HUSBAND, WHO PASSED 3823 02:14:53,001 --> 02:14:55,000 AWAY IN MAY, WAS HOSPITALIZED. 3824 02:14:55,001 --> 02:14:58,000 I WAS ABLE TO AFFORD TO PAY THE 3825 02:14:58,001 --> 02:15:03,000 HOSPITAL WITHOUT GOING BANKRUPT. 3826 02:15:03,001 --> 02:15:04,000 INCOME DEPEND ON OUR BENEFITS 3827 02:15:04,001 --> 02:15:12,000 FROM MEDICARE ADVANTAGE. 3828 02:15:12,001 --> 02:15:15,000 I AM RETIRED AND I DON'T --" FOR 3829 02:15:15,001 --> 02:15:16,000 A QUOTE -- "I AM RETIRED AND 3830 02:15:16,001 --> 02:15:17,000 DON'T KNOW HOW I WOULD HAVE 3831 02:15:17,001 --> 02:15:18,000 MANAGED WITHOUT MEDICARE 3832 02:15:18,001 --> 02:15:19,000 ADVANTAGE." 3833 02:15:19,001 --> 02:15:22,000 EN 3834 02:15:22,001 --> 02:15:24,000 LETTER. 3835 02:15:24,001 --> 02:15:26,000 NOW, SOME OF MY COLLEAGUES ON 3836 02:15:26,001 --> 02:15:28,000 THE OTHER SIDE OF THE AISLE 3837 02:15:28,001 --> 02:15:31,000 DON'T WANT SENIORS, EVEN PEOPLE 3838 02:15:31,001 --> 02:15:37,000 LIKE MY CONSTITUENT FROM IOWA 3839 02:15:37,001 --> 02:15:51,000 CITY, IOWA, MS. GALADO, TO KNOW 3840 02:15:51,001 --> 02:15:52,000 THAT THIS 2W06R 3841 02:15:52,001 --> 02:15:55,000 THEIR PAYMENTS. 3842 02:15:55,001 --> 02:15:56,000 THEY'RE CUTTING THEIR PAYMENTS 3843 02:15:56,001 --> 02:15:57,000 IN THE MEDICARE ADVANTAGE PLAN. 3844 02:15:57,001 --> 02:16:01,000 THAT DOESN'T MAKE A DIFFERENCE 3845 02:16:01,001 --> 02:16:03,000 TO MS. GUARDO. 3846 02:16:03,001 --> 02:16:05,000 BUT THAT THESE PAYMENTS MUST BE 3847 02:16:05,001 --> 02:16:07,000 SPENT ON ADDITIONAL 3848 02:16:07,001 --> 02:16:09,000 NOT JUST FREE MONEY FOR A 3849 02:16:09,001 --> 02:16:11,000 COMPANY TO USE OR FREE MONEY 3850 02:16:11,001 --> 02:16:15,000 THAT BENEFITS A MEDICARE 3851 02:16:15,001 --> 02:16:18,000 ADVANTAGE RECIPIENT WITHOUT ANY 3852 02:16:18,001 --> 02:16:22,000 CONCERN ABOUT WHAT IT COSTS. 3853 02:16:22,001 --> 02:16:25,000 75% OF THESE PAYMENTS MUST BE 3854 02:16:25,001 --> 02:16:27,000 SPENT FOR ADDITIONAL 3855 02:16:27,001 --> 02:16:28,000 AND THEN WHERE DOES THE REST OF 3856 02:16:28,001 --> 02:16:30,000 IT GO? 3857 02:16:30,001 --> 02:16:32,000 THE REST OF IT COMES BACK TO THE 3858 02:16:32,001 --> 02:16:35,000 FEDERAL TREASURY. 3859 02:16:35,001 --> 02:16:38,000 CUTS TO THESE MEDICARE ADVANTAGE 3860 02:16:38,001 --> 02:16:41,000 PAYMENTS ARE, IN FACT, CUTS IN 3861 02:16:41,001 --> 02:16:42,000 MEDICARE BENEFITS. 3862 02:16:42,001 --> 02:16:46,000 I'M MORE THAN HAPPY TO HAVE 3863 02:16:46,001 --> 02:16:48,000 DEBATE ON HOW TO REFORM MEDICARE 3864 02:16:48,001 --> 02:16:49,000 ADVANTAGE PAYMENTS. 3865 02:16:49,001 --> 02:16:52,000 WE SHOULD ALWAYS BE LOOKING FOR 3866 02:16:52,001 --> 02:16:56,000 WAYS TO MAKE PAYMENTS MORE EFFICIENT. 3867 02:16:56,001 --> 02:16:59,000 BUT THE SOLUTION IS NOT TO CUT 3868 02:16:59,001 --> 02:17:03,000 BENEFITS BY 64% THAT SENIORS 3869 02:17:03,001 --> 02:17:05,000 HAVE COME TO RELY ON TO FUND AN 3870 02:17:05,001 --> 02:17:08,000 ENTIRELY NEW ENTITLEMENT PROGRAM 3871 02:17:08,001 --> 02:17:10,000 THAT THIS COUNTRY CAN'T AFFORD. 3872 02:17:10,001 --> 02:17:12,000 AT A TIME WHEN SENIORS ARE IN 3873 02:17:12,001 --> 02:17:16,000 THE MIDST OF THE BIGGEST 3874 02:17:16,001 --> 02:17:18,000 ECONOMIC CRISIS SINCE THE GREAT 3875 02:17:18,001 --> 02:17:21,000 DEPRESSION, WE SHOULDN'T BE 3876 02:17:21,001 --> 02:17:22,000 DEBATING A BILL THAT SPENDS THEM 3877 02:17:22,001 --> 02:17:26,000 TO SPEND MORE MONEY ON HEALTH 3878 02:17:26,001 --> 02:17:28,000 CARE, BUT THAT IS EXACTLY WHAT 3879 02:17:28,001 --> 02:17:30,000 THIS 2,074-PAGE BILL WILL DO. 3880 02:17:30,001 --> 02:17:32,000 SENIORS THAT LOSE THEIR MEDICARE 3881 02:17:32,001 --> 02:17:38,000 ADVANTAGE AS A RESULT OF THIS 3882 02:17:38,001 --> 02:17:41,000 BILL MAY BE FORCED TO BUY A 3883 02:17:41,001 --> 02:17:42,000 MEDI-GAP PLAN TO FILL ALL THE 3884 02:17:42,001 --> 02:17:43,000 HOLES IN THE TRADITIONAL 3885 02:17:43,001 --> 02:17:46,000 MEDICARE PLAN. 3886 02:17:46,001 --> 02:17:47,000 THAT'S WHY MORE LOW-INC 3887 02:17:47,001 --> 02:17:50,000 SENIORS ENROLL IN MEDICARE ADVANTAGE. 3888 02:17:50,001 --> 02:17:51,000 THE SO-CALLED OVERPAYMENTS THAT 3889 02:17:51,001 --> 02:17:55,000 MY COLLEAGUES ON THE OTHER SIDE 3890 02:17:55,001 --> 02:17:57,000 OF THE AISLE KEEP DECRYING HELP 3891 02:17:57,001 --> 02:18:00,000 FILL IN A SIGNIFICANT COST 3892 02:18:00,001 --> 02:18:03,000 SHARING AND PREMIUMS THAT EXIST 3893 02:18:03,001 --> 02:18:06,000 IN TRADITIONAL MEDICARE. 3894 02:18:06,001 --> 02:18:07,000 SO THIS BILL WILL FORCE 3895 02:18:07,001 --> 02:18:09,000 LOW-INCOME SENIORS THAT PAY 3896 02:18:09,001 --> 02:18:13,000 LITTLE TO NOTHING UNDER MEDICARE 3897 02:18:13,001 --> 02:18:17,000 ADVANTAGE TO COME UP WITH $175 3898 02:18:17,001 --> 02:18:18,000 PER MONTH TO BUY A MEDI-GAP 3899 02:18:18,001 --> 02:18:20,000 PLAN. 3900 02:18:20,001 --> 02:18:23,000 THAT DOESN'T SOUND LIKE THAT'S A 3901 02:18:23,001 --> 02:18:24,000 VERY GOOD WAY TO HELP SENIORS. 3902 02:18:24,001 --> 02:18:26,000 THAT SOUNDS LIKE THIS BILL IS 3903 02:18:26,001 --> 02:18:29,000 PAYING FOR AN ENTIRELY NEW 3904 02:18:29,001 --> 02:18:31,000 ENTITLEMENT PROGRAM. 3905 02:18:31,001 --> 02:18:33,000 AND PAYING FOR IT, QUITE 3906 02:18:33,001 --> 02:18:35,000 FRANKLY, ON THE BACKS OF 3907 02:18:35,001 --> 02:18:36,000 11 MILLION MEDICARE 3908 02:18:36,001 --> 02:18:39,000 BENEFICIARIES. 3909 02:18:39,001 --> 02:18:48,000 SO I SUPPORT THE HATCH AMENDMEN 3910 02:18:48,001 --> 02:18:49,000 LET'S TAKE THE DZ 3911 02:18:49,001 --> 02:18:50,000 CUTS TO MEDICARE BACK TO THE 3912 02:18:50,001 --> 02:18:52,000 FINANCE COMMITTEE AND FIND A 3913 02:18:52,001 --> 02:18:55,000 WHICH TO IMPROVE THE PROGRAM 3914 02:18:55,001 --> 02:18:57,000 WITHOUT HURTING 11 MILLION SENIORS. 3915 02:18:57,001 --> 02:18:59,000 I WOULD LIKE TO AT THIS POINT, 3916 02:18:59,001 --> 02:19:02,000 MR. PRESIDENT, AS I YIELD THE 3917 02:19:02,001 --> 02:19:04,000 FLOOR TO YIELD FIVE MINUTES AS 3918 02:19:04,001 --> 02:19:05,000 MANAGER ON THIS SIDE 3919 02:19:05,001 --> 02:19:06,000 HU 3920 02:19:06,001 --> 02:19:07,000 MRS. HUTCHISON: THANK YOU, MR. 3921 02:19:07,001 --> 02:19:09,000 PRESIDENT. 3922 02:19:09,001 --> 02:19:10,000 MR. PRESIDENT, I APPRECIATE WHAT 3923 02:19:10,001 --> 02:19:14,000 THE DISTINGUISHED SENATOR FROM 3924 02:19:14,001 --> 02:19:16,000 IOWA HAS JUST TALKED 3925 02:19:16,001 --> 02:19:19,000 BECAUSE I SPECIFICALLY LIKE THE 3926 02:19:19,001 --> 02:19:20,000 FACT THAT HE'S RELATING THIS TO 3927 02:19:20,001 --> 02:19:21,000 WHERE WE ARE TODAY. 3928 02:19:21,001 --> 02:19:24,000 SOMETIMES IT'S -- IT SEEMS LIKE 3929 02:19:24,001 --> 02:19:26,000 WE'RE IN A 3930 02:19:26,001 --> 02:19:27,000 HOW STRETCHED PEOPLE ARE RIGHT 3931 02:19:27,001 --> 02:19:34,000 NOW. 3932 02:19:34,001 --> 02:19:35,000 WE ARE IN A TIME OF 3933 02:19:35,001 --> 02:19:36,000 PEOPLE WORRIED ABOUT KEEPING 3934 02:19:36,001 --> 02:19:39,000 THEIR JOBS OR WORRIED ABOUT 3935 02:19:39,001 --> 02:19:40,000 HAVING LOST THEIR JOBS. 3936 02:19:40,001 --> 02:19:42,000 WHERE ARE THEY GOING TO GET 3937 02:19:42,001 --> 02:19:45,000 HEALTH CARE? 3938 02:19:45,001 --> 02:19:46,000 YOUAVE SENIORS THAT ARE 3939 02:19:46,001 --> 02:19:48,000 STRETCHED BECAUSE THEY'RE NOT 3940 02:19:48,001 --> 02:19:49,000 ABLE TO EARN ANYTHING THAT WILL 3941 02:19:49,001 --> 02:19:50,000 HELP THEM VERY MUCH. 3942 02:19:50,001 --> 02:19:51,000 WE'RE IN A DISTRESSED TIME IN 3943 02:19:51,001 --> 02:19:52,000 THIS COUNTRY. 3944 02:19:52,001 --> 02:19:55,000 THERE'S NO DOUBT ABOUT IT. 3945 02:19:55,001 --> 02:19:58,000 AND TO TK ABOUT 3946 02:19:58,001 --> 02:19:59,000 MEDICARE $500 BILLION IS JUST 3947 02:19:59,001 --> 02:20:01,000 ASTOUNDING. 3948 02:20:01,001 --> 02:20:02,000 NOW, I'M CONCERNED ABOUT 3949 02:20:02,001 --> 02:20:04,000 HOSPITALS. 3950 02:20:04,001 --> 02:20:08,000 BECAUSE WE TALKED FOR THE LAST 3951 02:20:08,001 --> 02:20:10,000 45 MINUTES ABOUT THE CUTS TO 3952 02:20:10,001 --> 02:20:12,000 SERVICES, THE HEARING AIDS, THE 3953 02:20:12,001 --> 02:20:14,000 DENTAL WORK THAT SENIORS NEED, 3954 02:20:14,001 --> 02:20:16,000 THE EYE CARE 3955 02:20:16,001 --> 02:20:19,000 WE'VE TALKED ABOUT THE 3956 02:20:19,001 --> 02:20:23,000 BENEFITS, BUT WHAT ABOUT THE 3957 02:20:23,001 --> 02:20:26,000 CUTS TO 3958 02:20:26,001 --> 02:20:28,000 EVERY HOSPITAL IN TEXAS TREATS 3959 02:20:28,001 --> 02:20:33,000 PEOPLE WHO HAVE NO INSURANCE 3960 02:20:33,001 --> 02:20:34,000 AND, THEREFORE, GET 3961 02:20:34,001 --> 02:20:37,000 DISPROPAYMENTS THAT MAKE UP FOR 3962 02:20:37,001 --> 02:20:38,000 THE LOW REIMBURSEMENT RATES OF 3963 02:20:38,001 --> 02:20:44,000 MEDICARE. 3964 02:20:44,001 --> 02:20:46,000 A MAJOR COMPONENT 3965 02:20:46,001 --> 02:20:48,000 LESSENED PAYMENTS 3966 02:20:48,001 --> 02:20:53,000 PROVIDERS, TO DOCTO 3967 02:20:53,001 --> 02:20:54,000 TO HOSPITALS, TO 3968 02:20:54,001 --> 02:20:56,000 ADVANTAGE, WE TALKED ABOUT, 3969 02:20:56,001 --> 02:20:58,000 THAT'S A CUT OF $120 BILLION, 3970 02:20:58,001 --> 02:21:02,000 AND THEN HOME HEALTH AGENCIES. 3971 02:21:02,001 --> 02:21:04,000 ALL OF THESE SERVE OUR SENIORS. 3972 02:21:04,001 --> 02:21:07,000 -- OUR SENIORS IN SUCH GREAT WAYS. 3973 02:21:07,001 --> 02:21:10,000 AND LOOK AT THE 3974 02:21:10,001 --> 02:21:13,000 TRILLION DOLLARS OVER 10 YEARS. 3975 02:21:13,001 --> 02:21:17,000 THIS IS NOT 3976 02:21:17,001 --> 02:21:22,000 YOU CANNOT TAKE AWAY FROM 3977 02:21:22,001 --> 02:21:24,000 MEDICARE 3978 02:21:24,001 --> 02:21:26,000 REIMBURSEMENTS TO 3979 02:21:26,001 --> 02:21:28,000 BECAUSE WHAT'S GOING TO HAPPEN 3980 02:21:28,001 --> 02:21:30,000 TO A 3981 02:21:30,001 --> 02:21:34,000 HAPPEN TO A HOSPITAL IN A RURAL 3982 02:21:34,001 --> 02:21:36,000 AREA THAT IS BARELY HANGING ON 3983 02:21:36,001 --> 02:21:37,000 RIGHT NOW BECAUSE THEY'RE TRYING 3984 02:21:37,001 --> 02:21:40,000 TO MAKE ENDS MEET IN A MORE 3985 02:21:40,001 --> 02:21:41,000 EXPNSIVE TREATMENT AREA, -- 3986 02:21:41,001 --> 02:21:44,000 EXPENSIVE TREATMENT AREA, AND 3987 02:21:44,001 --> 02:21:46,000 THEY LOSE THAT ADDED BENEFIT -- 3988 02:21:46,001 --> 02:21:48,000 IT'S NOT A 3989 02:21:48,001 --> 02:21:50,000 PAYMENT, THAT WOULD MAKE THEM 3990 02:21:50,001 --> 02:21:52,000 WHOLE IN THE TREATMENT OF OUR 3991 02:21:52,001 --> 02:21:53,000 SENIORS, OUR LOW-INCOME SENIORS 3992 02:21:53,001 --> 02:21:56,000 AND OUR SENIORS? 3993 02:21:56,001 --> 02:21:59,000 THE TEXAS HOSPITAL ASSOCIATION 3994 02:21:59,001 --> 02:22:02,000 ESTIMATES THAT $2 BILLION WILL 3995 02:22:02,001 --> 02:22:06,000 BE CUT IN THE PAYMENTS TO 3996 02:22:06,001 --> 02:22:09,000 HOSPITALS FOR MEDICARE PATIENTS. 3997 02:22:09,001 --> 02:22:10,000 NOW, $2 BILLION OUT OF OUR 3998 02:22:10,001 --> 02:22:12,000 ECONOMY. 3999 02:22:12,001 --> 02:22:15,000 254 COUNTIES 4000 02:22:15,001 --> 02:22:17,000 MORE THAN O-FOURTH DO NOTAVE 4001 02:22:17,001 --> 02:22:19,000 AN ACUTE CARE HOSPITAL WITHIN 4002 02:22:19,001 --> 02:22:21,000 THEIR BOUNDARIES. 4003 02:22:21,001 --> 02:22:22,000 WITH THESE KINDS OF CUTS TO OUR 4004 02:22:22,001 --> 02:22:24,000 RURAL HOSPITALS, WE ARE TALKING 4005 02:22:24,001 --> 02:22:25,000 ABOUT LOSING MORE HOSPITALS, 4006 02:22:25,001 --> 02:22:26,000 THERE'S NO DOUBT ABOUT IT. 4007 02:22:26,001 --> 02:22:28,000 BECAUSE THEY'RE ALREADY 4008 02:22:28,001 --> 02:22:29,000 STRUGGLING. 4009 02:22:29,001 --> 02:22:31,000 WHY WE PAY FOR HEALTH CARE 4010 02:22:31,001 --> 02:22:33,000 REFORM ON THE BACKS OF OUR 4011 02:22:33,001 --> 02:22:35,000 SENIOR CITIZENS? 4012 02:22:35,001 --> 02:22:39,000 WHY WOULD WE 4013 02:22:39,001 --> 02:22:41,000 PROGRAM THAT THEY HAVE THAT IS 4014 02:22:41,001 --> 02:22:43,000 ORDER TO PAY FOR ANOTHER BIG 4015 02:22:43,001 --> 02:22:51,000 GOVERNMENT PROGRAM THAT IS GOING 4016 02:22:51,001 --> 02:22:52,000 TO COST $2.5 TR 4017 02:22:52,001 --> 02:22:56,000 $2.5 TRILLION, MOST OF WHICH IS 4018 02:22:56,001 --> 02:22:57,000 GOING TO BE ADDED TO 4019 02:22:57,001 --> 02:22:59,000 DEFICIT, ADDED TO THE DEBT IN 4020 02:22:59,001 --> 02:23:01,000 OUR COUNTRY. 4021 02:23:01,001 --> 02:23:05,000 AND WE'RE ALREADY HITTING THE 4022 02:23:05,001 --> 02:23:06,000 CEILING OF THE DEBT A 4023 02:23:06,001 --> 02:23:08,000 AT $12 TRILLION. 4024 02:23:08,001 --> 02:23:13,000 WE'RE IN A VERY TOUGH FINANCIAL TIME. 4025 02:23:13,001 --> 02:23:15,000 WE ARE IN A TIME THAT IS HARD 4026 02:23:15,001 --> 02:23:17,000 FO PEOPLE WHO HAVE LOST THEIR 4027 02:23:17,001 --> 02:23:18,000 JOBS, HARD FOR SENIORS WHO ARE 4028 02:23:18,001 --> 02:23:20,000 STRETCHED TO MAKE ENDS MEET. 4029 02:23:20,001 --> 02:23:21,000 HARD FOR HOSPITALS THAT 4030 02:23:21,001 --> 02:23:23,000 SERVING THESE SENIORS. 4031 02:23:23,001 --> 02:23:27,000 AND 4032 02:23:27,001 --> 02:23:29,000 COST OF THE TREATMENT AND, YET, 4033 02:23:29,001 --> 02:23:31,000 WE'RE TALKING ABOUT 4034 02:23:31,001 --> 02:23:39,000 THESE SERVICES. 4035 02:23:39,001 --> 02:23:41,000 OF 4036 02:23:41,001 --> 02:23:42,000 MEDICARE, $20 BILLION ARE FOR 4037 02:23:42,001 --> 02:23:44,000 THE REIMBURSEMENT RATES THAT 4038 02:23:44,001 --> 02:23:46,000 WILL NO LONGER BE 4039 02:23:46,001 --> 02:23:49,000 HOSPITALS WHOLE. 4040 02:23:49,001 --> 02:23:50,000 I'VE TALKED TO -- IN FACT, I 4041 02:23:50,001 --> 02:23:58,000 WENT TO THE MAJOR MEDICAL 4042 02:23:58,001 --> 02:24:00,000 CENTERS IN TEXAS, IN DALT DALLAS, IN 4043 02:24:00,001 --> 02:24:02,000 HOUSTON, AND THEN I WENT OUT TO 4044 02:24:02,001 --> 02:24:03,000 RURAL AREAS, AND IT IS THE TOPIC 4045 02:24:03,001 --> 02:24:04,000 OF CONVERSATION. 4046 02:24:04,001 --> 02:24:06,000 ANYONE WHO IS DEALING WITH A 4047 02:24:06,001 --> 02:24:10,000 HOSPITAL IN A RURAL AREA, 4048 02:24:10,001 --> 02:24:11,000 THEY'RE ALL SAYING: WHAT ARE YOU 4049 02:24:11,001 --> 02:24:13,000 DOING? 4050 02:24:13,001 --> 02:24:15,000 WELL, OF COURSE, WE'RE NOT DOING ANYTHING. 4051 02:24:15,001 --> 02:24:17,000 WE'RE FIGHTING THESE HEALTH CARE 4052 02:24:17,001 --> 02:24:19,000 CUTS. 4053 02:24:19,001 --> 02:24:21,000 BUT THEY'VE GOT TO KNOW WHAT IS 4054 02:24:21,001 --> 02:24:22,000 HAPPENING HERE SO WE 4055 02:24:22,001 --> 02:24:24,000 THAT RESULT. 4056 02:24:24,001 --> 02:24:26,000 MR. PRESIDENT, I UNDERSTAND THAT 4057 02:24:26,001 --> 02:24:28,000 MY TIME IS UP, AND I THINK THE 4058 02:24:28,001 --> 02:24:29,000 SENATOR FROM OKLAHOMA HAS THE 4059 02:24:29,001 --> 02:24:32,000 REST OF THE TIME ON OUR SIDE AND 4060 02:24:32,001 --> 02:24:33,000 I YIELD TO HIM. 4061 02:24:33,001 --> 02:24:35,000 THE PRESIDING OFFICER: THE 4062 02:24:35,001 --> 02:24:36,000 SENATOR FRO 4063 02:24:36,001 --> 02:24:39,000 MR. INHOFE: FIRST OF ALL, I 4064 02:24:39,001 --> 02:24:41,000 THANK THE SENATOR FROM TEXAS. 4065 02:24:41,001 --> 02:24:44,000 I YIELD MYSELF THE REMAINDER OF 4066 02:24:44,001 --> 02:24:45,000 YOUR TIME, WHICH I UNDERSTAND IS 4067 02:24:45,001 --> 02:24:47,000 UNTIL 10 AFTER THE HOUR. 4068 02:24:47,001 --> 02:24:49,000 MR. PRESIDENT, I WANT TO TALK 4069 02:24:49,001 --> 02:24:51,000 ABOUT THE TAX HERE TODAY, WHICH 4070 02:24:51,001 --> 02:24:52,000 IS OUR SUBJECT IN MAYBE A LITTLE 4071 02:24:52,001 --> 02:24:53,000 DIFFERENT WAY THAN SOME OF THE 4072 02:24:53,001 --> 02:24:56,000 OTHERS DID. 4073 02:24:56,001 --> 02:24:58,000 THE STATED PURPOSE OF THE 4074 02:24:58,001 --> 02:25:00,000 DEMOCRATS' HEALTH CARE PROPOSAL 4075 02:25:00,001 --> 02:25:02,000 IS TO DO TWO THINGS, LOWER COSTS 4076 02:25:02,001 --> 02:25:03,000 AN INCREASE COVERAGE. 4077 02:25:03,001 --> 02:25:06,000 -- AND INCREASE COVERAGE. 4078 02:25:06,001 --> 02:25:08,000 NOW, THIS BILL IS A MISERABLE 4079 02:25:08,001 --> 02:25:09,000 FAILURE UNDER BOTH COUNTS. 4080 02:25:09,001 --> 02:25:11,000 UNDER THE PLAN THE PREMIUMS ARE 4081 02:25:11,001 --> 02:25:12,000 EXPECTED TO INCREASE AS A RESULT 4082 02:25:12,001 --> 02:25:14,000 OF THE NEW TAXES, NEW 4083 02:25:14,001 --> 02:25:15,000 REGULATIONS AND RESTRICTIONS. 4084 02:25:15,001 --> 02:25:17,000 IN GENERAL YOU'RE GOING TO PAY 4085 02:25:17,001 --> 02:25:21,000 MORE FOR YOUR HEALTH INSURANCE 4086 02:25:21,001 --> 02:25:22,000 THANKS TO THE 4087 02:25:22,001 --> 02:25:23,000 2,000-PAGE BILL. 4088 02:25:23,001 --> 02:25:25,000 THAT IS IN DIRECT CONTRADICTION 4089 02:25:25,001 --> 02:25:26,000 OF THE STATED GOALS OF THE BILL ITSELF. 4090 02:25:26,001 --> 02:25:27,000 I'M GOING TO BE SPECIFIC ABOUT 4091 02:25:27,001 --> 02:25:29,000 THAT IN A MOMENT. 4092 02:25:29,001 --> 02:25:31,000 THE SECOND ISSUE IS COVERAGE. 4093 02:25:31,001 --> 02:25:33,000 AGAIN, WE FIND A MISERABLE 4094 02:25:33,001 --> 02:25:38,000 FAILURE, THE MOSS OFTEN CITED 4095 02:25:38,001 --> 02:25:39,000 NUMBER OF UNINSURED 4096 02:25:39,001 --> 02:25:41,000 47 MILLION AMERICANS THAT WOULD 4097 02:25:41,001 --> 02:25:43,000 BE UNINSURED. 4098 02:25:43,001 --> 02:25:44,000 I SAW SOME INTERESTING NUMBERS 4099 02:25:44,001 --> 02:25:46,000 IN "THE WASHINGTON POST" OPINION 4100 02:25:46,001 --> 02:25:49,000 PIECE THE OTHER DAY, WHICH KIND 4101 02:25:49,001 --> 02:25:50,000 OF RANKS OUT THE UNINSURED AND 4102 02:25:50,001 --> 02:25:52,000 HOW THEY'RE BROKEN DOWN. 4103 02:25:52,001 --> 02:25:57,000 THIS IS VERY SIGNICANT. 4104 02:25:57,001 --> 02:25:59,000 OF THE 47 MILLION, 39% RESIDE IN 4105 02:25:59,001 --> 02:26:01,000 THE FIVE STATES OF CALIFORNIA, 4106 02:26:01,001 --> 02:26:02,000 FLORIDA, NEW MEXICO, ARIZONA, 4107 02:26:02,001 --> 02:26:04,000 AND TEXAS. 4108 02:26:04,001 --> 02:26:08,000 OF COURSE THOSE ARE BORDER STAT. 4109 02:26:08,001 --> 02:26:10,000 INDEED, IT IS ESTIMATED THAT 4110 02:26:10,001 --> 02:26:12,000 9.1 MILLION OF THE 47 MIION 4111 02:26:12,001 --> 02:26:14,000 ARE ILLEGAL IMMIGRANTS, PEOPLE 4112 02:26:14,001 --> 02:26:19,000 HERE IN THIS COUNTRY ILLEGALLY. 4113 02:26:19,001 --> 02:26:21,000 NOW, 4114 02:26:21,001 --> 02:26:24,000 47 MILLION, 9.7 MILLION HAVE 4115 02:26:24,001 --> 02:26:25,000 INCOMES ABOVE $75,000 AND CHOOSE 4116 02:26:25,001 --> 02:26:26,000 NOT TO PURCHASE HEALTH 4117 02:26:26,001 --> 02:26:27,000 INSURANCE. 4118 02:26:27,001 --> 02:26:30,000 THIS BILL WOULD SOLVE THAT ISSUE 4119 02:26:30,001 --> 02:26:32,000 BY USING A COERCIVE POWER OF THE 4120 02:26:32,001 --> 02:26:34,000 FEDERAL GOVERNMENT TO FORCE 4121 02:26:34,001 --> 02:26:37,000 THESE CITIZENS TO ALLOCATE THEIR 4122 02:26:37,001 --> 02:26:38,000 RESOURCES IN A MANNER THAT MEETS 4123 02:26:38,001 --> 02:26:39,000 THE BUREAUCRATS IN WASHINGTON 4124 02:26:39,001 --> 02:26:42,000 AND THE POLITICIANS. 4125 02:26:42,001 --> 02:26:43,000 THE BILL MAKES IT A CRIME NOT TO 4126 02:26:43,001 --> 02:26:45,000 HAVE HEALTH INSURANCE SO -- AND 4127 02:26:45,001 --> 02:26:46,000 IF YOU DON'T GET IT, YOU GET 4128 02:26:46,001 --> 02:26:50,000 TAXED. 4129 02:26:50,001 --> 02:26:51,000 LASTLY, A TOTAL OF 14 MILLION OF 4130 02:26:51,001 --> 02:26:53,000 THE 47 MILLION ARE CURRENTLY 4131 02:26:53,001 --> 02:26:56,000 ELIGIBLE FOR CURRENT GOVERNMENT 4132 02:26:56,001 --> 02:26:58,000 PROGRAMS, MEDICAID, MEDICARE, 4133 02:26:58,001 --> 02:26:59,000 SCHIP AND SO FORTH AND CHOOSE 4134 02:26:59,001 --> 02:27:01,000 NOT TO SIGN UP. 4135 02:27:01,001 --> 02:27:03,000 NOW, IF YOU DO THE MATH, THAT 4136 02:27:03,001 --> 02:27:06,000 REDUCES THAT 47 MILLION DOWN -- 4137 02:27:06,001 --> 02:27:08,000 IF YOU TAKE OUT THE ILLEGALS AND 4138 02:27:08,001 --> 02:27:10,000 THE OTHERS FOR THE REASONS I 4139 02:27:10,001 --> 02:27:12,000 STATED TO ABOUT 14 MILLION. 4140 02:27:12,001 --> 02:27:13,000 SO THIS BY AND LARGE IS WHAT 4141 02:27:13,001 --> 02:27:15,000 PEOPLE ARE TALKING ABOUT WHEN 4142 02:27:15,001 --> 02:27:17,000 THEY MENTION THE 47 MILLION 4143 02:27:17,001 --> 02:27:20,000 UNINSURED AMERICANS. 4144 02:27:20,001 --> 02:27:21,000 I THINK THESE NUMBERS SHED SOME 4145 02:27:21,001 --> 02:27:22,000 INTERESTING LIGHT ONHE 4146 02:27:22,001 --> 02:27:24,000 COMPENSATION OF THE UNINSURED 4147 02:27:24,001 --> 02:27:26,000 AM AROUND. 4148 02:27:26,001 --> 02:27:27,000 PRESIDENT OBAMA, INTERESTINGLY, 4149 02:27:27,001 --> 02:27:30,000 USES A DIFFERENT NUMBER. 4150 02:27:30,001 --> 02:27:35,000 HE DOESN'T USE 47 MILLION. 4151 02:27:35,001 --> 02:27:36,000 HE USES 30 BILLION -- DISCUSS ME -- 30 MILLION. 4152 02:27:36,001 --> 02:27:39,000 BECAUSE I THINK HE WANTS TO 4153 02:27:39,001 --> 02:27:40,000 AVOID THE EMBRACING ISSUE, AND I 4154 02:27:40,001 --> 02:27:41,000 THINK THAT'S PROBABLY WISE OF 4155 02:27:41,001 --> 02:27:43,000 HIM TO DO THAT. 4156 02:27:43,001 --> 02:27:45,000 HE DOESN'T WANT TO BE ACCUSED OF 4157 02:27:45,001 --> 02:27:47,000 GIVING RICH BENEFITS TO THOSE 4158 02:27:47,001 --> 02:27:50,000 WHO ARE HERE ILLEGALLY. 4159 02:27:50,001 --> 02:27:51,000 HE'S NOT USING 47 MILLION, BUT 4160 02:27:51,001 --> 02:27:54,000 30 MILLION UNINSURED AMERICANS. 4161 02:27:54,001 --> 02:27:55,000 I NOTED WITH GREAT INTEREST THE 4162 02:27:55,001 --> 02:27:57,000 C.B.O.'S ESTIMATE OF THE NUMBER 4163 02:27:57,001 --> 02:27:59,000 OF AMERICANS WHO WILL NOT HAVE 4164 02:27:59,001 --> 02:28:01,000 HEALTH INSURANCE EVEN IF THIS 4165 02:28:01,001 --> 02:28:02,000 BILL WERE TO BE ENACTED OVER THE 4166 02:28:02,001 --> 02:28:05,000 WISHES OF THE MAJORITY OF THE 4167 02:28:05,001 --> 02:28:07,000 AMERICAN PEOPLE, 24 MILLION. 4168 02:28:07,001 --> 02:28:08,000 THIS BILL STILL 4169 02:28:08,001 --> 02:28:10,000 24 MILLION AMERICANS UNINSURED 4170 02:28:10,001 --> 02:28:12,000 AFTER SPENDING $2.5 TRILLION TO 4171 02:28:12,001 --> 02:28:13,000 DO JUST THAT WHILE AT THE SAME 4172 02:28:13,001 --> 02:28:15,000 TIME MAKING HEALTH CARE MORE 4173 02:28:15,001 --> 02:28:17,000 EXPENSIVE FOR THE REST OF US. 4174 02:28:17,001 --> 02:28:19,000 YOU KNOW, I LIKE TO USE -- I 4175 02:28:19,001 --> 02:28:20,000 HEAR THE OTHER SIDE OFTEN 4176 02:28:20,001 --> 02:28:21,000 THROWING NUMBERS AROUND WITHOUT 4177 02:28:21,001 --> 02:28:26,000 ANY DOCUMENTATION. 4178 02:28:26,001 --> 02:28:27,000 AND ISED THE C.B.O. AND OTHERS 4179 02:28:27,001 --> 02:28:30,000 NONPARTISAN, CREDIBLE SOURCES SO 4180 02:28:30,001 --> 02:28:32,000 THAT WE CAN AVOID DOING THAT. 4181 02:28:32,001 --> 02:28:34,000 PRESIDENT OBAMA WANTS TO SPEN SPEND $2.5 TRILLION IN NEW 4182 02:28:34,001 --> 02:28:36,000 HEALTH CARE PROMISES AT A TIME 4183 02:28:36,001 --> 02:28:37,000 WHEN THE COUNTRY CAN'T AFFORD 4184 02:28:37,001 --> 02:28:40,000 THE PROMISES WE'VE ALREADY MADE 4185 02:28:40,001 --> 02:28:44,000 AND WE HAVE A RECORD ONE-YEAR 4186 02:28:44,001 --> 02:28:47,000 BUDGET DEFICIT OF $1.4 TRILLION. 4187 02:28:47,001 --> 02:28:48,000 WHICH, BY THE WAY, MEANS THAT 47 4188 02:28:48,001 --> 02:28:49,000 CENTS OUT OF EVERY SINGLE DOLLAR 4189 02:28:49,001 --> 02:28:51,000 THAT THE FEDERAL GOVERNMENT 4190 02:28:51,001 --> 02:28:54,000 SPENDS THIS YEAR IS BORROWED. 4191 02:28:54,001 --> 02:28:56,000 IN 10 YEARS, 16% OR NEARL 4192 02:28:56,001 --> 02:28:59,000 OUT OF EVERY $5 THAT THE 4193 02:28:59,001 --> 02:29:00,000 GOVERNMENT SPENDS, WILL BE SPENT 4194 02:29:00,001 --> 02:29:02,000 SOLELY ON INTEREST PAYMENTS ON 4195 02:29:02,001 --> 02:29:03,000 THE DT. 4196 02:29:03,001 --> 02:29:05,000 OBAMA'S BUDGET DOUBLES THE 4197 02:29:05,001 --> 02:29:06,000 FEDERAL DEBT IN FIVE YEARS AND 4198 02:29:06,001 --> 02:29:08,000 TRIPLES IT IN 10 YEARS. 4199 02:29:08,001 --> 02:29:09,000 WE TALKED ABOUT THIS ON THE 4200 02:29:09,001 --> 02:29:10,000 FLOOR. 4201 02:29:10,001 --> 02:29:11,000 I DON'T THINK THERE'S 4202 02:29:11,001 --> 02:29:16,000 DISAGREEMENT ON THIS. 4203 02:29:16,001 --> 02:29:17,000 ON TOP OF THIS WE FACE 4204 02:29:17,001 --> 02:29:18,000 FACED $60 BILLION FROM THE 4205 02:29:18,001 --> 02:29:20,000 CURRENT ENTITLEMENTS OF SOCIAL 4206 02:29:20,001 --> 02:29:22,000 SECURITY, MEDICARE, AND 4207 02:29:22,001 --> 02:29:24,000 MEDICAID. 4208 02:29:24,001 --> 02:29:25,000 THIS HEALTH CARE PLAN LAYERS 4209 02:29:25,001 --> 02:29:27,000 ANOTHER UNAFFORDABLE ENTITLEMENT 4210 02:29:27,001 --> 02:29:28,000 ON TOP OF MEDICARE AND MEDICAID 4211 02:29:28,001 --> 02:29:32,000 AND SOCIAL SECURITY AND THE 4212 02:29:32,001 --> 02:29:33,000 OTHER ENTITLEMENTS THAT WE HAVE. 4213 02:29:33,001 --> 02:29:35,000 ON A SYSTEM THAT'S ALREADY -- 4214 02:29:35,001 --> 02:29:37,000 ALREADY CRUMBLING. 4215 02:29:37,001 --> 02:29:39,000 IT SEEMS TO ME THAT THIS BILL IS 4216 02:29:39,001 --> 02:29:41,000 WHAT THE AMERICAN PEOPLE DO 4217 02:29:41,001 --> 02:29:42,000 NEED AND I THINK THAT THAT'S WHY 4218 02:29:42,001 --> 02:29:44,000 MOST AMERICANS ARE REPORTING 4219 02:29:44,001 --> 02:29:46,000 THAT THIS BILL IS SOMETHING THAT 4220 02:29:46,001 --> 02:29:49,000 THEY DON'T WANT AT THIS TIME OR 4221 02:29:49,001 --> 02:29:50,000 EVER. 4222 02:29:50,001 --> 02:29:51,000 I THINK IT'S COMMON SENSE. 4223 02:29:51,001 --> 02:29:52,000 NOW, READING THROUGH THE 4224 02:29:52,001 --> 02:29:54,000 LEGISLATION, ONE IS STRUCK BY A 4225 02:29:54,001 --> 02:29:57,000 MYRIAD OF WAYS THIS BILL RAISES 4226 02:29:57,001 --> 02:29:59,000 TAXES ON AMERICAN CITIZENS. 4227 02:29:59,001 --> 02:30:01,000 FROM JOB-CREATING SMALL 4228 02:30:01,001 --> 02:30:02,000 BUSINESSES TO MIDDLCLASS 4229 02:30:02,001 --> 02:30:07,000 FAMILIES, I COUNT ABOUT A DOZEN 4230 02:30:07,001 --> 02:30:08,000 OF THEM ADDING UP TO 4231 02:30:08,001 --> 02:30:09,000 ABOUT $500 BILLION IN TAX 4232 02:30:09,001 --> 02:30:10,000 INCREASES OVER THE NEXT FEW 4233 02:30:10,001 --> 02:30:12,000 YEARS. 4234 02:30:12,001 --> 02:30:14,000 HALF A TRILLION DOLLARS IN NEW TAXES. 4235 02:30:14,001 --> 02:30:16,000 SO EVERYONE SHOULD GET READY TO 4236 02:30:16,001 --> 02:30:18,000 PAY HIGHER TAXES, HIGHER HEALTH 4237 02:30:18,001 --> 02:30:20,000 CARE BILLS AND HIGHER TAX BILL 4238 02:30:20,001 --> 02:30:23,000 SHOULD THIS MEASURE BECE LAW. 4239 02:30:23,001 --> 02:30:25,000 AND SOME MIGHT BE INCLINED TO 4240 02:30:25,001 --> 02:30:26,000 SAY BUT PRESIDENT OBAMA PROMISED 4241 02:30:26,001 --> 02:30:29,000 WE WOULDN'T RAISE TAXES. 4242 02:30:29,001 --> 02:30:32,000 THAT WAS INDEED A CAMPAIGN 4243 02:30:32,001 --> 02:30:35,000 PROMISE, AND THE ADMINISTRATION 4244 02:30:35,001 --> 02:30:36,000 THAT NO ONE MAKING UNDER 4245 02:30:36,001 --> 02:30:37,000 UNDER $250,000 PER YEAR WOULD 4246 02:30:37,001 --> 02:30:39,000 SEE THEIR TAXES GO UP. 4247 02:30:39,001 --> 02:30:40,000 LET ME GO AHEAD AND QUOTE THAT. 4248 02:30:40,001 --> 02:30:41,000 THIS IS WHAT PRESIDENT OBAMA 4249 02:30:41,001 --> 02:30:45,000 SAID DURING THE CAMPAIGN, AND 4250 02:30:45,001 --> 02:30:47,000 I'M QUOTING -- "I CAN MAKE A 4251 02:30:47,001 --> 02:30:48,000 FIRM PLEDGE. 4252 02:30:48,001 --> 02:30:49,000 NO FAMILY MAKING LESS THAN 4253 02:30:49,001 --> 02:30:50,000 THAN $250,000 WILL SEE THEIR 4254 02:30:50,001 --> 02:30:52,000 TAXES INCREASE. 4255 02:30:52,001 --> 02:30:54,000 NOT YOUR INCOME TAXES, NOT YOUR 4256 02:30:54,001 --> 02:30:56,000 PAYROLL TAXES, NOT YOUR CAPITAL 4257 02:30:56,001 --> 02:30:58,000 GAINS TAXES, NOT ANY TAXES." 4258 02:30:58,001 --> 02:31:00,000 SO WE STARTED ANALYZING THIS 4259 02:31:00,001 --> 02:31:03,000 BILL, AND GUESS WHAT WE FOUND OUT. 4260 02:31:03,001 --> 02:31:04,000 WHEN THE BILL IS FULLY ENACTED, 4261 02:31:04,001 --> 02:31:05,000 THE NONPARTISAN JOINT COMMITTEE 4262 02:31:05,001 --> 02:31:08,000 ON TAXATION -- NOW, KEEP IN 4263 02:31:08,001 --> 02:31:10,000 MIND, MR. PRESIDENT, I'M VOTING 4264 02:31:10,001 --> 02:31:13,000 SOURCES HERE THAT ARE CREDIBLE 4265 02:31:13,001 --> 02:31:15,000 SOURCES AND NONPARTISAN SOURCES. 4266 02:31:15,001 --> 02:31:17,000 THE JOINT COMMITTEE ON TAXATION 4267 02:31:17,001 --> 02:31:20,000 FOUND THAT THE AVERAGE 4268 02:31:20,001 --> 02:31:23,000 INDIVIDUAL MAKING $50,000 AND 4269 02:31:23,001 --> 02:31:24,000 FAMILIES MAKING $75,000 WOULD 4270 02:31:24,001 --> 02:31:26,000 SEE THEIR TAXES GO UP. 4271 02:31:26,001 --> 02:31:28,000 LET ME REPEAT THAT. 4272 02:31:28,001 --> 02:31:30,000 FAMILIES MAKING $50,000 AS AN 4273 02:31:30,001 --> 02:31:31,000 INDIVIDUAL OR $75,000 AS A 4274 02:31:31,001 --> 02:31:33,000 FAMILY WOULD HAVE THEIR TAXES GO 4275 02:31:33,001 --> 02:31:35,000 UP UNDER THIS BILL. 4276 02:31:35,001 --> 02:31:38,000 AND INDEED, ACCORDING TO THE 4277 02:31:38,001 --> 02:31:39,000 JOINT COMMITTEE ON TAXATION, 4278 02:31:39,001 --> 02:31:41,000 42 MILLION MIDDLE-CLASS FAMILIES 4279 02:31:41,001 --> 02:31:44,000 AND INDIVIDUALS, THOSE MAKING 4280 02:31:44,001 --> 02:31:46,000 LESS THAN $200,000 ON AVERAGE, 4281 02:31:46,001 --> 02:31:48,000 WILL PAY HIGHER TAXES IN THIS BILL. 4282 02:31:48,001 --> 02:31:50,000 PRESIDENT OBAMA'S HEALTH CARE 4283 02:31:50,001 --> 02:31:52,000 REFORM BILL CURRENTLY UNDER 4284 02:31:52,001 --> 02:31:55,000 CONSIDERATION IN THE SENATE 4285 02:31:55,001 --> 02:31:56,000 RAISES REVENUES TO A LARGE 4286 02:31:56,001 --> 02:31:59,000 EXTENT ON THE BACKS OF 4287 02:31:59,001 --> 02:32:03,000 MIDDLE-CLASS AMERICANS, DESPITE 4288 02:32:03,001 --> 02:32:04,000 THE CANDIDATE OBAMA'S PLEDGE NOT 4289 02:32:04,001 --> 02:32:06,000 TO DO THAT. 4290 02:32:06,001 --> 02:32:08,000 SO LET'S LOOK AT SOME OF THESE 4291 02:32:08,001 --> 02:32:09,000 INSTANCES WHERE WE GET TAXED. 4292 02:32:09,001 --> 02:32:12,000 BEGINNING THIS AGAIN. 4293 02:32:12,001 --> 02:32:14,000 THIS IS FROM THE JOINT TAX 4294 02:32:14,001 --> 02:32:16,000 COMMITTEE AND FROM THE C.B.O. 4295 02:32:16,001 --> 02:32:17,000 IF YOU HAVE HEALTH INSURANCE, IF 4296 02:32:17,001 --> 02:32:19,000 YOU HAVE INSURANCE, IF YOU GET 4297 02:32:19,001 --> 02:32:20,000 TAXED, ACCORDING TO THE 4298 02:32:20,001 --> 02:32:23,000 NONPARTISAN CONGRESSIONAL BUDGET 4299 02:32:23,001 --> 02:32:24,000 OFFICE, NEW EXCISE 4300 02:32:24,001 --> 02:32:26,000 TO HEALTH INSURANCE PROVIDERS 4301 02:32:26,001 --> 02:32:27,000 WILL END UP TAXING THE BENEFICIARIES. 4302 02:32:27,001 --> 02:32:30,000 THIS TAX ALSO HAS THE EFFECT OF 4303 02:32:30,001 --> 02:32:31,000 INCREASING PREMIUMS AS WELL, SO 4304 02:32:31,001 --> 02:32:32,000 YOU'RE DOUBLE TAXED ON THIS 4305 02:32:32,001 --> 02:32:33,000 DEAL. 4306 02:32:33,001 --> 02:32:34,000 NOW, THAT'S IF YOU DO HAVE 4307 02:32:34,001 --> 02:32:35,000 HEALTH INSURANCE. 4308 02:32:35,001 --> 02:32:36,000 WHAT IF YOU DON'T HAVE HEALTH 4309 02:32:36,001 --> 02:32:37,000 INSURANCE? 4310 02:32:37,001 --> 02:32:38,000 YOU STILL GET TAXED. 4311 02:32:38,001 --> 02:32:41,000 UNDER THIS BILL, YOU GET TAXED 4312 02:32:41,001 --> 02:32:42,000 IF YOU DON'T CARRY HEALTH 4313 02:32:42,001 --> 02:32:43,000 INSURANCE AS A PENALTY. 4314 02:32:43,001 --> 02:32:44,000 AND HOW DOES THIS -- WHERE DOES 4315 02:32:44,001 --> 02:32:47,000 THIS BURDEN FALL? 4316 02:32:47,001 --> 02:32:48,000 YOU GUESSED IT, IN MIDDLE-CLASS AMERICA. 4317 02:32:48,001 --> 02:32:50,000 C.B.O. HAS SAID THAT HALF OF THE 4318 02:32:50,001 --> 02:32:55,000 AMERICANS AFFECTED BY THIS 4319 02:32:55,001 --> 02:32:56,000 PROVISION MAKE BETWEEN $22,000 4320 02:32:56,001 --> 02:32:57,000 AND $68,000 FOR AAMILY OF 4321 02:32:57,001 --> 02:33:00,000 FOUR. 4322 02:33:00,001 --> 02:33:01,000 THAT'S $22,000 TO $68,000 FOR A 4323 02:33:01,001 --> 02:33:03,000 FAMILY OF FOUR. 4324 02:33:03,001 --> 02:33:04,000 THAT'S IN MIDDLE-CLASS AMERICA, 4325 02:33:04,001 --> 02:33:06,000 MR. PRESIDENT. IF YOU TAKE PRESCRIPTION DRUGS, 4326 02:33:06,001 --> 02:33:08,000 YOU GET TAXED, ANOTHER AREA. 4327 02:33:08,001 --> 02:33:10,000 ACCORDING TO THE JOINT -- THE 4328 02:33:10,001 --> 02:33:12,000 J.C.T. AND THE C.B.O., NEW TAXES 4329 02:33:12,001 --> 02:33:14,000 IN THIS BILL APPLIED TO THE 4330 02:33:14,001 --> 02:33:16,000 PROVISIONS OF PRESCRIPTION DRUGS 4331 02:33:16,001 --> 02:33:18,000 WILL END UP RAISING THE COSTS OF THOSE DRUGS. 4332 02:33:18,001 --> 02:33:21,000 SO YOU'RE TAXED AGAIN. 4333 02:33:21,001 --> 02:33:22,000 IF YOU HAPPEN TO NEED A MEDICAL DEVICE. 4334 02:33:22,001 --> 02:33:23,000 THIS IS SOMETHING I'M REALLY 4335 02:33:23,001 --> 02:33:24,000 SENSITIVE TO BECAUSE -- AND I 4336 02:33:24,001 --> 02:33:26,000 VICE PRESIDENT HEARD MUCH 4337 02:33:26,001 --> 02:33:28,000 DISCUSSION OF THIS ON THE FLOOR 4338 02:33:28,001 --> 02:33:29,000 SO FAR, BECAUSE IT'S A DIFFICULT 4339 02:33:29,001 --> 02:33:30,000 THING. 4340 02:33:30,001 --> 02:33:32,000 PEOPLE -- I WAS TALKING TO SENATOR ENZI. 4341 02:33:32,001 --> 02:33:34,000 HE SAID PEOPLE DON'T REALLY KNOW 4342 02:33:34,001 --> 02:33:37,000 WHAT MEDICAL DEVICES ARE. 4343 02:33:37,001 --> 02:33:39,000 THE STENTS, THE -- THESE ARE 4344 02:33:39,001 --> 02:33:40,000 THINGS THAT YOU CAN -- THAT ARE 4345 02:33:40,001 --> 02:33:41,000 AVAILABLE HERE IN AMERICA. 4346 02:33:41,001 --> 02:33:43,000 YOU CAN'T FIND IN MANY OF THE 4347 02:33:43,001 --> 02:33:44,000 OTHER COUNTRIES. 4348 02:33:44,001 --> 02:33:45,000 SO IF YOU NEED A MEDICAL DEVICE, 4349 02:33:45,001 --> 02:33:48,000 YOU GET TAXED. 4350 02:33:48,001 --> 02:33:51,000 IF YOU HAVE HIGH OUT-OF-POCKET 4351 02:33:51,001 --> 02:33:56,000 MEDICAL BILLS, YOU GET TAXED. 4352 02:33:56,001 --> 02:33:59,000 MY SENATE LAW, BRAD -- MY 4353 02:33:59,001 --> 02:34:01,000 SON-IN-LAW, BRAD SWAN, INSTALLS 4354 02:34:01,001 --> 02:34:03,000 PACEMAKERS AND DEFIBRILLATORS. 4355 02:34:03,001 --> 02:34:05,000 I CAN NEVER SAY THAT RIGHT. 4356 02:34:05,001 --> 02:34:06,000 AT 1:00 THIS MORNING -- I WAS 4357 02:34:06,001 --> 02:34:07,000 TALKING TO HIM THIS MORNING WHEN 4358 02:34:07,001 --> 02:34:09,000 HE TOLD ME WHAT HAPPENED LAST NIGHT. 4359 02:34:09,001 --> 02:34:11,000 HE SAID AT 1:00 THEY GOT A CALL 4360 02:34:11,001 --> 02:34:15,000 TO GO OUT TO THE EMERGENCY ROOM 4361 02:34:15,001 --> 02:34:17,000 IN ST. FRANCIS HOSPITA IN MY 4362 02:34:17,001 --> 02:34:19,000 CITY OF TULSA, OKLAHOMA. 4363 02:34:19,001 --> 02:34:20,000 THEY HAD AN-YEAR-OLD BOY WITH NO 4364 02:34:20,001 --> 02:34:21,000 HEARTBEAT. 4365 02:34:21,001 --> 02:34:23,000 HE WAS BORN WITH CONGENITAL 4366 02:34:23,001 --> 02:34:24,000 HEART DISEASE, AND HE PUT IN A 4367 02:34:24,001 --> 02:34:25,000 PACEMAKER AT THAT TIME AND HE 4368 02:34:25,001 --> 02:34:26,000 WAS PERFECTLY HEALTHY IN THE MORNING. 4369 02:34:26,001 --> 02:34:28,000 THAT'S SOMETHING I THINK MOST 4370 02:34:28,001 --> 02:34:29,000 DOCTORS WOULD AGREE THAT THAT 4371 02:34:29,001 --> 02:34:32,000 CHILD WOULD NOT HAVE LIVED. 4372 02:34:32,001 --> 02:34:34,000 MY OLDER SISTER MARILYN FACED A 4373 02:34:34,001 --> 02:34:35,000 SIMILAR SITUATION NINE YEARS AGO 4374 02:34:35,001 --> 02:34:37,000 AND SHE IS ALIVE TODAY AND SHE 4375 02:34:37,001 --> 02:34:39,000 IS HEALTHY TODAY, AND SHE WOULD 4376 02:34:39,001 --> 02:34:44,000 NOT BE ALIVE TODAY. 4377 02:34:44,001 --> 02:34:47,000 THAT'S HOW SERIOUS THIS IS. 4378 02:34:47,001 --> 02:34:51,000 I TALKED TO HIM THIS MORNING 4379 02:34:51,001 --> 02:34:53,000 ABOUT THE SIGNIFICANCE OF THE -- 4380 02:34:53,001 --> 02:34:54,000 THE MEDICAL DEVICES, AND 4381 02:34:54,001 --> 02:34:55,000 GOING TO QUOTE HIS ANSWER. 4382 02:34:55,001 --> 02:34:57,000 I QUOTE IT DOWN. 4383 02:34:57,001 --> 02:34:59,000 HE SAID THE DECISION OF WHO 4384 02:34:59,001 --> 02:35:00,000 NEEDS A PACEMAKER COULD BE 4385 02:35:00,001 --> 02:35:02,000 COMPLICATED, PARTICULARLY THE 4386 02:35:02,001 --> 02:35:04,000 DECISION TO PUT IN A PACEMAKER 4387 02:35:04,001 --> 02:35:06,000 ON SOMEONE WE MIGHT CONSIDER 4388 02:35:06,001 --> 02:35:08,000 QUITE ELDERLY, BUT IT'S FALSE 4389 02:35:08,001 --> 02:35:10,000 ECONOMY TO DENY PUTTING ONE IN 4390 02:35:10,001 --> 02:35:13,000 BECAUSE OF THEIR RISK OF 4391 02:35:13,001 --> 02:35:14,000 FALLING, BREAKING A HIP OR 4392 02:35:14,001 --> 02:35:16,000 SHOULDER IN THE CASE WHERE THEY 4393 02:35:16,001 --> 02:35:19,000 FALL THE COSTS WOULD BECOME MUCH HIGHER. 4394 02:35:19,001 --> 02:35:20,000 THE COSTS OF A PACEMAKER PALES 4395 02:35:20,001 --> 02:35:23,000 IN COMPARISON WITH THE COST OF A 4396 02:35:23,001 --> 02:35:24,000 STROKE OR MULTIPLE FRACTURES. 4397 02:35:24,001 --> 02:35:26,000 THE PACEMAKER, BY THE WAY, 4398 02:35:26,001 --> 02:35:27,000 MR. PRESIDENT, COSTS ABOUT 4399 02:35:27,001 --> 02:35:29,000 ABOUT $5,000 AND LASTS ABOUT A 4400 02:35:29,001 --> 02:35:31,000 YEAR. 4401 02:35:31,001 --> 02:35:32,000 THAT'S $500 DEAL. 4402 02:35:32,001 --> 02:35:33,000 SO I THINK, MR. PRESINT, THIS 4403 02:35:33,001 --> 02:35:36,000 IS A QUALITY OF LIFE ISSUE THAT 4404 02:35:36,001 --> 02:35:39,000 WE COULD LOSE WITH ONE OF THE -- 4405 02:35:39,001 --> 02:35:40,000 WITH THE DOCRATS' 4406 02:35:40,001 --> 02:35:42,000 GOVERNMENT-RUN HEALTH CARE SCHEMES. 4407 02:35:42,001 --> 02:35:44,000 SO THOSE ARE THE -- JUST SOME 4408 02:35:44,001 --> 02:35:46,000 EXAMPLES OF WHAT WE CAN DO TO 4409 02:35:46,001 --> 02:35:47,000 PAY HIGHER TAXES UNDER THIS 4410 02:35:47,001 --> 02:35:48,000 BILL. 4411 02:35:48,001 --> 02:35:49,000 IF YOU HAVE HEALTH INSURANCE, 4412 02:35:49,001 --> 02:35:50,000 YOU PAY HIGHER TAXES. 4413 02:35:50,001 --> 02:35:51,000 IF YOU DON'T HAVE IT, YOU PAY 4414 02:35:51,001 --> 02:35:52,000 HIGHER TAXES. 4415 02:35:52,001 --> 02:35:53,000 IF YOU PURCHASE A MEDICAL 4416 02:35:53,001 --> 02:35:55,000 DEVICE, YOU HAVE HIGHER TAXES. 4417 02:35:55,001 --> 02:35:56,000 IF YOU PAY YOUR OWN MEDICAL 4418 02:35:56,001 --> 02:35:57,000 BILLS OUT OF YOUR POCKET, YOU 4419 02:35:57,001 --> 02:35:58,000 HAVE HIGHER TAXES. 4420 02:35:58,001 --> 02:36:00,000 IF YOU TAKE PRESCRIPTION DRUGS, 4421 02:36:00,001 --> 02:36:04,000 YOU HAVE HIGHER TAXES. 4422 02:36:04,001 --> 02:36:05,000 ALL THESE ACTIVITIES ARE TAXED 4423 02:36:05,001 --> 02:36:07,000 UNDER THIS LEGISLATION. 4424 02:36:07,001 --> 02:36:08,000 I WANT NOW TO TURN TO EXAMINE 4425 02:36:08,001 --> 02:36:10,000 ONE TAX PROVISION IN PARTICULAR 4426 02:36:10,001 --> 02:36:11,000 THAT I FIND STRIKINGLY 4427 02:36:11,001 --> 02:36:13,000 DISHONEST, DAMAGING AND 4428 02:36:13,001 --> 02:36:16,000 EXPENSIVE TO THE TAXPAYER. 4429 02:36:16,001 --> 02:36:18,000 AN ADDITIONAL MEDICARE PAYROLL 4430 02:36:18,001 --> 02:36:19,000 TAX THAT'S IN THIS LEGISLATION. 4431 02:36:19,001 --> 02:36:22,000 IT'S A PERFECT EXAMPLE OF HOW 4432 02:36:22,001 --> 02:36:24,000 YOU GET THE BILL -- YOU HAVE TO 4433 02:36:24,001 --> 02:36:28,000 GO INTO IT TO FIND THESE THINGS. 4434 02:36:28,001 --> 02:36:29,000 THERE ARE CLAN CLANDESTINE TAXES 4435 02:36:29,001 --> 02:36:31,000 IN THE BILL THAT WILL HIT YOU 4436 02:36:31,001 --> 02:36:33,000 WHEN YOU BASICALLY DON'T EXPECT IT. 4437 02:36:33,001 --> 02:36:34,000 THE BILL SAYS THAT PEOPLE MAKING 4438 02:36:34,001 --> 02:36:36,000 MAKING $200,000 A YEAR ARE GOING 4439 02:36:36,001 --> 02:36:38,000 TO PAY AN ADDITIONAL PAYROLL TAX 4440 02:36:38,001 --> 02:36:39,000 CALLED A HOSPITAL INSURANCE 4441 02:36:39,001 --> 02:36:41,000 PAYROLL TAX. 4442 02:36:41,001 --> 02:36:42,000 THAT RAISES OVER $53 BILLION. 4443 02:36:42,001 --> 02:36:44,000 NOW, KEEP IN MIND, THIS IS ABOVE 4444 02:36:44,001 --> 02:36:45,000 THE TAXES THAT WE'RE ALREADY 4445 02:36:45,001 --> 02:36:47,000 PAYING. 4446 02:36:47,001 --> 02:36:48,000 WE'RE GETTING THESE PEOPLE $200,000. 4447 02:36:48,001 --> 02:36:50,000 YOU MIGHT THINK THAT'S A LOT OF 4448 02:36:50,001 --> 02:36:51,000 MONEY, BUT THERE'S A CATCH TO 4449 02:36:51,001 --> 02:36:53,000 THIS AND THEY DIDN'T INDEX IT. 4450 02:36:53,001 --> 02:36:56,000 IF YOU DON'T INDEX THE $200,000, 4451 02:36:56,001 --> 02:36:58,000 THEN THE PERIOD OF TIME GOES BY, 4452 02:36:58,001 --> 02:37:00,000 IT'S FAR GREATER THAN THE AMOUNT 4453 02:37:00,001 --> 02:37:01,000 THAT -- THAT IT WOULD SOUND LIKE 4454 02:37:01,001 --> 02:37:03,000 TODAY. 4455 02:37:03,001 --> 02:37:05,000 IN FACT, I WOULD SAY THAT IN TEN 4456 02:37:05,001 --> 02:37:08,000 YEARS FROM NOW, THAT $200,000 4457 02:37:08,001 --> 02:37:09,000 WOULD PRETTY MUCH FIT A LOT OF 4458 02:37:09,001 --> 02:37:10,000 THE MIDDLE-CLASS PEOPLE IN 4459 02:37:10,001 --> 02:37:12,000 ERICA. 4460 02:37:12,001 --> 02:37:14,000 SO THERE IS THIS INCREASE OF 4461 02:37:14,001 --> 02:37:15,000 ADDITIONAL MEDICARE AND PAYROLL TAX. 4462 02:37:15,001 --> 02:37:17,000 THIS BILL THAT 4463 02:37:17,001 --> 02:37:19,000 RAISES $50 BILLION IS NOT 4464 02:37:19,001 --> 02:37:20,000 INDEXED, AND WE KNOW WHAT -- HOW 4465 02:37:20,001 --> 02:37:21,000 THAT'S GOING TO EXTEND TO OTHER 4466 02:37:21,001 --> 02:37:22,000 PEOPLE NOW. 4467 02:37:22,001 --> 02:37:23,000 I REMBERANDIDATE OBAMA 4468 02:37:23,001 --> 02:37:25,000 MAKING A FIRM PLEDGE NOT T 4469 02:37:25,001 --> 02:37:26,000 RAISE TAXES ON MIDDLE-CLASS 4470 02:37:26,001 --> 02:37:28,000 AMERICANS. 4471 02:37:28,001 --> 02:37:29,000 HOWEVER, THIS HEALTH CARE REFORM 4472 02:37:29,001 --> 02:37:31,000 BILL BEFORE US BREAKS THAT 4473 02:37:31,001 --> 02:37:33,000 PLEDGE ON NUMEROUS OCCASIONS. 4474 02:37:33,001 --> 02:37:35,000 BUT IT'S NOT UIKE THE NEW 4475 02:37:35,001 --> 02:37:37,000 TAXES WHICH WILL BE IMPOSED ON 4476 02:37:37,001 --> 02:37:38,000 OTHER MEASURES THE DEMOCRAT 4477 02:37:38,001 --> 02:37:39,000 CONGRESS AND PRESIDENT OBAMA 4478 02:37:39,001 --> 02:37:42,000 WOULD LIKE TO ENACT. 4479 02:37:42,001 --> 02:37:44,000 I JUST MENTIONED THE 4480 02:37:44,001 --> 02:37:46,000 THE $500 BILLION IN NEW TAXES ON 4481 02:37:46,001 --> 02:37:48,000 THE HEALTH BILL IT RAISES. 4482 02:37:48,001 --> 02:37:50,000 THERE'S ANOTHER TAX AND ANOTHER 4483 02:37:50,001 --> 02:37:51,000 PROGRAM GOING ON I'VE TALKED 4484 02:37:51,001 --> 02:37:53,000 ABOUT ON THIS FLOOR MANY TIMES, 4485 02:37:53,001 --> 02:37:54,000 AND THAT IS THE CAPTAIN. 4486 02:37:54,001 --> 02:37:57,000 THAT'S STILL ON THE FLOOR. 4487 02:37:57,001 --> 02:37:58,000 THAT COULD COME UP AT ANY TIME. 4488 02:37:58,001 --> 02:38:00,000 OF COURSE, THAT'S NOT SOMETHING 4489 02:38:00,001 --> 02:38:02,000 THAT WOULD BE $500 BILLION OVER 4490 02:38:02,001 --> 02:38:04,000 A TEN-YEAR PERIOD. 4491 02:38:04,001 --> 02:38:08,000 THAT WOULD TAX THE AMERICAN 4492 02:38:08,001 --> 02:38:10,000 PEOPLE IN EXCESS OF $300 BILLION 4493 02:38:10,001 --> 02:38:12,000 EVERY YEAR. 4494 02:38:12,001 --> 02:38:17,000 AND I QUOTE AS MY SOURCES THERE, 4495 02:38:17,001 --> 02:38:18,000 THE WHARTON SCHOOL OF ECONOMICS, 4496 02:38:18,001 --> 02:38:20,000 HAVE DONE EVALUATIONS. 4497 02:38:20,001 --> 02:38:21,000 SO IT'S NOT JUST THIS BILL, EVEN THOUGH TS IS WHAT WE'RE 4498 02:38:21,001 --> 02:38:23,000 TALKING ABOUT TODAY. 4499 02:38:23,001 --> 02:38:25,000 WE STILL 4500 02:38:25,001 --> 02:38:26,000 OTHER LGZ THAT ARE BEING 4501 02:38:26,001 --> 02:38:27,000 PROMOTED -- OTHER LEGISLATION 4502 02:38:27,001 --> 02:38:28,000 THAT ARE BEING PROMOTED BY THE 4503 02:38:28,001 --> 02:38:31,000 PRESIDENT AND BY THE DEMOCRATS 4504 02:38:31,001 --> 02:38:34,000 IN HERE, AND THE -- PRESIDENT 4505 02:38:34,001 --> 02:38:36,000 OBAMA'S ADMINISTRATION'S OWN 4506 02:38:36,001 --> 02:38:39,000 TREASURY DEPARTMENT ESTIMATED 4507 02:38:39,001 --> 02:38:42,000 THAT A CAPTAIN LEGISLATION WOULD 4508 02:38:42,001 --> 02:38:44,000 COST EACH FAMILY IN AMERICA 4509 02:38:44,001 --> 02:38:45,000 AMERICA $1,761 A YEAR. 4510 02:38:45,001 --> 02:38:47,000 NOW, THAT'S REALLY MUCH MORE 4511 02:38:47,001 --> 02:38:50,000 THAN THAT IN HEARTLAND AMERICA. 4512 02:38:50,001 --> 02:38:51,000 IN OKLAHOMA, IT WOULD BE CLOSER 4513 02:38:51,001 --> 02:38:53,000 TO $3,300 A YEAR. 4514 02:38:53,001 --> 02:38:55,000 SO WE'RE TALKING ABOUT SOME 4515 02:38:55,001 --> 02:38:58,000 VERY VERY LARGE TAX INCREASES, 4516 02:38:58,001 --> 02:39:01,000 BUT AGAIN, BACK TO THE -- THE HEALTH BILL. 4517 02:39:01,001 --> 02:39:03,000 I NOTED EARLIER THAT THE 4518 02:39:03,001 --> 02:39:04,000 GOVERNOR -- THE GOVERNMENT-RUN 4519 02:39:04,001 --> 02:39:06,000 HEALTH CARE SYSTEM 4520 02:39:06,001 --> 02:39:09,000 BY THE PRESIDENT AND BY THE 4521 02:39:09,001 --> 02:39:10,000 DEMOCRATS IS EXPECTED TO COST 4522 02:39:10,001 --> 02:39:13,000 COST $2.5 TRILLION ON TOP OF THE 4523 02:39:13,001 --> 02:39:15,000 ALREADY EXPLODING RECORD DEFICITS. 4524 02:39:15,001 --> 02:39:16,000 THIS BILL WILL INCREASE 4525 02:39:16,001 --> 02:39:20,000 PAYMENTS. 4526 02:39:20,001 --> 02:39:22,000 WE MAKE ON OUR COUNTRY'S 4527 02:39:22,001 --> 02:39:23,000 EVER-EXPLODING FEDERAL DEBT. 4528 02:39:23,001 --> 02:39:24,000 THE DEMOCRAT CONGRES AGENDA 4529 02:39:24,001 --> 02:39:25,000 CLEARLY INCLUDES MORE TAXES ON 4530 02:39:25,001 --> 02:39:27,000 AMERICA. 4531 02:39:27,001 --> 02:39:28,000 THEY MAY BE HIDDEN BUT THEY ARE 4532 02:39:28,001 --> 02:39:29,000 THERE. 4533 02:39:29,001 --> 02:39:30,000 IT'S DISINGENUOUS, IT'S COSTLY, 4534 02:39:30,001 --> 02:39:32,000 AND IT'S ANOTHER REASON THIS 4535 02:39:32,001 --> 02:39:33,000 BILL SHOULD NOT BE PASSED BY THE 4536 02:39:33,001 --> 02:39:34,000 U.S. SENATE. 4537 02:39:34,001 --> 02:39:35,000 I SAY ANOTHER. 4538 02:39:35,001 --> 02:39:37,000 THE OTHER REASON AND THE MAIN 4539 02:39:37,001 --> 02:39:39,000 REASON IS THAT A GOVERNMENT-RUN 4540 02:39:39,001 --> 02:39:53,000 HEALTH SYSTEM DOESN'T WORK. 4541 02:39:53,001 --> 02:39:56,000 I YIELD THE 4542 02:39:56,001 --> 02:39:57,000 MR. BAUCUS: MR. PRESIDENT? THE PRESIDING OFFICER: THE 4543 02:39:57,001 --> 02:39:59,000 SENATOR FROM MONTANA. 4544 02:39:59,001 --> 02:40:00,000 MR. BAUCUS: MR. PRESIDENT, I 4545 02:40:00,001 --> 02:40:02,000 UNDERSTAND THAT WE'RE NOW UNDER 4546 02:40:02,001 --> 02:40:04,000 THE ORDER WHERE THE HALF-HOUR IS ALLOCATED TO THE MAJORITY SIDE, 4547 02:40:04,001 --> 02:40:05,000 IS THAT CORRECT? THE PRESIDING OFFICER: THAT'S 4548 02:40:05,001 --> 02:40:06,000 CORRECT. 4549 02:40:06,001 --> 02:40:07,000 WE HAVE 30 MINUTES, SENATOR. 4550 02:40:07,001 --> 02:40:09,000 MR. BAUCUS: MR. PRESIDENT, I 4551 02:40:09,001 --> 02:40:10,000 RESERVE MYSELF TEN MINUTES. THE PRESIDING OFFICER: WITHOUT 4552 02:40:10,001 --> 02:40:11,000 OBJECTION, SO ORDERED. 4553 02:40:11,001 --> 02:40:13,000 MR. BAUCUS: MR. PRESIDENT, I 4554 02:40:13,001 --> 02:40:15,000 JUST WANT TO JUST HELP PEOPLE 4555 02:40:15,001 --> 02:40:17,000 UNDERSTAND THIS LEGISLATION. 4556 02:40:17,001 --> 02:40:19,000 I'M SURE MANY DO, BUT I'M 4557 02:40:19,001 --> 02:40:21,000 THERE ARE SOME WHO DON'T WITH 4558 02:40:21,001 --> 02:40:24,000 RESPECT TO THE CHOICES THAT 4559 02:40:24,001 --> 02:40:26,000 PEOPLE WILL HAVE. 4560 02:40:26,001 --> 02:40:27,000 WE HAVE A UNIQUELY AMERICAN 4561 02:40:27,001 --> 02:40:28,000 SYSTEM OF HEALTH CARE IN 4562 02:40:28,001 --> 02:40:30,000 AMERICA. 4563 02:40:30,001 --> 02:40:31,000 IT'S ROUGHLY HALF PUBLIC, HALF PRIVATE. 4564 02:40:31,001 --> 02:40:34,000 AND THE GOAL OF THIS LEGISLATION 4565 02:40:34,001 --> 02:40:35,000 IS TO RETAIN WHAT WE HAVE. 4566 02:40:35,001 --> 02:40:37,000 IT IS BASICALLY THAT SAME 4567 02:40:37,001 --> 02:40:38,000 BALANCE OF PUBLIC AND PRIVATE. 4568 02:40:38,001 --> 02:40:40,000 IT'S WORKED PRETTY WELL FOR 4569 02:40:40,001 --> 02:40:41,000 AMERICA, IT'S UNIQUELY AMERICAN. 4570 02:40:41,001 --> 02:40:42,000 WE'RE NOT CANADA. 4571 02:40:42,001 --> 02:40:44,000 WE'RE NOT GREAT BRITAIN. 4572 02:40:44,001 --> 02:40:45,000 WE'RE NOT SWITZERLAND. 4573 02:40:45,001 --> 02:40:47,000 WE'RE THE UNITED STATES OF AMERICA. 4574 02:40:47,001 --> 02:40:49,000 I THINK IT'S JUST GOOD TO BUILD 4575 02:40:49,001 --> 02:40:53,000 ON OUR CURRENT SYSTEM, MAKE OUR 4576 02:40:53,001 --> 02:40:55,000 CURRENT SYSTEM WORK BETTER. 4577 02:40:55,001 --> 02:40:57,000 I'M PROMPTED TO EXPLAIN THE 4578 02:40:57,001 --> 02:41:00,000 CHOICES IN PART BY THE STATEMENT 4579 02:41:00,001 --> 02:41:02,000 BY THE SENIOR SENATOR FROM 4580 02:41:02,001 --> 02:41:04,000 ARIZONA WHO SAID THAT MEDICARE 4581 02:41:04,001 --> 02:41:06,000 ADVANTAGE 4582 02:41:06,001 --> 02:41:08,000 GET EYEGLASSES AND DENTAL CARE, 4583 02:41:08,001 --> 02:41:10,000 AND THAT'S TRUE. 4584 02:41:10,001 --> 02:41:11,000 HE WENT ON TO SAY THAT, GEE, 4585 02:41:11,001 --> 02:41:13,000 SHOULDN'T MEMBERS OF CONGRESS 4586 02:41:13,001 --> 02:41:14,000 LIKE ALL THAT AND WANT TO KEEP 4587 02:41:14,001 --> 02:41:16,000 ALL THAT BECAUSE MEMBERS 4588 02:41:16,001 --> 02:41:18,000 CONGRESS GET FREE 4589 02:41:18,001 --> 02:41:20,000 FREE EYEGLASSES. 4590 02:41:20,001 --> 02:41:22,000 WELL, THAT'S REALLY NOT TRUE. 4591 02:41:22,001 --> 02:41:23,000 MEMBERS OF CONGRESS DON'T GET 4592 02:41:23,001 --> 02:41:26,000 THAT. 4593 02:41:26,001 --> 02:41:27,000 BUT IT IS TRUE THAT MEMBERS OF 4594 02:41:27,001 --> 02:41:29,000 CONGRESS 4595 02:41:29,001 --> 02:41:30,000 FEDERAL EMPLOYEES, ALL FEDERAL 4596 02:41:30,001 --> 02:41:31,000 EMPLOYEES, MEMBERS OF CONGRESS, 4597 02:41:31,001 --> 02:41:32,000 PEOPLE OF T FOREST SERVICE, 4598 02:41:32,001 --> 02:41:33,000 ALL AROUND THE COUNTRY, ALL THE 4599 02:41:33,001 --> 02:41:36,000 FEDERAL EMPLOYEES PARTICIPATE IN 4600 02:41:36,001 --> 02:41:39,000 THE SAME SYSTEM. 4601 02:41:39,001 --> 02:41:41,000 IT'S CALLED FEHBP, FEDERAL 4602 02:41:41,001 --> 02:41:43,000 EMPLOYEES HEALTH BENEFITS PLA 4603 02:41:43,001 --> 02:41:46,000 WHERE FEDERAL EMPLOYEES AND 4604 02:41:46,001 --> 02:41:47,000 MEMBER OF CONGRESS, ALL 4605 02:41:47,001 --> 02:41:48,000 TOGETHER, THE SAME, CAN CHOOSE 4606 02:41:48,001 --> 02:41:49,000 AMONG MANY DIFFERENT PRIVATE 4607 02:41:49,001 --> 02:41:51,000 HEALTH INSURANCE PLANS. 4608 02:41:51,001 --> 02:41:53,000 THERE IS AN OPEN ROLLMENT SEON. 4609 02:41:53,001 --> 02:41:54,000 IN FACT, WE'RE IN THE MIDDLE OF 4610 02:41:54,001 --> 02:41:55,000 IT RIGHT NOW WHERE MEMBERS OF 4611 02:41:55,001 --> 02:41:57,000 CONGRESS AND ALL FEDERAL 4612 02:41:57,001 --> 02:41:59,000 EMPLOYEES CAN LOOK TO SEE 4613 02:41:59,001 --> 02:42:00,000 WHETHER THEY WANT TO CHOOSE A 4614 02:42:00,001 --> 02:42:01,000 DIFFERENT INSURANCE COMPANY OR 4615 02:42:01,001 --> 02:42:05,000 NOT. 4616 02:42:05,001 --> 02:42:08,000 NOW, SOME OF THOSE COMPANIES DO 4617 02:42:08,001 --> 02:42:09,000 PROVIDE DENTAL AND VISION COVERAGE. 4618 02:42:09,001 --> 02:42:11,000 SOME DON'T. 4619 02:42:11,001 --> 02:42:13,000 SO IF A FEDERAL EMPLOYEE WANTS 4620 02:42:13,001 --> 02:42:15,000 TO CHOOSE A PLAN THAT COVERS 4621 02:42:15,001 --> 02:42:19,000 DENTAL AND VISION, HE OR SHE CAN DO SO. 4622 02:42:19,001 --> 02:42:23,000 JUST PAY THE PREMIUM AND YOU'RE 4623 02:42:23,001 --> 02:42:25,000 COVERED WITH DENTAL AND VISION. 4624 02:42:25,001 --> 02:42:31,000 AND WE'RE SETTING UP UNDER THIS 4625 02:42:31,001 --> 02:42:33,000 LEGISLATION AN EXCHANGE VERY 4626 02:42:33,001 --> 02:42:36,000 FEHBP WHERE PEOPLE WHO DON'T 4627 02:42:36,001 --> 02:42:38,000 HAVE HEALTH INSURANCE CAN GO 4628 02:42:38,001 --> 02:42:39,000 LOOK ON THE EXCHANGE, CHOOSE 4629 02:42:39,001 --> 02:42:41,000 AMONG PRIVATE COMPANIES, WHICH 4630 02:42:41,001 --> 02:42:44,000 ONE MAKES THE MOST SENSE TO THEM. 4631 02:42:44,001 --> 02:42:47,000 SOME MAY HAVE DENTAL, SOME MAY 4632 02:42:47,001 --> 02:42:48,000 HAVE EYEGLASS COVERAGE, SOME MAY NOT. 4633 02:42:48,001 --> 02:42:49,000 THAT'S JUST A CHOICE PEOPLE 4634 02:42:49,001 --> 02:42:51,000 COULD MAKE. 4635 02:42:51,001 --> 02:42:53,000 AND IF THEY -- IN ADDITION TO 4636 02:42:53,001 --> 02:42:54,000 THAT, THERE IS EVEN MORE CHOICE 4637 02:42:54,001 --> 02:42:58,000 BECAUSE CURRENTLY A FEDERAL 4638 02:42:58,001 --> 02:43:00,000 EMPLOYEE DOES NOT HAVE TO JOIN FEHBP. 4639 02:43:00,001 --> 02:43:04,000 A FEDERAL EMPLOYEE CAN CHOOSE 4640 02:43:04,001 --> 02:43:06,000 NOT TO GET HEALTH INSURANCE IF 4641 02:43:06,001 --> 02:43:07,000 HE WANTS TO OR MAYBE THROUGH HIS 4642 02:43:07,001 --> 02:43:09,000 OR HER SPOUSE SOMEPLACE ELSE. 4643 02:43:09,001 --> 02:43:11,000 THE SAME WOULD BE TRUE WITH THE 4644 02:43:11,001 --> 02:43:12,000 EXCHANGE SET NEWSPAPER THIS 4645 02:43:12,001 --> 02:43:14,000 LEGISLATION. 4646 02:43:14,001 --> 02:43:15,000 THE PERSON COULD BUY AMONG 4647 02:43:15,001 --> 02:43:16,000 DIFFERENT COMPETING PRIVATE 4648 02:43:16,001 --> 02:43:17,000 PLANS THAT OFFER HEALTH 4649 02:43:17,001 --> 02:43:19,000 INSURANCE ON THE EXCHANGE, OR A 4650 02:43:19,001 --> 02:43:21,000 PERSON COULD GO OUTSIDE THE 4651 02:43:21,001 --> 02:43:22,000 EXCHANGE BECAUSE HE OR SHE 4652 02:43:22,001 --> 02:43:24,000 THINKS HE CAN GET A BETTER DEAL 4653 02:43:24,001 --> 02:43:27,000 IF THAT'S WHAT THAT PERSON WANTS. 4654 02:43:27,001 --> 02:43:30,000 SO I JUST WANT TO MAKE IT CLEAR 4655 02:43:30,001 --> 02:43:32,000 HERE THAT WE'RE ENCOURAGING 4656 02:43:32,001 --> 02:43:33,000 CHOICE, WE'RE ENCOURAGING 4657 02:43:33,001 --> 02:43:35,000 COMPETITION, AND I MIGHT SAY 4658 02:43:35,001 --> 02:43:39,000 THAT UNDER THE LEGISLATION, 4659 02:43:39,001 --> 02:43:43,000 DEMOCRATS OF CONGRESS FULLY 4660 02:43:43,001 --> 02:43:44,000 PARTICIPATE IN 4661 02:43:44,001 --> 02:43:45,000 CO-EQUAL WITH OTHERS. 4662 02:43:45,001 --> 02:43:48,000 IF THERE IS A PRIVATE OPTION, 4663 02:43:48,001 --> 02:43:49,000 MEMBERS OF CONGRESS CAN 4664 02:43:49,001 --> 02:43:50,000 CONTRIBUTE -- CAN PARTICIPATE IN 4665 02:43:50,001 --> 02:43:53,000 THAT AS WELL. 4666 02:43:53,001 --> 02:43:56,000 IN FACT, WE ARE REQUIRING 4667 02:43:56,001 --> 02:43:57,000 SENATORS AND THEIR STAFFS -- 4668 02:43:57,001 --> 02:43:58,000 THEY DON'T HAVE TO PARTICIPATE 4669 02:43:58,001 --> 02:43:59,000 IN THE EXCHANGE, BUT IT'S 4670 02:43:59,001 --> 02:44:01,000 CERTAINLY AVAILABLE TO THEM AND 4671 02:44:01,001 --> 02:44:02,000 THEY CAN OPT OUT IF THEY WANT 4672 02:44:02,001 --> 02:44:04,000 TO. 4673 02:44:04,001 --> 02:44:08,000 NOW, LET ME JUST SAY A LITTLE 4674 02:44:08,001 --> 02:44:10,000 BIT ABOUT MEDICARE ADVANTAGE, 4675 02:44:10,001 --> 02:44:11,000 AND WHAT DOES MEDPAC SAY ABOUT 4676 02:44:11,001 --> 02:44:12,000 MEDICARE ADVANTAGE? 4677 02:44:12,001 --> 02:44:15,000 SEVERAL YEARS AGO, CONGRESS 4678 02:44:15,001 --> 02:44:17,000 ESTABLISHED AN ADVISORY BOARD, 4679 02:44:17,001 --> 02:44:20,000 IT'S NOW CALLED MEDPAC, TO 4680 02:44:20,001 --> 02:44:23,000 ADVISE ON HOW MEDICARE SHOULD 4681 02:44:23,001 --> 02:44:25,000 PAY PROVIDERS AND TRADITIONAL 4682 02:44:25,001 --> 02:44:27,000 FEE-FOR-SERVICE AND PRIVATE 4683 02:44:27,001 --> 02:44:28,000 MEDICAL INSURERS AND MEDICARE ADVANTAGE. 4684 02:44:28,001 --> 02:44:29,000 AGAIN, MEDICARE ADVANTAGE ARE 4685 02:44:29,001 --> 02:44:30,000 PRIVATE COMPANIES. 4686 02:44:30,001 --> 02:44:32,000 THEY HAVE EXECUTIVES, STOCKHOLDERS. 4687 02:44:32,001 --> 02:44:34,000 IT'S A PRI 4688 02:44:34,001 --> 02:44:37,000 AND MEDPAC ADVISES HOW MUCH 4689 02:44:37,001 --> 02:44:40,000 CONGRESS SHOULD PROVIDE -- 4690 02:44:40,001 --> 02:44:42,000 SHOULD PAY MEDPAC AND OTHER 4691 02:44:42,001 --> 02:44:45,000 MEDICARE PROVIDERS AND 4692 02:44:45,001 --> 02:44:47,000 TRADITIONAL FEE-FOR-SERVICE. 4693 02:44:47,001 --> 02:44:50,000 IT'S AN INDEPENDENT AGENC IT'S 4694 02:44:50,001 --> 02:44:52,000 EXPERTS, NONPARTISAN, HIGHLY 4695 02:44:52,001 --> 02:44:54,000 RESPECTED. 4696 02:44:54,001 --> 02:44:55,000 EACH REPORTS TO CONGRESS AND 4697 02:44:55,001 --> 02:44:56,000 EXAMINES ISSUES ON MEDICARE. 4698 02:44:56,001 --> 02:44:58,000 HERE IS WHAT MEDPAC HAD TO SAY 4699 02:44:58,001 --> 02:45:01,000 ABOUT THE CURRENT STATE OF 4700 02:45:01,001 --> 02:45:02,000 MEDICARE ADVANTAGE IN ITS 2009, 4701 02:45:02,001 --> 02:45:04,000 JUNE, REPORT. 4702 02:45:04,001 --> 02:45:06,000 I'M GOING TO QUOTE NOW FROM THIS 4703 02:45:06,001 --> 02:45:08,000 INDEPENDENT ADVISORY PANEL -- 4704 02:45:08,001 --> 02:45:11,000 "FIRST WE ESTIMATE THAT IN 2009, 4705 02:45:11,001 --> 02:45:13,000 MAYOR PAYS ABOUT $12 BILLION 4706 02:45:13,001 --> 02:45:14,000 MORE FOR ENROLLEES IN BENEFIT 4707 02:45:14,001 --> 02:45:16,000 PLANS THAN IT WOULD IN 4708 02:45:16,001 --> 02:45:17,000 FEE-FOR-SERVICE MEDICARE. 4709 02:45:17,001 --> 02:45:19,000 SECOND, CURRENT HIGH PAYMENTS 4710 02:45:19,001 --> 02:45:22,000 HAVE RESULTED IN SOME PLANS THAT 4711 02:45:22,001 --> 02:45:27,000 BRING NO INNOVATION BUT SIMPLY MIC FEE-FOR-SERVICE MEDICARE 4712 02:45:27,001 --> 02:45:28,000 AT A MUCH HIGHER COST TO THE PROGRAM. IN OTHER WORDS, THEY'RE SAYING 4713 02:45:28,001 --> 02:45:30,000 THAT MEDICARE ADVANTAGE PLANS 4714 02:45:30,001 --> 02:45:33,000 GET PAID FOR A LOT MORE BUT WITH 4715 02:45:33,001 --> 02:45:35,000 NO INNOVATION THAN -- THAN THE 4716 02:45:35,001 --> 02:45:45,000 FEE-FOR-SERVICE MEDICARE. 4717 02:45:45,001 --> 02:45:49,000 AND THEY ALSO SAY, SM, MEDPAC -- 4718 02:45:49,001 --> 02:45:52,000 "THEY'RE NOT ENROLLED IN 4719 02:45:52,001 --> 02:45:55,000 MEDICARE ADVANTAGE WHICH ARE SUBSIDIZED." 4720 02:45:55,001 --> 02:45:56,000 IN ADDITION, THEY SAY, "THESE 4721 02:45:56,001 --> 02:45:57,000 EXCESSIVE PAYMENTS OFTEN 4722 02:45:57,001 --> 02:45:58,000 ENCOURAGE INEFFICIENT PLANS TO 4723 02:45:58,001 --> 02:46:00,000 ENTER THE PROGRAM, FURTHER 4724 02:46:00,001 --> 02:46:02,000 RAISING COSTS TO MEDICARE." 4725 02:46:02,001 --> 02:46:03,000 BECAUSE THERE'S SO 4726 02:46:03,001 --> 02:46:05,000 CURRENTLY GIVEN TO MEDICARE 4727 02:46:05,001 --> 02:46:08,000 ADVANTAGE PLANS, ACCORDING TO 4728 02:46:08,001 --> 02:46:09,000 MEDICATIONSPAC, THAT -- 4729 02:46:09,001 --> 02:46:10,000 MEDMAC THAT ENCOURAGE 4730 02:46:10,001 --> 02:46:11,000 INEFFICIENT PLANS TO ENTER THE 4731 02:46:11,001 --> 02:46:12,000 PROGRAM. 4732 02:46:12,001 --> 02:46:13,000 WHY NOT? 4733 02:46:13,001 --> 02:46:16,000 THEY'RE NOT ALL THIS EXTRA MONEY. 4734 02:46:16,001 --> 02:46:17,000 FURTHER QUOTED FROM MEDPAC, "THE 4735 02:46:17,001 --> 02:46:19,000 COST OF 4736 02:46:19,001 --> 02:46:20,000 SUBSIDIES IS BORNE BY TAXPAYERS 4737 02:46:20,001 --> 02:46:22,000 WHO FINANCE THE MEDICARE PROGRAM 4738 02:46:22,001 --> 02:46:24,000 AND BY ALL MEDICARE 4739 02:46:24,001 --> 02:46:25,000 BENEFICIARIES THROUGH PAR 4740 02:46:25,001 --> 02:46:26,000 PREMIUMS." 4741 02:46:26,001 --> 02:46:30,000 OR TO SAY IT DIFFERENTLY, ABOUT 4742 02:46:30,001 --> 02:46:31,000 78% OF AMERICANS WHO ARE NOT IN 4743 02:46:31,001 --> 02:46:34,000 MEDICARE ADVANTAGE PLANS ARE 4744 02:46:34,001 --> 02:46:37,000 PAYING 4745 02:46:37,001 --> 02:46:39,000 $90-PER-YEAR TAX FOR WHICH THEY 4746 02:46:39,001 --> 02:46:41,000 GET NO BENEFIT, WHICH GOES INTO 4747 02:46:41,001 --> 02:46:42,000 THE MEDICARE ADVANTAGE PLANS. 4748 02:46:42,001 --> 02:46:44,000 IN ADDITION, THE PART-B PREMIUM 4749 02:46:44,001 --> 02:46:45,000 FOR ALL BENEFICIARIES IS 4750 02:46:45,001 --> 02:46:47,000 INCREASED BY ABOUT $3 4751 02:46:47,001 --> 02:46:48,000 REGARDLESS OF WHETHER YOU 4752 02:46:48,001 --> 02:46:51,000 RECEIVE ANY OF THE BENEFIT. 4753 02:46:51,001 --> 02:46:52,000 THAT'S ANOTHER QUOTE FROM MEDPAC. 4754 02:46:52,001 --> 02:46:54,000 I MIGHT SAY A COUPLE MORE QTES 4755 02:46:54,001 --> 02:46:55,000 FROM MEDPAC. 4756 02:46:55,001 --> 02:46:56,000 "ADDITIONAL MEDICARE ADVANTAGE 4757 02:46:56,001 --> 02:46:58,000 PAYMENTS HASTEN THE INSOLVENCY 4758 02:46:58,001 --> 02:47:00,000 OF THE MEDICARE PART-A TRUST 4759 02:47:00,001 --> 02:47:02,000 FUND BY 18 MONTHS." 4760 02:47:02,001 --> 02:47:05,000 THAT'S AN INTERESTING STATEMENT. 4761 02:47:05,001 --> 02:47:07,000 "THE ADDITIONAL M.A. PAYMENTS 4762 02:47:07,001 --> 02:47:08,000 HASTEN THE INSOLVENCY 4763 02:47:08,001 --> 02:47:11,000 MEDICARE PART-A TRUST FUND BY 18 MONTHS." 4764 02:47:11,001 --> 02:47:14,000 THAT'S THE HOSPITAL VERSION. 4765 02:47:14,001 --> 02:47:15,000 GOING ON QUOTES FROM MEDPAC, 4766 02:47:15,001 --> 02:47:17,000 "ALTHOUGH MANY PLANS ARE 4767 02:47:17,001 --> 02:47:21,000 AVAILABLE, ONLY SOME ARE OF HIGH 4768 02:47:21,001 --> 02:47:22,000 QUALITY IN ADDITION," CONTINUING 4769 02:47:22,001 --> 02:47:25,000 THEIR QUOTE, "ONLY ABOUT HALF OF 4770 02:47:25,001 --> 02:47:27,000 THE BENEFICIARIES NATIONWIDE 4771 02:47:27,001 --> 02:47:30,000 HAVE ACCESS TO A PLAN THAT 4772 02:47:30,001 --> 02:47:31,000 C.M.S. RATES AS ABOVE AVERAGE IN 4773 02:47:31,001 --> 02:47:33,000 OVERALL PLAN QUALITY." 4774 02:47:33,001 --> 02:47:36,000 THIS IS WHAT MEDPAC SAYS, THAT'S 4775 02:47:36,001 --> 02:47:42,000 THE NONPARTISAN EXPERTS THAT 4776 02:47:42,001 --> 02:47:43,000 HELP ADVISE CONGRESS IN WHAT 4777 02:47:43,001 --> 02:47:45,000 REIMBURSEMENT LEVELS, WHAT THEY SHOULD BE. 4778 02:47:45,001 --> 02:47:46,000 NOW, WE'VE HEARD DAY AFTER DAY 4779 02:47:46,001 --> 02:47:48,000 THIS THIS BILL IS CUTTING 4780 02:47:48,001 --> 02:47:49,000 MEDICARE BENEFITS FOR OUR SENIORS. 4781 02:47:49,001 --> 02:47:50,000 WHAT MY COLLEAGUES ON THE OTHER 4782 02:47:50,001 --> 02:47:53,000 SIDE OF THE AISLE REALIZE THAT 4783 02:47:53,001 --> 02:47:55,000 THIS BILL DOES NOT CUT, REDUCE, 4784 02:47:55,001 --> 02:47:56,000 OR ELIMINATE A SINGLE GUARANTEED 4785 02:47:56,001 --> 02:47:57,000 BENEFIT. 4786 02:47:57,001 --> 02:47:59,000 THEY TURN THEIR ARGUMENT TO MEDICARE ADVANTAGE. 4787 02:47:59,001 --> 02:48:00,000 I THINK THEY FINALLY RECOGNIZE 4788 02:48:00,001 --> 02:48:01,000 THAT THERE ARE NO GUARANTEED 4789 02:48:01,001 --> 02:48:02,000 BENEFITS CUT IN THIS LEGISLATION 4790 02:48:02,001 --> 02:48:03,000 SO THEY TURN TO MEDICARE 4791 02:48:03,001 --> 02:48:05,000 ADVANTAGE AND THEY ARGUE THAT 4792 02:48:05,001 --> 02:48:06,000 THE EFFICIENCIES AND SAVINGS 4793 02:48:06,001 --> 02:48:08,000 WOULD BE ACHIEVED BY ENDING 4794 02:48:08,001 --> 02:48:09,000 BILLIONS OF DOLLARS OF 4795 02:48:09,001 --> 02:48:11,000 OVERPAYMENTS TO THESE PRIVATE 4796 02:48:11,001 --> 02:48:15,000 PLANS WILL EITHER END THE 4797 02:48:15,001 --> 02:48:16,000 PROGRAM OR DRAMATICALLY CUT 4798 02:48:16,001 --> 02:48:17,000 SERVICES TO BENEFICIARIES. 4799 02:48:17,001 --> 02:48:22,000 BUT LET'S JUST LOOK AT THE 4800 02:48:22,001 --> 02:48:24,000 NUMBERS. 4801 02:48:24,001 --> 02:48:26,000 THIS CHART SHOWS THE YEARLY 4802 02:48:26,001 --> 02:48:29,000 SPENDING FOR MEDICARE ADVANTAGE 4803 02:48:29,001 --> 02:48:32,000 IN BILLIONS OF DOLLARS. 4804 02:48:32,001 --> 02:48:35,000 SO YOU CAN SEE FROM THE CHART 4805 02:48:35,001 --> 02:48:41,000 THAT IN THE YEAR, SAY, 2009, 4806 02:48:41,001 --> 02:48:42,000 $110 BILLION WILL BE SPENT ON MEDICARE ADVANTAGE PLANS. 4807 02:48:42,001 --> 02:48:45,000 AND MOVING TO THE RIGHT TEN 4808 02:48:45,001 --> 02:48:48,000 YEARS LATER, IN THE YEAR 2019, 4809 02:48:48,001 --> 02:48:51,000 IT'S ABOUT $204 BILLIO 4810 02:48:51,001 --> 02:48:53,000 EXCUSE ME, THE -- IS SPENT. 4811 02:48:53,001 --> 02:48:58,000 SO IF YOU TOTAL IT ALL UP, IT'S 4812 02:48:58,001 --> 02:48:59,000 ABOUT $1.7 TRILLION THAT WILL BE 4813 02:48:59,001 --> 02:49:01,000 SPENT ON MEDICARE ADVANTAGE 4814 02:49:01,001 --> 02:49:04,000 PLANS OVER THE NEXT TEN YEARS. 4815 02:49:04,001 --> 02:49:05,000 NOW, YOU SEE THAT LITTLE -- WHAT 4816 02:49:05,001 --> 02:49:06,000 COLOR IS THAT? 4817 02:49:06,001 --> 02:49:08,000 IT'S KIND OF ANRANGE, IT'S 4818 02:49:08,001 --> 02:49:10,000 KIND OF AN INTERESTING SORT OF 4819 02:49:10,001 --> 02:49:11,000 RED, WHATER IT IS, AT THE TOP 4820 02:49:11,001 --> 02:49:13,000 OF THAT CHART? 4821 02:49:13,001 --> 02:49:15,000 THAT REPRESENTS THE REDUCTION IN 4822 02:49:15,001 --> 02:49:18,000 MEDICARE ADVANTAGE PLANS 4823 02:49:18,001 --> 02:49:19,000 PAYMENTS UNDER THIS LEGISLATION. 4824 02:49:19,001 --> 02:49:21,000 IT'S NOT VERY MUCH, AS YOU CAN 4825 02:49:21,001 --> 02:49:23,000 TELL BY LOOKING AT THE CHART. 4826 02:49:23,001 --> 02:49:26,000 IT AVERAGES OUT I THINK AROUND 4827 02:49:26,001 --> 02:49:28,000 10% REDUCTION IN MEDICARE 4828 02:49:28,001 --> 02:49:32,000 ADVANTAGE PAYMENTS. 4829 02:49:32,001 --> 02:49:34,000 SO WHEN YOU HEAR THE CROCODILE 4830 02:49:34,001 --> 02:49:38,000 TEARS HOW MEDICARE ADVANTAGE IS 4831 02:49:38,001 --> 02:49:39,000 BEING CUT, HEAR ALL THESE 4832 02:49:39,001 --> 02:49:40,000 DRAMATIC STATEMENTS THAT SO MUCH 4833 02:49:40,001 --> 02:49:42,000 IS GOING TO BE TAKEN AWAY FROM 4834 02:49:42,001 --> 02:49:43,000 SENIORS BECAUSE CONGRESS IS 4835 02:49:43,001 --> 02:49:45,000 CUTTING MEDICARE ADVANTAGE, THE 4836 02:49:45,001 --> 02:49:47,000 FACT IS WE'RE REDUCING THE RATE 4837 02:49:47,001 --> 02:49:50,000 OF INCREASE IN MEDICARE 4838 02:49:50,001 --> 02:49:52,000 ADVANTAGE PAYMENTS BY ONLY ABOUT 4839 02:49:52,001 --> 02:49:54,000 10%, AND UNDER THIS LEGISLATION, 4840 02:49:54,001 --> 02:49:56,000 ABOUT $1.7 TRILLION WILL BE 4841 02:49:56,001 --> 02:50:00,000 SPENT ON MEDICARE ADVANTAGE 4842 02:50:00,001 --> 02:50:02,000 PLANS. 4843 02:50:02,001 --> 02:50:04,000 REMEMBER, MEDPAC SAYS THESE ARE 4844 02:50:04,001 --> 02:50:08,000 OVERPAYMENTS. 4845 02:50:08,001 --> 02:50:09,000 MEDPAC SAY THAT THIS 10% IS 4846 02:50:09,001 --> 02:50:10,000 ABOUT -- REDUCTION IS WHAT THEY 4847 02:50:10,001 --> 02:50:11,000 SHOULD BE PAID. 4848 02:50:11,001 --> 02:50:13,000 AND REMBER, TOO, THAT THESE 4849 02:50:13,001 --> 02:50:15,000 ARE PRIVATE PLANS. 4850 02:50:15,001 --> 02:50:16,000 THESE ARE PRIVATE COMPANIES. 4851 02:50:16,001 --> 02:50:18,000 IT'S NOT MEDICARE. 4852 02:50:18,001 --> 02:50:22,000 THESE ARE PRIVATE COMPANIES 4853 02:50:22,001 --> 02:50:24,000 RECEIVING THESE -- THESE PAYMENTS. 4854 02:50:24,001 --> 02:50:26,000 AND THEY'RE INSURANCE COMPANIES. IT'S INTERESTING TO ME, 4855 02:50:26,001 --> 02:50:33,000 MR. PRESIDENT, THAT A LOT OF 4856 02:50:33,001 --> 02:50:34,000 MEMBERS OF CONGRESS 4857 02:50:34,001 --> 02:50:36,000 WILD ABOUT INSURANCE COMPANIES. 4858 02:50:36,001 --> 02:50:39,000 WELL, MEDPAC -- EXCUSE ME. 4859 02:50:39,001 --> 02:50:41,000 THE MEDICARE ADVANTAGE COMPANIES 4860 02:50:41,001 --> 02:50:42,000 ARE INSURANCE COMPANIES. THEY'RE PRIVATE COMPANIES. 4861 02:50:42,001 --> 02:50:43,000 THAT'S WHAT THEY ARE. 4862 02:50:43,001 --> 02:50:44,000 THEY'RE INSURANCE COMPANIES. 4863 02:50:44,001 --> 02:50:46,000 THEY'VE GOT THEIR PRIVATE 4864 02:50:46,001 --> 02:50:47,000 INSURANCE COMPANY CHIEF EXECUTIVE. 4865 02:50:47,001 --> 02:50:48,000 THEY'VE GOT THEIR PRIVATE 4866 02:50:48,001 --> 02:50:49,000 INSURANCE COMPANY OFFICERS. 4867 02:50:49,001 --> 02:50:50,000 THEY'VE GOT THEIR PRIVATE 4868 02:50:50,001 --> 02:50:51,000 INSURANCE COMPANY STOCKHOLDERS. 4869 02:50:51,001 --> 02:50:52,000 THEY'VE GOT THEIR PRIVATE 4870 02:50:52,001 --> 02:50:55,000 INSURANCE COMPANY ADMINISTRATIVE 4871 02:50:55,001 --> 02:50:56,000 COSTS AND MARKETING EXPENSES. 4872 02:50:56,001 --> 02:50:59,000 THEY'RE PRIVATE INSURANCE COMPANIES. 4873 02:50:59,001 --> 02:51:01,000 THAT'S WHAT THEY ARE. 4874 02:51:01,001 --> 02:51:03,000 AND IT'S -- IT'S -- THAT -- WE 4875 02:51:03,001 --> 02:51:04,000 SHOULD NOT LOSE SIGHT OF ALL OF 4876 02:51:04,001 --> 02:51:09,000 THAT. 4877 02:51:09,001 --> 02:51:11,000 NOW, I WANT TO ALSO POINT OUT 4878 02:51:11,001 --> 02:51:16,000 THAT AS PRIVATE INSURANCE 4879 02:51:16,001 --> 02:51:18,000 COMPANIES, THESE MEDICARE 4880 02:51:18,001 --> 02:51:26,000 ADVANTAGE PLANS ARE DOING PRETTY WELL. 4881 02:51:26,001 --> 02:51:28,000 LET ME QUOTE FROM AN OPEN HIERM OPPENHEIMER?? 4882 02:51:28,001 --> 02:51:29,000 CAPITAL ANALYST ABOUT MEDICARE 4883 02:51:29,001 --> 02:51:32,000 ADVANTAGE PLANS. 4884 02:51:32,001 --> 02:51:34,000 "BETWEEN 2006 AND 2009, WE 4885 02:51:34,001 --> 02:51:39,000 ESTIMATE THAT MEDICARE" HE MEANT 4886 02:51:39,001 --> 02:51:40,000 ADVANTAGE COUNTED FOR NEARLY 79% 4887 02:51:40,001 --> 02:51:42,000 OF THE GROSS PROFITS IN THE 4888 02:51:42,001 --> 02:51:43,000 INDUSTRY HIGHLIGHTED BY AN 4889 02:51:43,001 --> 02:51:45,000 ESTIMATED GROSS PROFIT INCREASE 4890 02:51:45,001 --> 02:51:48,000 OF $1.9 BILLION IN 2009 RELATIVE 4891 02:51:48,001 --> 02:51:49,000 TO COMMERCIAL RISK EARNINGS GAINS." 4892 02:51:49,001 --> 02:51:51,000 NOW, COMMERCIAL RISK EARNINGS 4893 02:51:51,001 --> 02:51:55,000 GAINS ARE THE ORDINARY HEALTH 4894 02:51:55,001 --> 02:51:56,000 INSURANCE COMPANIES BUT 75% OF 4895 02:51:56,001 --> 02:51:59,000 THE GROSS PROFIT INCREASE WAS 4896 02:51:59,001 --> 02:52:01,000 UNDER MEDICARE ADVANTAGE PLANS 4897 02:52:01,001 --> 02:52:05,000 NOT TRADITIONAL HEALTH 4898 02:52:05,001 --> 02:52:08,000 INSURANCE. 4899 02:52:08,001 --> 02:52:14,000 I MIGHT SAY TOO -- I DON'T HAVE THE PAPERS HERE. 4900 02:52:14,001 --> 02:52:16,000 MAYBE I CAN FIND THEM. 4901 02:52:16,001 --> 02:52:18,000 JUST WORTH NOTING. 4902 02:52:18,001 --> 02:52:24,000 THESE ARE PRIVATE COMPANIES. 4903 02:52:24,001 --> 02:52:25,000 THEY'RE NOT -- IT'S NOT 4904 02:52:25,001 --> 02:52:26,000 KNOW, TRADITIONAL MEDICARE. 4905 02:52:26,001 --> 02:52:29,000 OH, HERE IT IS. 4906 02:52:29,001 --> 02:52:33,000 LET'S LOOK AT -- THIS IS 4907 02:52:33,001 --> 02:52:34,000 INTERESTING. 4908 02:52:34,001 --> 02:52:35,000 YOU KNOW, WHAT IS THE 4909 02:52:35,001 --> 02:52:37,000 COMPENSATION OF THESE INSURANCE 4910 02:52:37,001 --> 02:52:42,000 COMPANIES' EXECUTIVES, THESE 4911 02:52:42,001 --> 02:52:44,000 MEDICARE ADVANTAGE PLANS? 4912 02:52:44,001 --> 02:52:45,000 AETNA'S -- OF THE C.E.O., THE 4913 02:52:45,001 --> 02:52:48,000 TOTAL COMPENSATION OF THE C.E.O. 4914 02:52:48,001 --> 02:52:49,000 OF AETNA IS $24 MILLION A YEAR. 4915 02:52:49,001 --> 02:52:51,000 THE TOTAL COMPENSATION OF THE 4916 02:52:51,001 --> 02:52:54,000 C.E.O. OF COVENTRY IS $89 MILLION. 4917 02:52:54,001 --> 02:52:55,000 WELLCARE IS $8 MILLION 4918 02:52:55,001 --> 02:52:57,000 HUMANA, $4. MILLION A YEAR. 4919 02:52:57,001 --> 02:52:58,000 UNITED HEALTHCARE, $3 MILLION. 4920 02:52:58,001 --> 02:53:00,000 NOW, PEOPLE SHOULD BE ABLE TO 4921 02:53:00,001 --> 02:53:02,000 MAKE SOME MONEY AND OFFICERS OF 4922 02:53:02,001 --> 02:53:08,000 COMPANIES SHOULD BE ABLE TO, YOU 4923 02:53:08,001 --> 02:53:09,000 KNOW, DO OKAY, BUT HERE WE'RE 4924 02:53:09,001 --> 02:53:11,000 TALKING ABOUT VERY HIGH SALARIES 4925 02:53:11,001 --> 02:53:18,000 THAT THESE INSURANCE COMPANIES 4926 02:53:18,001 --> 02:53:20,000 PAY TO THEIR TOP EXECUTIVES 4927 02:53:20,001 --> 02:53:25,000 AND, FRANKLY, IF THERE'S A 10% 4928 02:53:25,001 --> 02:53:26,000 REDUCTION IN $1. TRILLION OVER7 TRILLION OVER 4929 02:53:26,001 --> 02:53:28,000 TEN YEARS, THEY COULD, YOU 4930 02:53:28,001 --> 02:53:30,000 THINK, TAKE SOME OF THAT 10% 4931 02:53:30,001 --> 02:53:34,000 MAYBE IN SALARY REDUCTION OR 4932 02:53:34,001 --> 02:53:35,000 DIVIDEND TO STOCKHOLDERS, MAKE 4933 02:53:35,001 --> 02:53:36,000 OTHER COST SAVINGS. 4934 02:53:36,001 --> 02:53:40,000 IT DOESN'T HAVE T COME OUT OF 4935 02:53:40,001 --> 02:53:41,000 THEIR -- THE BENEFICIARIES. 4936 02:53:41,001 --> 02:53:42,000 AND IT'S , THEY THE EXECUTIVES, 4937 02:53:42,001 --> 02:53:44,000 THAT ARE MAKING THESE DECISIONS 4938 02:53:44,001 --> 02:53:45,000 OF WHERE THE 10% -- 4939 02:53:45,001 --> 02:53:46,000 AND 4940 02:53:46,001 --> 02:53:49,000 THAT ARE MAKING THESE DECISIONS 4941 02:53:49,001 --> 02:53:53,000 OF WHERE THE 10% IS ALLOCATED. 4942 02:53:53,001 --> 02:53:54,000 I JUST BOTTOM LINE WANT TO SAY 4943 02:53:54,001 --> 02:53:55,000 I'M NOT OPPOSED TO MEDICARE 4944 02:53:55,001 --> 02:53:56,000 ADVANTAGE PLANS. 4945 02:53:56,001 --> 02:53:58,000 FRANKLY ARE I THINK IT'S GOOD 4946 02:53:58,001 --> 02:53:59,000 THAT WE HAVE MEDICARE ADVANTAGE PLANS. 4947 02:53:59,001 --> 02:54:00,000 MEDICARE ADVANTAGE PLANS PROVIDE 4948 02:54:00,001 --> 02:54:01,000 A LITTLE COMPETION TO 4949 02:54:01,001 --> 02:54:03,000 MEDICARE. 4950 02:54:03,001 --> 02:54:04,000 THEY JUST -- THEY HELP MAKE -- 4951 02:54:04,001 --> 02:54:09,000 KEEP THE SYSTEM ON ITS 4952 02:54:09,001 --> 02:54:11,000 BUT WE HAVE ANBLIGATION HERE 4953 02:54:11,001 --> 02:54:12,000 AS MEMBERS OF THIS SENATE, TO 4954 02:54:12,001 --> 02:54:14,000 TAXPAYERS, TO SENIORS TO CUT 4955 02:54:14,001 --> 02:54:17,000 WASTE AND TO -- AND CUT 4956 02:54:17,001 --> 02:54:19,000 OVERPAYMENTS IN A WAY THAT DOES 4957 02:54:19,001 --> 02:54:22,000 NOT HARM BENEFICIARIES. 4958 02:54:22,001 --> 02:54:25,000 AND THESE ARE REDUCTIONS 4959 02:54:25,001 --> 02:54:27,000 RECOMMENDED TO CONGRESS BY THE 4960 02:54:27,001 --> 02:54:29,000 BEST EXECUTIVE, BEST ADVISORY 4961 02:54:29,001 --> 02:54:31,000 BOARD OF EXPERTS WE COULD FIND. 4962 02:54:31,001 --> 02:54:32,000 THEY 4963 02:54:32,001 --> 02:54:33,000 MEMBERS OF THIN AIR, MEMBERS OF 4964 02:54:33,001 --> 02:54:34,000 CONGRESS THINK THIS UP. 4965 02:54:34,001 --> 02:54:36,000 THEY WERE RECOMMENDED TO US BY 4966 02:54:36,001 --> 02:54:40,000 THE MEDPAC ADVISORY BOARD. 4967 02:54:40,001 --> 02:54:41,000 AND, SECOND, THERE IS NO 4968 02:54:41,001 --> 02:54:42,000 REDUCTION IN GUARANTEED BENEFITS 4969 02:54:42,001 --> 02:54:45,000 TO SENIORS. 4970 02:54:45,001 --> 02:54:48,000 THAT'S JT -- THAT'S ABSOLUTELY ABSOLUTE. THERE'S NO REDUCTION IN 4971 02:54:48,001 --> 02:54:49,000 GUARANTEED BENEFITS TO MEDICARE 4972 02:54:49,001 --> 02:54:51,000 ADVANTAGE PARTICIPANTS. 4973 02:54:51,001 --> 02:54:52,000 SO, A, WE'RE BEING FAIR. 4974 02:54:52,001 --> 02:54:53,000 THIS CHART SHOWS IT. 4975 02:54:53,001 --> 02:54:58,000 WE'RE TRYING TO FIND THE RIGHT 4976 02:54:58,001 --> 02:55:00,000 LEVEL 4977 02:55:00,001 --> 02:55:01,000 A WAY SO THERE'S NO REDUCTION IN 4978 02:55:01,001 --> 02:55:02,000 IN -- IN BENEFICIARIES' BENEFITS. 4979 02:55:02,001 --> 02:55:07,000 IN FACT, UNDER THIS LEGISLATION, 4980 02:55:07,001 --> 02:55:08,000 WE ADD MORE BENEFITS FOR ALL 4981 02:55:08,001 --> 02:55:09,000 MEDICARE -- MEDICARE ADVANTAGE 4982 02:55:09,001 --> 02:55:11,000 AS WELL AS TRADITIONAL FEE-FOR-SERVICE MEDICARE. 4983 02:55:11,001 --> 02:55:13,000 AND I MIGHT ADD IN THIS 4984 02:55:13,001 --> 02:55:16,000 LEGISLATION, WE 4985 02:55:16,001 --> 02:55:17,000 TO MEDICARE ADVANTAGE PLANS THAT 4986 02:55:17,001 --> 02:55:18,000 SHOW DEMONSTRATED IMPROVEMENT IN 4987 02:55:18,001 --> 02:55:20,000 QUALITY. 4988 02:55:20,001 --> 02:55:23,000 AS I MENTIONED, MEDPAC SAID A 4989 02:55:23,001 --> 02:55:24,000 LOT OF THESE PLANS ARE TOTALLY 4990 02:55:24,001 --> 02:55:25,000 INEFFICIENT, A LOT OF THESE 4991 02:55:25,001 --> 02:55:27,000 PLANS HAVE NO COORDINATED CARE, 4992 02:55:27,001 --> 02:55:28,000 A LOT OF THESE PLANS DO NOT HAVE 4993 02:55:28,001 --> 02:55:29,000 ANY QUALITY BUT THEY GET THE 4994 02:55:29,001 --> 02:55:31,000 EXTRA MONEY. 4995 02:55:31,001 --> 02:55:34,000 SO WE'RE SAYING, LET'S GET THE 4996 02:55:34,001 --> 02:55:36,000 COMPENSATION LEVEL FAIR, WE DO 4997 02:55:36,001 --> 02:55:38,000 IT IN A COMPETIVE BIDDING BASIS. 4998 02:55:38,001 --> 02:55:40,000 I THINK THE AVERAGE BID FOR AN 4999 02:55:40,001 --> 02:55:42,000 AREA WHERE WE ALSO SAY LET'S 5000 02:55:42,001 --> 02:55:44,000 MAKE SURE THAT THERE'S NO 5001 02:55:44,001 --> 02:55:45,000 REDUCTION IN -- IN GUARANTEED 5002 02:55:45,001 --> 02:55:46,000 BENEFITS AT THE SAME TIME. 5003 02:55:46,001 --> 02:55:47,000 I THINK THAT'S THE RESPONSIBLE 5004 02:55:47,001 --> 02:55:50,000 THING TO DO. 5005 02:55:50,001 --> 02:55:52,000 SO ALL THESE ARGUMENTS, THESE 5006 02:55:52,001 --> 02:55:53,000 SOUND BITES, FRANKLY, THAT YOU 5007 02:55:53,001 --> 02:55:55,000 HEAR ON THE OTHER SIDE OF THE 5008 02:55:55,001 --> 02:55:56,000 AISLE ARE JUST THAT, THEY'RE 5009 02:55:56,001 --> 02:55:59,000 SOUND BITES. 5010 02:55:59,001 --> 02:56:00,000 THEY'RE NOT REALLY AN HONEST 5011 02:56:00,001 --> 02:56:02,000 ANAL HERE. 5012 02:56:02,001 --> 02:56:04,000 SO I JUST ENCOURAGE US TO KEEP 5013 02:56:04,001 --> 02:56:06,000 IN MIND, KEEP IN PERSPECTIVE 5014 02:56:06,001 --> 02:56:07,000 WHAT WE'RE DOING HERE SO WE CAN 5015 02:56:07,001 --> 02:56:08,000 HELP PROVIDE A BETTER HEALTH 5016 02:56:08,001 --> 02:56:09,000 CARE SYSTEM FOR OUR COUNTRY. 5017 02:56:09,001 --> 02:56:10,000 THIS IS ONLY ONE PART OF IT. 5018 02:56:10,001 --> 02:56:15,000 THERE ARE MANY OTHER PARTS BUT 5019 02:56:15,001 --> 02:56:16,000 THIS IS JUST ONE. 5020 02:56:16,001 --> 02:56:18,000 MR. PRESIDENT, I'D NOW LIKE TO 5021 02:56:18,001 --> 02:56:19,000 YIELD TO THE SENATOR FROM 5022 02:56:19,001 --> 02:56:20,000 MICHIGAN. 5023 02:56:20,001 --> 02:56:22,000 MS. STABENOW: THANK YOU. 5024 02:56:22,001 --> 02:56:23,000 THANK YOU. MR. PRES 5025 02:56:23,001 --> 02:56:24,000 THE PRESIDING OFFICER: YOU HAVE 5026 02:56:24,001 --> 02:56:26,000 14 1/2 MINUTES. 5027 02:56:26,001 --> 02:56:28,000 I'M SORRY, 13 1/2 MINUTES. 5028 02:56:28,001 --> 02:56:30,000 MR. BAUCUS: I SEE SENATOR DODD'S 5029 02:56:30,001 --> 02:56:32,000 ON THE FLOOR. 5030 02:56:32,001 --> 02:56:33,000 COULD YOU, SENATOR, MAYBE FIVE 5031 02:56:33,001 --> 02:56:35,000 MINUTES? 5032 02:56:35,001 --> 02:56:36,000 WE COULD PROBABLY GET SOME MORE. 5033 02:56:36,001 --> 02:56:38,000 MS. STABENOW: SEVEN MINUTES 5034 02:56:38,001 --> 02:56:39,000 WOULD DO. 5035 02:56:39,001 --> 02:56:40,000 MR. BAUCUS: TAKE WHAT YOU WANT. 5036 02:56:40,001 --> 02:56:41,000 WE'LL FIND THE TIME. 5037 02:56:41,001 --> 02:56:42,000 MS. STABENOW: THANK YOU. 5038 02:56:42,001 --> 02:56:43,000 MR. PRESIDENT? THE PRESIDING OFFICER: THE 5039 02:56:43,001 --> 02:56:44,000 SENATOR FROM MICHIGAN IS RECOGNIZED. 5040 02:56:44,001 --> 02:56:45,000 MS. STABENOW: THANK YOU, 5041 02:56:45,001 --> 02:56:46,000 MR. PRESIDENT. 5042 02:56:46,001 --> 02:56:48,000 AND, FIRST, I WANT TO THANK OUR 5043 02:56:48,001 --> 02:56:51,000 DISTINGUISHED CHAIRMAN THE 5044 02:56:51,001 --> 02:56:53,000 FINANCE COMMITTEE FOR DEBUNKING 5045 02:56:53,001 --> 02:56:55,000 WHAT HAS JUST BEEN SAID ON THE 5046 02:56:55,001 --> 02:56:57,000 FLOOR 5047 02:56:57,001 --> 02:57:00,000 OTHER SIDE OF THE AISLE, LAYING 5048 02:57:00,001 --> 02:57:02,000 T THE FACTS OF WHAT IS AND IS 5049 02:57:02,001 --> 02:57:05,000 NOT HAPPENING WITH MEDICARE ADVANTAGE. 5050 02:57:05,001 --> 02:57:07,000 AND I'D LIKE TO BUILD ON THAT AS 5051 02:57:07,001 --> 02:57:08,000 WELL. 5052 02:57:08,001 --> 02:57:11,000 I WOULD ENCOURAGE ANYONE WHO IS 5053 02:57:11,001 --> 02:57:12,000 INTERESTED TO GO TO THE WEB SITE 5054 02:57:12,001 --> 02:57:15,000 OF AARP. 5055 02:57:15,001 --> 02:57:17,000 ONE OF THE ORGANIZATIONS WE KNOW 5056 02:57:17,001 --> 02:57:20,000 TAKE A LOOK AT WHAT THEY SAY 5057 02:57:20,001 --> 02:57:22,000 ABOUT T MYTH THAT HETH CARE 5058 02:57:22,001 --> 02:57:24,000 REFORM WILL HURT 5059 02:57:24,001 --> 02:57:26,000 AND THEY LAY OUT SEVERAL THINGS. 5060 02:57:26,001 --> 02:57:27,000 ONE IS "NONE OF THE HEALTH CARE 5061 02:57:27,001 --> 02:57:28,000 REFORM PROPOSALS BEING 5062 02:57:28,001 --> 02:57:30,000 CONSIDERED BY CONGRESS WOULD CUT 5063 02:57:30,001 --> 02:57:33,000 MEDICARE BENEFITS OR INCREASE 5064 02:57:33,001 --> 02:57:34,000 YOUR OUT-OF-POCKET COSTS FOR 5065 02:57:34,001 --> 02:57:37,000 MEDICARE SERVICES." 5066 02:57:37,001 --> 02:57:38,000 AND THEN JUST THIS 5067 02:57:38,001 --> 02:57:42,000 SUPPORTING OUR 5068 02:57:42,001 --> 02:57:44,000 PUT OUT A STATEMENT THAT -- A 5069 02:57:44,001 --> 02:57:48,000 LETTER THAT AT THE END, AGAIN, 5070 02:57:48,001 --> 02:57:49,000 THEY REITERATED, "MOST 5071 02:57:49,001 --> 02:57:51,000 IMPORTANTLY, THE LEGISLATION 5072 02:57:51,001 --> 02:57:53,000 DOES NOT REDUCE ANY GUARANTEED 5073 02:57:53,001 --> 02:57:55,000 MEDICARE BENEFITS." 5074 02:57:55,001 --> 02:57:56,000 I FIND IT INTERESTING, 5075 02:57:56,001 --> 02:57:59,000 MR. PRESIDENT, THAT OUR 5076 02:57:59,001 --> 02:58:00,000 COLLEAGUES WHO A FEW YEARS AGO 5077 02:58:00,001 --> 02:58:03,000 QUOTED AARP ALL THE TIME WHEN WE 5078 02:58:03,001 --> 02:58:05,000 WERE DEBATING THE MEDICARE 5079 02:58:05,001 --> 02:58:06,000 PRESCRIPTION DRUG BILL. 5080 02:58:06,001 --> 02:58:09,000 I WOULD GUESS THAT EVERY SINGLE 5081 02:58:09,001 --> 02:58:12,000 ONE OF OUR REPUBLICAN COLLEAGUES 5082 02:58:12,001 --> 02:58:13,000 USED THEIR SUPPORT IN PUTTING 5083 02:58:13,001 --> 02:58:15,000 FORWARD THEIR BILL. 5084 02:58:15,001 --> 02:58:19,000 NOW THEY ARE TRYING TO 5085 02:58:19,001 --> 02:58:21,000 DISPARAGE, WHICH I 5086 02:58:21,001 --> 02:58:22,000 WHICH IS A VERY CRICIAL 5087 02:58:22,001 --> 02:58:23,000 ORGANIZATION BECAUSE THEY DON'T 5088 02:58:23,001 --> 02:58:25,000 A-- CREDIBLE ORGANIZATION 5089 02:58:25,001 --> 02:58:26,000 BECAUSE THEY DON'T AGREE WHAT 5090 02:58:26,001 --> 02:58:28,000 ARE AARP IS SAYING. 5091 02:58:28,001 --> 02:58:30,000 BUT THE MILLIONS OF PEOPLE THAT 5092 02:58:30,001 --> 02:58:31,000 BELONG TO AARP WILL BE THROICHG 5093 02:58:31,001 --> 02:58:32,000 WHAT THEY ARE SAYING -- 5094 02:58:32,001 --> 02:58:33,000 LISTENING TO WHAT THEY ARE 5095 02:58:33,001 --> 02:58:35,000 SAYING BECAUSE WE ARE NOT, IN 5096 02:58:35,001 --> 02:58:36,000 FACT, CUTTING THE GUARANTEED MEDICARE BENEFITS. 5097 02:58:36,001 --> 02:58:38,000 AND IN ADDITION TO THAT, WE HAVE 5098 02:58:38,001 --> 02:58:39,000 THE ALLIANCE FOR 5099 02:58:39,001 --> 02:58:40,000 AMERICANS, THE NATIONAL 5100 02:58:40,001 --> 02:58:42,000 COMMITTEE T PRESERVE SOCIAL 5101 02:58:42,001 --> 02:58:44,000 SECURITY AND MEDICARE ALL SAYING 5102 02:58:44,001 --> 02:58:48,000 THAT THEY SUPPORT WHAT WE ARE 5103 02:58:48,001 --> 02:58:50,000 DOING AND THAT THEY HAVE 5104 02:58:50,001 --> 02:58:52,000 DEBUNKED THE REPUBLICAN SCARE 5105 02:58:52,001 --> 02:58:54,000 TACTICS POINT BY POINT. 5106 02:58:54,001 --> 02:58:57,000 SO WHAT IS REALLY HAPPENING HERE, MR. PRESIDENT? 5107 02:58:57,001 --> 02:58:59,000 THE REALITY IS THAT COLLEAGUES 5108 02:58:59,001 --> 02:59:02,000 ON THE OTHER SIDE OF THE AISLE, 5109 02:59:02,001 --> 02:59:04,000 SINCE THE INCEPTION OF MEDICARE, 5110 02:59:04,001 --> 02:59:05,000 HAVE BEEN FIGHTING EVEN THE 5111 02:59:05,001 --> 02:59:07,000 EXISTENCE OF MEDICARE. 5112 02:59:07,001 --> 02:59:11,000 IT WAS DEMOCRATS AND A 5113 02:59:11,001 --> 02:59:13,000 DEMOCRATIC PRESIDENT IN 1965 OR 5114 02:59:13,001 --> 02:59:16,000 19 -- 1965 THAT PASSED MEDICARE 5115 02:59:16,001 --> 02:59:19,000 OVER THE OBJECTIONS, THE SAME 5116 02:59:19,001 --> 02:59:22,000 ARGUMENTS WE'RE HEARING TODAY WE HEARD THEN. 5117 02:59:22,001 --> 02:59:23,000 NOW EVERYONE SEES THAT 5118 02:59:23,001 --> 02:59:24,000 MEDICARE'S A GREAT AMERICAN 5119 02:59:24,001 --> 02:59:28,000 SUCCESS STORY. 5120 02:59:28,001 --> 02:59:29,000 BUT WE HAVE SEEN SO MANY EFFORTS 5121 02:59:29,001 --> 02:59:30,000 EFFORTS. 5122 02:59:30,001 --> 02:59:32,000 IN THE 1990'S, WHEN I WAS A 5123 02:59:32,001 --> 02:59:35,000 MEMBER OF THE HOUSE, SPEAKER GINGRICH INSIDE HIS "CONTRACT 5124 02:59:35,001 --> 02:59:38,000 WITH AMERICA" IN 1994 THAT THEY 5125 02:59:38,001 --> 02:59:40,000 WANTED TO COME IN, THEY WANTED 5126 02:59:40,001 --> 02:59:41,000 TO -- TO CHANGE MEDICARE, THEY 5127 02:59:41,001 --> 02:59:44,000 COULDN'T DIRECTLY DO IT SO THEY 5128 02:59:44,001 --> 02:59:45,000 WOULD DO IT THROUGH THE BACK 5129 02:59:45,001 --> 02:59:46,000 DOOR AND LET IT WITHER ON THE 5130 02:59:46,001 --> 02:59:49,000 VINE, THOSE FAMOUS WORDS THAT WE 5131 02:59:49,001 --> 02:59:50,000 HEARD AT THAT TIME, IN TERMS OF 5132 02:59:50,001 --> 02:59:52,000 TRYING TO PRIVATIZE MEDICARE, 5133 02:59:52,001 --> 02:59:58,000 WHICH IS WHAT I BELIEVE MEDICARE 5134 02:59:58,001 --> 03:00:01,000 ADVANTAGE REALLY RECENTLY IN THE DEBATE ON THE 5135 03:00:01,001 --> 03:00:03,000 HOUSE OF 5136 03:00:03,001 --> 03:00:05,000 80% OF THE HOUSE REPUBLICANS 5137 03:00:05,001 --> 03:00:06,000 SUPPORT AN EFFORT TO DO AWAY 5138 03:00:06,001 --> 03:00:08,000 WITH MEDICARE AT ALL AS WE KNOW 5139 03:00:08,001 --> 03:00:11,000 IT AS A GUARANTEED BENEFIT. 5140 03:00:11,001 --> 03:00:13,000 AND, INSTEAD, GIVE VOUCHERS TO 5141 03:00:13,001 --> 03:00:14,000 SENIORS TO GO BUY FROM PRIVATE 5142 03:00:14,001 --> 03:00:16,000 FOR-PROFIT INSURANCE COMPANIES. 5143 03:00:16,001 --> 03:00:17,000 SO WE KNOW WHAT THE REALITY OF 5144 03:00:17,001 --> 03:00:21,000 THIS IS. 5145 03:00:21,001 --> 03:00:22,000 THIS IS ABOUT THE FOR-PROFIT 5146 03:00:22,001 --> 03:00:26,000 INSURANCE INDUSTRY THAT RIGHT 5147 03:00:26,001 --> 03:00:28,000 NOW IS 5148 03:00:28,001 --> 03:00:30,000 EVERY -- WHETHER IT'S 5149 03:00:30,001 --> 03:00:34,000 CONGRESSIONAL BUDGET OFFICE, 5150 03:00:34,001 --> 03:00:37,000 WHETHER IT'S MEDPAC, ANY 5151 03:00:37,001 --> 03:00:38,000 ANALYSIS WILL SAY THAT THEY ARE 5152 03:00:38,001 --> 03:00:40,000 RECEIVING OVERPAYMENTS RIGHT NOW 5153 03:00:40,001 --> 03:00:41,000 AND WE ARE TRYING TO RATCHET THAT BACK. 5154 03:00:41,001 --> 03:00:43,000 AND WHAT IS HAPPENING? 5155 03:00:43,001 --> 03:00:45,000 WHY SHOULD FOLKS CARE? 5156 03:00:45,001 --> 03:00:48,000 OF COURSE, 5157 03:00:48,001 --> 03:00:52,000 OVERPAYMENTS MUCH BUT WE HAVE 5158 03:00:52,001 --> 03:00:54,000 ABOUT MAYBE 15% OR SO, 15% TO 5159 03:00:54,001 --> 03:00:56,000 20% OF SENIORS RIGHT NOW THAT 5160 03:00:56,001 --> 03:00:58,000 ARE IN THE MEDICARE ADVANTAGE 5161 03:00:58,001 --> 03:01:01,000 PROGRAM, AND WE'VE BEEN TOLD BY 5162 03:01:01,001 --> 03:01:03,000 THE BUDGET OFFICE THAT THE 80% 5163 03:01:03,001 --> 03:01:06,000 TO 85% THAT HAVE NOT, HAVE SEEN 5164 03:01:06,001 --> 03:01:07,000 THEIR PREMIUMS GO UP TO PAY FOR 5165 03:01:07,001 --> 03:01:09,000 OVERPAYMENTS TO FOR-PROFIT 5166 03:01:09,001 --> 03:01:11,000 INSURANCE COMPANIES. 5167 03:01:11,001 --> 03:01:13,000 THAT'S NOT FAIR, MR. PRESIDENT. 5168 03:01:13,001 --> 03:01:15,000 THAT IS NOT FAIR THAT THE VAST 5169 03:01:15,001 --> 03:01:17,000 MAJORITY OF SENIORS AND PEOPLE 5170 03:01:17,001 --> 03:01:19,000 WITH DISABILITIES WOULD SEE 5171 03:01:19,001 --> 03:01:24,000 THEIR PREMIUMS GO UP UNDER 5172 03:01:24,001 --> 03:01:26,000 MEDICARE TO PAY FOR FOR-PROFIT 5173 03:01:26,001 --> 03:01:27,000 INSURANCE COMPANIES TO GET A 5174 03:01:27,001 --> 03:01:28,000 PIECE OF THE ACTION UNDER 5175 03:01:28,001 --> 03:01:32,000 MEDICARE. 5176 03:01:32,001 --> 03:01:34,000 SECONDLY, WE KNOW THAT THE 5177 03:01:34,001 --> 03:01:36,000 MEDICARE ADVANTAGE PROGRAM, AS 5178 03:01:36,001 --> 03:01:38,000 THE CHAIRMAN HAS SAID IN READING 5179 03:01:38,001 --> 03:01:40,000 THE REPORT,AS ACTUALL 5180 03:01:40,001 --> 03:01:41,000 THE SOLVENCY OF THE MEDICARE 5181 03:01:41,001 --> 03:01:44,000 TRUST FUND WORSE. 5182 03:01:44,001 --> 03:01:47,000 IT'S GOING TO RUN OUT OF MONEY 5183 03:01:47,001 --> 03:01:48,000 SOONER IF WE DON'T STOP THESE OVERPAYMENTS. 5184 03:01:48,001 --> 03:01:50,000 OUR LEGISLATION, RATHER THAN 5185 03:01:50,001 --> 03:01:52,000 HAVING IT RUN OUT OF MONEY 18 5186 03:01:52,001 --> 03:01:54,000 MONTHS EARLIER, WILL INCREASE 5187 03:01:54,001 --> 03:01:56,000 THE SOLVENCY BY FIVE YEARS. 5188 03:01:56,001 --> 03:01:58,000 AND WE ARE COMMITTED TO INCREASE 5189 03:01:58,001 --> 03:02:01,000 AND CONTINUING THE SOLVENCY OF 5190 03:02:01,001 --> 03:02:02,000 THE TRUST FUND AND PROTECTING 5191 03:02:02,001 --> 03:02:06,000 MEDICARE FOR THE FUTURE BECAUSE 5192 03:02:06,001 --> 03:02:08,000 WE DO BELIEVE IT IS A GREAT 5193 03:02:08,001 --> 03:02:10,000 AMERICAN SUCCESS STORY. 5194 03:02:10,001 --> 03:02:11,000 AND WE'RE QUITE PROUD THAT 5195 03:02:11,001 --> 03:02:13,000 DEMOCRATS CREATED MEDICARE 5196 03:02:13,001 --> 03:02:15,000 A DEMOCRATIC PRESIDENT. 5197 03:02:15,001 --> 03:02:16,000 AND WE'RE PROUD THAT IT'S 5198 03:02:16,001 --> 03:02:18,000 DEMOCRATS NOW COMING FORWARD TO 5199 03:02:18,001 --> 03:02:19,000 MAKE SURE THAT WE PROTECT 5200 03:02:19,001 --> 03:02:21,000 MEDICARE FOR THE FUTURE. 5201 03:02:21,001 --> 03:02:24,000 SO WHAT IS REALLY HAPPENING HERE 5202 03:02:24,001 --> 03:02:28,000 IS THAT WE ARE SEEING A VARIETY 5203 03:02:28,001 --> 03:02:29,000 OF STALLING TACTICS, A 5204 03:02:29,001 --> 03:02:32,000 OF EFFORTS ON THE OTHER SIDE, 5205 03:02:32,001 --> 03:02:34,000 NOT ONLY TO STOP US FROM MOVING 5206 03:02:34,001 --> 03:02:36,000 FORWARD ON HEALTH INSURANCE 5207 03:02:36,001 --> 03:02:39,000 REFORM, BUT EFFORTS TIME AND 5208 03:02:39,001 --> 03:02:40,000 TIME AGAIN TO PROTECT THE 5209 03:02:40,001 --> 03:02:42,000 FOR-PROFIT INSURANCE COMPANIES. 5210 03:02:42,001 --> 03:02:44,000 AND SO FOR THE RECORD, MR. 5211 03:02:44,001 --> 03:02:47,000 PRESIDENT, I JUST WANT TO READ 5212 03:02:47,001 --> 03:02:49,000 TO YOU THAT THE LIST OF MEDICARE 5213 03:02:49,001 --> 03:02:52,000 BENEFITS THAT EVERYONE RECEIVES 5214 03:02:52,001 --> 03:02:53,000 NOW AND THE BENEFITS THAT WILL 5215 03:02:53,001 --> 03:02:55,000 CONTINUE REGARDLESS OF THIS. 5216 03:02:55,001 --> 03:02:57,000 REGARDLESS OF WHETHER WE CUT 5217 03:02:57,001 --> 03:03:00,000 BACK ON SOME OF THE PROFITS OF 5218 03:03:00,001 --> 03:03:02,000 THE FOR-PROFIT INSURANCE 5219 03:03:02,001 --> 03:03:03,000 COMPANIES. 5220 03:03:03,001 --> 03:03:05,000 IN-PATIENT HOSPITAL CARE AND 5221 03:03:05,001 --> 03:03:07,000 NURSES, DOCTORS' OFFICES, LAB 5222 03:03:07,001 --> 03:03:10,000 TESTS, PREVENTE SCREENING, 5223 03:03:10,001 --> 03:03:13,000 SCHOOL NURSING, HOSPICE CARE, 5224 03:03:13,001 --> 03:03:14,000 HOME HEAH, DURABLE MEDICAL 5225 03:03:14,001 --> 03:03:16,000 EQUIPMENT, EMERGENCY ROOM, 5226 03:03:16,001 --> 03:03:20,000 KIDNEY ANALYSI OUT-PATIENT 5227 03:03:20,001 --> 03:03:23,000 MENTAL HEALTH, PHYSICAL THERAPY, 5228 03:03:23,001 --> 03:03:26,000 IMAGING, X-RAYS, AND SO ON, 5229 03:03:26,001 --> 03:03:27,000 ORGAN TRANSPLANTS AND WELCOME TO 5230 03:03:27,001 --> 03:03:28,000 MEDICARE PHYSICAL. 5231 03:03:28,001 --> 03:03:30,000 THEY'RE COVERED NOW AND THEY 5232 03:03:30,001 --> 03:03:31,000 WILL BE COVERED UNDER THIS 5233 03:03:31,001 --> 03:03:32,000 LEGISLATION MUCH THE DIFFERENCE 5234 03:03:32,001 --> 03:03:34,000 IS WE WILL TAKE THE OVERPAYMENTS 5235 03:03:34,001 --> 03:03:35,000 TO THE FOR-PROFIT INSURANCE 5236 03:03:35,001 --> 03:03:39,000 COMPANIES AND PUT IT BACK INTO 5237 03:03:39,001 --> 03:03:40,000 MEDICARE TO REDUCE THE COST FOR 5238 03:03:40,001 --> 03:03:43,000 PRESCRIPTION DRUGS, WHAT'S NOW 5239 03:03:43,001 --> 03:03:45,000 BECOME THE INFAMS DOUGHNUT 5240 03:03:45,001 --> 03:03:46,000 HOLE, THE GAP IN COVERAGE. 5241 03:03:46,001 --> 03:03:48,000 WE'RE GOING TO BEGIN TO CLOSE 5242 03:03:48,001 --> 03:03:50,000 THAT BY TAKING THE EXCESS 5243 03:03:50,001 --> 03:03:52,000 PROFITS OF THE FOR-PROFIT 5244 03:03:52,001 --> 03:03:54,000 COMPANIES, PUTTING IT BACK INTO MEDICARE. 5245 03:03:54,001 --> 03:03:56,000 WE'RE GOING TO REDUCE THE 5246 03:03:56,001 --> 03:04:00,000 PREMIUMS THAT SENIORS PAY FOR 5247 03:04:00,001 --> 03:04:02,000 DRUGS AND MEDICAL CARE, 5248 03:04:02,001 --> 03:04:04,000 ELIMINATE CO-PAYS SO THAT PEOPLE 5249 03:04:04,001 --> 03:04:06,000 CAN GET PREVENTIVE CARE WITHOUT 5250 03:04:06,001 --> 03:04:07,000 A FEE AND WE'RE GOING TO 5251 03:04:07,001 --> 03:04:09,000 STRENGTHEN MEDICARE FOR THE FUTURE. 5252 03:04:09,001 --> 03:04:12,000 MR. PRESIDENT, I WOULD JUST 5253 03:04:12,001 --> 03:04:14,000 WRAP-UP BY 5254 03:04:14,001 --> 03:04:16,000 LEGISLATION IN TOTAL IS ABOUT SAVING LIVES. 5255 03:04:16,001 --> 03:04:19,000 IT'S ABOUT SAVING MONEY. 5256 03:04:19,001 --> 03:04:23,000 IT'S ABOUT SAVING MEDICARE. 5257 03:04:23,001 --> 03:04:24,000 WE ADMIT OUR GOAL IS NOT TO SAVE 5258 03:04:24,001 --> 03:04:26,000 THE PROFITS OF FORROFIT 5259 03:04:26,001 --> 03:04:28,000 INSURANCE COMPANIES. 5260 03:04:28,001 --> 03:04:32,000 WE'RE GUILTY OF THAT. 5261 03:04:32,001 --> 03:04:36,000 WE ARE FOCUSED ON MAKING SURE 5262 03:04:36,001 --> 03:04:39,000 MEDICARE IS STRONG, VIBRANT, 5263 03:04:39,001 --> 03:04:41,000 SOLVENT FOR THE FUTURE, FOR OUR 5264 03:04:41,001 --> 03:04:43,000 FUTURE GENERATIONS AS WELL AS 5265 03:04:43,001 --> 03:04:44,000 OUR SENIORS TODAY. 5266 03:04:44,001 --> 03:04:47,000 AND, BY THE WAY, WE'RE GOING TO 5267 03:04:47,001 --> 03:04:48,000 MAKE SURE THAT WE ARE SAVING 5268 03:04:48,001 --> 03:04:49,000 LIVES AND SAVING MONEY IN THE 5269 03:04:49,001 --> 03:04:53,000 PROCESS. 5270 03:04:53,001 --> 03:04:57,000 SO I WOULD STRONGLY URGE US TO 5271 03:04:57,001 --> 03:04:59,000 OPPOSE ANY EFFORT THAT IS PUT 5272 03:04:59,001 --> 03:05:01,000 FORWARD THAT WOULD BE DONE IN 5273 03:05:01,001 --> 03:05:04,000 THE INTEREST OF THE INSURANCE 5274 03:05:04,001 --> 03:05:06,000 INDUSTRY AT THE EXPENSE OF 5275 03:05:06,001 --> 03:05:08,000 SENIORS IN AMERICA. 5276 03:05:08,001 --> 03:05:09,000 THAT'S WHAT THESE EFFORTS TO 5277 03:05:09,001 --> 03:05:10,000 RECOMMIT -- TO COMMIT ARE ALL 5278 03:05:10,001 --> 03:05:12,000 ABOUT. 5279 03:05:12,001 --> 03:05:13,000 AND I HOPE THAT WE WILL 5280 03:05:13,001 --> 03:05:16,000 THEM. 5281 03:05:16,001 --> 03:05:17,000 THANK 5282 03:05:17,001 --> 03:05:19,000 MR. DODD: MR. PRESIDENT? THE PRESIDINOFFICER: THE 5283 03:05:19,001 --> 03:05:23,000 SENATOR FROM CONNECTICUT IS 5284 03:05:23,001 --> 03:05:24,000 COGNIZED. 5285 03:05:24,001 --> 03:05:25,000 COLLEAGUE FROM MICHIGAN WHO IS A 5286 03:05:25,001 --> 03:05:29,000 MEMBER OF THE FINANCE COMMITTEE 5287 03:05:29,001 --> 03:05:31,000 AND STALWART DEFENDER OF THE 5288 03:05:31,001 --> 03:05:33,000 MEDICARE PROGRAM AND THE ELDERLY 5289 03:05:33,001 --> 03:05:34,000 NOT ONLY IN HER STATE, BUT 5290 03:05:34,001 --> 03:05:37,000 AROUND THE COUNTRY. 5291 03:05:37,001 --> 03:05:40,000 SHE HAS OFFERED COMING ENTER AND 5292 03:05:40,001 --> 03:05:42,000 WORTH -- COGENT AND WORTHWHILE 5293 03:05:42,001 --> 03:05:45,000 INFORMATION ON THIS SUBJECT MATTER. 5294 03:05:45,001 --> 03:05:46,000 WE KEEP GOING AROUND AND AROUND 5295 03:05:46,001 --> 03:05:48,000 AND AROUND IN THIS DEBATE. 5296 03:05:48,001 --> 03:05:49,000 AND IT'S A LITTLE BIT 5297 03:05:49,001 --> 03:05:51,000 FRUSTRATING BECAUSE WE'RE 5298 03:05:51,001 --> 03:05:54,000 TALKING ABOUT 5299 03:05:54,001 --> 03:05:56,000 OR NOT WE'RE GOING TO LIMIT TO 5300 03:05:56,001 --> 03:05:58,000 PRIVATE INSURANCE COMPANIES THAT 5301 03:05:58,001 --> 03:06:01,000 ARE UNDER THE RULE OF SOMETHING 5302 03:06:01,001 --> 03:06:02,000 CALLED MEDICARE ADVANTAGE. 5303 03:06:02,001 --> 03:06:05,000 AGAIN, THESE ARE PRIVATE 5304 03:06:05,001 --> 03:06:07,000 COMPANIES THAT ARE RECEIVING 5305 03:06:07,001 --> 03:06:09,000 SUBSIDIES SUPPORTED BY MEDICARE 5306 03:06:09,001 --> 03:06:11,000 BENEFICIARIES AND THE TAXPAYE 5307 03:06:11,001 --> 03:06:14,000 OF THIS COUNTRY. 5308 03:06:14,001 --> 03:06:15,000 AND WE'RE TALKING ABOUT 5309 03:06:15,001 --> 03:06:17,000 ELIMINATING MEDICARE 5310 03:06:17,001 --> 03:06:19,000 BUT RATHER RESTRAINING. 5311 03:06:19,001 --> 03:06:21,000 WE HAD A GREAT CHART UP HERE A 5312 03:06:21,001 --> 03:06:22,000 FEW MINUTES AGO 5313 03:06:22,001 --> 03:06:23,000 BAUCUS HAD. 5314 03:06:23,001 --> 03:06:27,000 I'LL GET IT UP HERE IN A PEW 5315 03:06:27,001 --> 03:06:34,000 MINUTES MUCH IT -- IF -- IN A FEW MINUTES. 5316 03:06:34,001 --> 03:06:36,000 WE'RE NOT ELIMINATING 5317 03:06:36,001 --> 03:06:38,000 WE'RE WHERE BASED ON PERFORMANCE 5318 03:06:38,001 --> 03:06:39,000 AN QUALITY, WE GIVE 5319 03:06:39,001 --> 03:06:41,000 MEDICARE ADVANTAGE. 5320 03:06:41,001 --> 03:06:44,000 SO CONTRARY TO THE ARGUMENT 5321 03:06:44,001 --> 03:06:46,000 YOU'VE HEARD BY THOSE WHO ARE 5322 03:06:46,001 --> 03:06:47,000 HERALDING MEDICARE ADVANTAGE, 5323 03:06:47,001 --> 03:06:52,000 DESPITE THE FACT THAT THE VERY 5324 03:06:52,001 --> 03:06:55,000 COMPANIES WHO ARGUED FOR 5325 03:06:55,001 --> 03:06:57,000 TO BEGIN WITH PROMISED TO REDUCE 5326 03:06:57,001 --> 03:06:59,000 COSTS, BE RE EFFICIENT, IN 5327 03:06:59,001 --> 03:07:00,000 FACT, TODAY, IT'S OPPOSITE. 5328 03:07:00,001 --> 03:07:02,000 YOU'RE LOOKING AT A SITUATION 5329 03:07:02,001 --> 03:07:05,000 WHERE YOU HAVE PEOPLE ACTUALLY 5330 03:07:05,001 --> 03:07:07,000 PAYING 5331 03:07:07,001 --> 03:07:09,000 THE GOVERNMENT PAYS THESE 5332 03:07:09,001 --> 03:07:11,000 MEDICARE ADVANTAGE INSURANCE 5333 03:07:11,001 --> 03:07:12,000 COMP 5334 03:07:12,001 --> 03:07:14,000 THINGS FOR SENIORS THAT MEDICARE 5335 03:07:14,001 --> 03:07:16,000 DOES FOR $1. 5336 03:07:16,001 --> 03:07:17,000 THAT'S BASICALLY ON AVERAGE WHAT 5337 03:07:17,001 --> 03:07:19,000 IT AMOUNTS TO. 5338 03:07:19,001 --> 03:07:20,000 THE QUESTION IS: CAN WE REDUCE 5339 03:07:20,001 --> 03:07:22,000 THE COST OF THESE OVERPAYMENTS 5340 03:07:22,001 --> 03:07:24,000 WHICH ARE BASICALLY ENDING UP 5341 03:07:24,001 --> 03:07:25,000 THE POCKETS OF THE PEOPLE 5342 03:07:25,001 --> 03:07:27,000 LOOKING FOR THE PROFIT. 5343 03:07:27,001 --> 03:07:29,000 THERE'S NOTHING WRONG WITH 5344 03:07:29,001 --> 03:07:31,000 PROFITS AT ALL IN THESE PRIVATE COMPANIES. 5345 03:07:31,001 --> 03:07:33,000 BUT LET'S DECLARE THEM WHAT THEY ARE. 5346 03:07:33,001 --> 03:07:36,000 THIS IS NOT TRADITIONAL MEDICARE. 5347 03:07:36,001 --> 03:07:39,000 THESE ARE PRIVATE COMPANIES THAT 5348 03:07:39,001 --> 03:07:41,000 ARE ANXIOUS NOT ONLY, I 5349 03:07:41,001 --> 03:07:42,000 TO PROVIDE BENEFITS TO THEIR 5350 03:07:42,001 --> 03:07:45,000 BENEFICIARIES, BUT ARE ALSO 5351 03:07:45,001 --> 03:07:46,000 LOOKING TO 5352 03:07:46,001 --> 03:07:48,000 THERE'S NOTHING WRONG ABOUT THAT. 5353 03:07:48,001 --> 03:07:49,000 BUT SINCE THE PREMIUMS WERE SET 5354 03:07:49,001 --> 03:07:51,000 BY STATUTE, AS THEY HAVE BEEN IN 5355 03:07:51,001 --> 03:07:53,000 THIS AREA, AND BASICALLY WE HAVE 5356 03:07:53,001 --> 03:07:55,000 AN OBLIGATION TO TRY KEEP OUR 5357 03:07:55,001 --> 03:07:57,000 COSTS DOWN, WE'RE TRYING TO DO 5358 03:07:57,001 --> 03:07:59,000 SO BECAUSE THE PROMISES 5359 03:07:59,001 --> 03:08:01,000 INITIALLY MADE HAVE NOT BEEN KEPT. 5360 03:08:01,001 --> 03:08:03,000 IN FACT, T COSTS ARE VASTLY 5361 03:08:03,001 --> 03:08:04,000 EXCEEDING THE PROMISES THAT WERE MADE. 5362 03:08:04,001 --> 03:08:06,000 THE AMENDMENT THAT WE'RE GOING 5363 03:08:06,001 --> 03:08:07,000 TO BE HEARING ABOUT FROM OUR 5364 03:08:07,001 --> 03:08:13,000 FR 5365 03:08:13,001 --> 03:08:15,000 COMPILATION, MR. PRESIDENT, OF 5366 03:08:15,001 --> 03:08:18,000 SOME OF THE GREATEST HITS WE'VE 5367 03:08:18,001 --> 03:08:20,000 HEARD, STALLING WITH, OF COURSE, 5368 03:08:20,001 --> 03:08:21,000 ARCANE OBSTRUCTION PRACTICES, 5369 03:08:21,001 --> 03:08:24,000 STANDING UP FOR THE PRIVATE 5370 03:08:24,001 --> 03:08:25,000 COMPANIES HERE, AT OUR 5371 03:08:25,001 --> 03:08:27,000 I HAVE NO TROUBLE WITHSTANDING 5372 03:08:27,001 --> 03:08:30,000 UP FOR PRIVATE COMPANIES THAT DO A GOOD JOB 5373 03:08:30,001 --> 03:08:32,000 WHEN YOU DO SO 5374 03:08:32,001 --> 03:08:33,000 SCARING SENIORS WITH BASELESS 5375 03:08:33,001 --> 03:08:36,000 CLAIMS, THEN I DO OBJECT. 5376 03:08:36,001 --> 03:08:38,000 AND THAT'S WHAT'S GOING ON HERE. 5377 03:08:38,001 --> 03:08:41,000 QUITE FRANKLY TODAY, OVER 80% OF 5378 03:08:41,001 --> 03:08:43,000 OUR ELDERLY ARE PAYING $90 A 5379 03:08:43,001 --> 03:08:45,000 YEAR IN ADDITIONAL PREMIUM COSTS 5380 03:08:45,001 --> 03:08:47,000 WITHOUT GETTING ANY BENEFIT FROM 5381 03:08:47,001 --> 03:08:53,000 IT WHATSOEVER TO PROVIDE 5382 03:08:53,001 --> 03:08:55,000 BENEFITS UNDER T PROGRAM. 5383 03:08:55,001 --> 03:08:57,000 THAT'S NOT EQUITABLE. 5384 03:08:57,001 --> 03:08:59,000 THE 80% OF OUR ELDERLY NEED TO 5385 03:08:59,001 --> 03:09:00,000 KNOW IN ALL OF THIS THAT YOU'RE 5386 03:09:00,001 --> 03:09:03,000 BEING DISADVANTAGED BY 5387 03:09:03,001 --> 03:09:05,000 WHAT THE FINANCE COMMITTEE IS 5388 03:09:05,001 --> 03:09:07,000 TRYING TO 5389 03:09:07,001 --> 03:09:09,000 LEADERSHIP OF MAX BAUCUS, IS 5390 03:09:09,001 --> 03:09:11,000 TRYING TO BRING EQUITY BACK. 5391 03:09:11,001 --> 03:09:12,000 NOTHING IN THIS BILL DOES AWAY 5392 03:09:12,001 --> 03:09:14,000 WITH MEDICARE ADVANTAGE. 5393 03:09:14,001 --> 03:09:16,000 NOTHING. 5394 03:09:16,001 --> 03:09:19,000 IT BACK TO A SENSE OF REALITY 5395 03:09:19,001 --> 03:09:20,000 AND NOT, AGAIN, DISADVANTAGE -- 5396 03:09:20,001 --> 03:09:22,000 TALK ABOUT ADVANTAGE -- 5397 03:09:22,001 --> 03:09:24,000 DISADVANTAGE 80% OF OUR SENIORS. 5398 03:09:24,001 --> 03:09:25,000 RIGHT NOW IT'S MEDICARE 5399 03:09:25,001 --> 03:09:26,000 DISADVANTAGE IT OUGHT 5400 03:09:26,001 --> 03:09:27,000 CALLED BECAUSE THAT'S WHAT IT DOES. 5401 03:09:27,001 --> 03:09:30,000 IT DISADVANTAGES. 5402 03:09:30,001 --> 03:09:32,000 WHY SHOULD 8 5403 03:09:32,001 --> 03:09:33,000 THIS COUNTRY PAY HIGHER PREMIUMS 5404 03:09:33,001 --> 03:09:35,000 AND NO BENEFITS AT THE EXPENSE 5405 03:09:35,001 --> 03:09:38,000 OF THE 20% WHO ARE GOING TO GET 5406 03:09:38,001 --> 03:09:39,000 SOME ADVANTAGE OUT OF THIS. 5407 03:09:39,001 --> 03:09:42,000 GET VERY LITTLE ADVANTAGE. 5408 03:09:42,001 --> 03:09:43,000 WITH THE PROFITS. 5409 03:09:43,001 --> 03:09:45,000 I'LL TELL YOU WHY THAT HAPPENS 5410 03:09:45,001 --> 03:09:47,000 IN A MINUTE HERE. 5411 03:09:47,001 --> 03:09:50,000 JUST TO MAKE MY POINT, ACCORDING 5412 03:09:50,001 --> 03:09:52,000 TO THE OPPENHEIMER ANALYST CARL 5413 03:09:52,001 --> 03:09:55,000 McDONALD, IN A REPORT ISSUED 5414 03:09:55,001 --> 03:09:57,000 LESS THAN A MONTH AGO, BETWEEN 5415 03:09:57,001 --> 03:10:00,000 2006 AND 2009 -- THIS IS A 5416 03:10:00,001 --> 03:10:03,000 REPORT, NOW, FROM THEM, 5417 03:10:03,001 --> 03:10:05,000 OPPENHEIMER CAPITAL, WE 5418 03:10:05,001 --> 03:10:07,000 ESTIMATE, A 5419 03:10:07,001 --> 03:10:09,000 ADVANTAGE ACCOUNTED FOR 75% OF 5420 03:10:09,001 --> 03:10:11,000 THE INCREASE IN GROSS PROFITS 5421 03:10:11,001 --> 03:10:14,000 AMONG THE LARGER PLANS IN THE INDUSTRY. 5422 03:10:14,001 --> 03:10:18,000 HI LIGHTED BY AN -- A GROSS 5423 03:10:18,001 --> 03:10:20,000 PROFIT INCREASE OF $1.9 BILLION 5424 03:10:20,001 --> 03:10:22,000 IN 2009 RELATIVE TO COMMERCIAL 5425 03:10:22,001 --> 03:10:23,000 RISK EARNINGS WITH GAINS 5426 03:10:23,001 --> 03:10:24,000 OF $600 MILLION. 5427 03:10:24,001 --> 03:10:26,000 I KNOW THE CHAIRMAN OF THE 5428 03:10:26,001 --> 03:10:27,000 FINANCE COMMITTEE MADE THAT 5429 03:10:27,001 --> 03:10:28,000 POINT, BUT IT DESERVES TO BE 5430 03:10:28,001 --> 03:10:30,000 MADE OVER AGAIN. 5431 03:10:30,001 --> 03:10:31,000 35% OF THE INCREASE IN GROSS 5432 03:10:31,001 --> 03:10:32,000 PROFITS CAME IN THE MEDICARE 5433 03:10:32,001 --> 03:10:34,000 ADVANTAGE PLAN. 5434 03:10:34,001 --> 03:10:35,000 THESE PROFITS COME OUT OF THE 5435 03:10:35,001 --> 03:10:37,000 POCKET OF 5436 03:10:37,001 --> 03:10:39,000 BECAUSE OF OUR 5437 03:10:39,001 --> 03:10:40,000 OFURS, THE MEDICARE 5438 03:10:40,001 --> 03:10:43,000 BENEFICIARIES WHO ARE PAYING 5439 03:10:43,001 --> 03:10:44,000 THOSE EXTRA DOLLARS. 5440 03:10:44,001 --> 03:10:45,000 -- EVERY 5441 03:10:45,001 --> 03:10:47,000 YEAR WITHOUT RECEIVING ANY OF 5442 03:10:47,001 --> 03:10:50,000 THE BENEFITS AT ALL. 5443 03:10:50,001 --> 03:10:51,000 SO THE -- OUR BILL WILL 5444 03:10:51,001 --> 03:10:52,000 AND STRENGTHEN MEDICARE AND 5445 03:10:52,001 --> 03:10:54,000 EXTEND THE LIFE OF THE TRUST 5446 03:10:54,001 --> 03:10:55,000 FUND, AS YOU HEARD OVER AND OVER 5447 03:10:55,001 --> 03:10:57,000 AGAIN. 5448 03:10:57,001 --> 03:10:58,000 BUT IT DESERVES TO BE REPEATED. 5449 03:10:58,001 --> 03:10:59,000 THAT'S NOT A FACT TO DISPUTE. 5450 03:10:59,001 --> 03:11:00,000 THAT IS A FACT. 5451 03:11:00,001 --> 03:11:01,000 WE EXTEND 5452 03:11:01,001 --> 03:11:02,000 MEDICARE PROGRAM. 5453 03:11:02,001 --> 03:11:04,000 IT'S PART OF THE WAY OUR BILL 5454 03:11:04,001 --> 03:11:06,000 ADDS TO THE USE OF MEDICARE IS 5455 03:11:06,001 --> 03:11:07,000 BY ELIMINATING WASTEFUL 5456 03:11:07,001 --> 03:11:09,000 OVERPAYMENTS AND THAT'S WHAT THESE ARE. 5457 03:11:09,001 --> 03:11:10,000 THESE ARE 5458 03:11:10,001 --> 03:11:12,000 FAR BEYOND WHAT WAS ANTICIPATED 5459 03:11:12,001 --> 03:11:13,000 WHEN THE PROGRAM WAS WRITTEN. 5460 03:11:13,001 --> 03:11:15,000 AND, AS I MENTIONED A MOMENT 5461 03:11:15,001 --> 03:11:18,000 AGO, THE GOVERNMT PAYS 5462 03:11:18,001 --> 03:11:20,000 INSURANCE COMPANIES IN MEDICARE 5463 03:11:20,001 --> 03:11:22,000 ADVANTAGE PROGRAM, $1.14 TO DO 5464 03:11:22,001 --> 03:11:26,000 THE VERY SAME THING FOR SENIORS 5465 03:11:26,001 --> 03:11:28,000 THAT TRADITIONAL MEDICARE DOE 5466 03:11:28,001 --> 03:11:29,000 FOR $1. 5467 03:11:29,001 --> 03:11:30,000 SO THOSE ARE 5468 03:11:30,001 --> 03:11:32,000 WE'RE TRYING BRING BACK. 5469 03:11:32,001 --> 03:11:34,000 THERE'S NO EVIDENCE THAT THE WASTEFUL OVERPAYMENTS DO 5470 03:11:34,001 --> 03:11:35,000 ANYTHING TO IMPROVE THE CARE OF 5471 03:11:35,001 --> 03:11:38,000 OUR SENIORS. 5472 03:11:38,001 --> 03:11:39,000 AT THE SAME TIME THEY SPEED 5473 03:11:39,001 --> 03:11:41,000 MEDICARE'S DISSENT INTO 5474 03:11:41,001 --> 03:11:43,000 BANKRUPTCY AND RAISE PREMIUMS 5475 03:11:43,001 --> 03:11:45,000 FOR ALL MEDICARE BENEFICIARIES, 5476 03:11:45,001 --> 03:11:47,000 AS I MENTIONED. 5477 03:11:47,001 --> 03:11:49,000 OUR BILL WOULD END THAT WASTE, 5478 03:11:49,001 --> 03:11:51,000 USE THE MONEY THEY SAVE TO HELP 5479 03:11:51,001 --> 03:11:52,000 SENIORS PAY FOR PRESCRIPTION 5480 03:11:52,001 --> 03:11:54,000 DRUGS, BY CLOSING THE DOUGHNUT HOLE. 5481 03:11:54,001 --> 03:11:57,000 FOR THE SECOND TIME IN LESS THAN 5482 03:11:57,001 --> 03:12:02,000 A WEEK, OUR FRIENDS ON THE OTHER 5483 03:12:02,001 --> 03:12:03,000 SIDE ARE USING TACTICS 5484 03:12:03,001 --> 03:12:05,000 PROGRESS FOR -- THE PAYMENTS 5485 03:12:05,001 --> 03:12:07,000 THAT COM OUT OF THE HIDE OF OUR 5486 03:12:07,001 --> 03:12:08,000 TAXPAYERS AND ELDERLY. 5487 03:12:08,001 --> 03:12:10,000 THAT'S ALL THAT IT DOES. 5488 03:12:10,001 --> 03:12:13,000 IFOU LOOK AT THE CHART, IF 5489 03:12:13,001 --> 03:12:14,000 GO TO 2019, ALMOST 10 YEARS FROM 5490 03:12:14,001 --> 03:12:15,000 NOW, WHAT IS THE DIFFERENCE 5491 03:12:15,001 --> 03:12:17,000 BETWEEN WHAT OUR BILL DOES AND 5492 03:12:17,001 --> 03:12:19,000 WHAT THOSE WHO WANT NO CHANGE IN 5493 03:12:19,001 --> 03:12:21,000 THIS WHATSOEVER DO? 5494 03:12:21,001 --> 03:12:23,000 THE DIFFERENCE 5495 03:12:23,001 --> 03:12:28,000 WE ALLOW THIS IN THE POST-REFORM 5496 03:12:28,001 --> 03:12:30,000 PERIOD IN 2019 FOR $183 BILLION 5497 03:12:30,001 --> 03:12:32,000 GOING TO MEDICARE ADVANTAGE. 5498 03:12:32,001 --> 03:12:36,000 WHAT THE OPPOSITION WANTS IS TO 5499 03:12:36,001 --> 03:12:37,000 HOLD IT AT $204 BILLION IN 2019. 5500 03:12:37,001 --> 03:12:38,000 THAT'S $20 BILLION. 5501 03:12:38,001 --> 03:12:40,000 THAT'S A SAVINGS WE'RE LOOKING 5502 03:12:40,001 --> 03:12:41,000 FOR IN THAT YEAR. 5503 03:12:41,001 --> 03:12:43,000 -- IN ORDER TO REDUCE THE 5504 03:12:43,001 --> 03:12:45,000 OVERPAYMENTS AND, AGA 5505 03:12:45,001 --> 03:12:46,000 THOSE RESOURCES SO THAT OUR 5506 03:12:46,001 --> 03:12:47,000 ELDERLY CAN AFFORD PRESCRIPTION 5507 03:12:47,001 --> 03:12:48,000 DRUGS. 5508 03:12:48,001 --> 03:12:49,000 NOW, YOU WANT TO SIDE WITH THESE 5509 03:12:49,001 --> 03:12:51,000 COMPANIES, THEY'RE STILL GOING 5510 03:12:51,001 --> 03:12:53,000 TO MAKE A PROFIT, MR. PRESIDENT. 5511 03:12:53,001 --> 03:12:54,000 THIS IS NOT DEPRIVING THEM OF 5512 03:12:54,001 --> 03:12:55,000 THAT AT ALL. 5513 03:12:55,001 --> 03:12:58,000 IT'S BRINGING DOWN THE PROFIT 5514 03:12:58,001 --> 03:12:59,000 MARGINS TO FAR MORE REALISTIC 5515 03:12:59,001 --> 03:13:01,000 LEVELS AN ELIMINATING THE NEEDS 5516 03:13:01,001 --> 03:13:02,000 FOR THE 5517 03:13:02,001 --> 03:13:04,000 ABOUT OR AT LEAST REDUCE THE 5518 03:13:04,001 --> 03:13:07,000 WELL AS THE PAYMENTS BEING MADE 5519 03:13:07,001 --> 03:13:09,000 BY THE 5520 03:13:09,001 --> 03:13:10,000 NOTHING UNDER THIS PROGRAM AT ALL. 5521 03:13:10,001 --> 03:13:11,000 LET ME MAKE MY CASE TO YOU ON 5522 03:13:11,001 --> 03:13:15,000 THIS POINT. 5523 03:13:15,001 --> 03:13:17,000 AGAIN, 5524 03:13:17,001 --> 03:13:19,000 ENLISTED THE GUARANTEED BEN - 5525 03:13:19,001 --> 03:13:21,000 LISTED THE GUARANTEED BENEFITS, 5526 03:13:21,001 --> 03:13:22,000 AND I KNOW THE 5527 03:13:22,001 --> 03:13:23,000 WELL. 5528 03:13:23,001 --> 03:13:25,000 WE ADD BENEFITS. 5529 03:13:25,001 --> 03:13:27,000 IN ADDITION TO THE IN-PATIENT 5530 03:13:27,001 --> 03:13:30,000 HOSPITAL CARE AND DOCTORS' 5531 03:13:30,001 --> 03:13:31,000 OFFICE VISITS AND KIDNEY 5532 03:13:31,001 --> 03:13:34,000 DIALYSIS, EMERGENCY CARE, 5533 03:13:34,001 --> 03:13:35,000 OCCUPATIONAL THERAPY, ORGAN 5534 03:13:35,001 --> 03:13:36,000 TRANSPLANTS, ALL OF THESE 5535 03:13:36,001 --> 03:13:39,000 ISSUES, WE ALSO DO THINGS UNDER 5536 03:13:39,001 --> 03:13:41,000 OUR BILL THAT PRESENTLY AREN'T AVAILABLE. 5537 03:13:41,001 --> 03:13:43,000 ONE, WE ARE REDUCE THE SIZE OF 5538 03:13:43,001 --> 03:13:44,000 THE MEDICARE DOUGHNUT HOLE. 5539 03:13:44,001 --> 03:13:49,000 WHICH IS HUGE FOR PEOPLE. 5540 03:13:49,001 --> 03:13:51,000 WE REDUCE PREMIUMSOR SENIORS 5541 03:13:51,001 --> 03:13:53,000 TO PAY FOR DRUGS AND MEDICAL CARE. 5542 03:13:53,001 --> 03:13:56,000 THAT'S A HUGE BREAKTHROUGH. 5543 03:13:56,001 --> 03:13:58,000 WE ELIMINATE THE CO-PAYS. 5544 03:13:58,001 --> 03:14:00,000 ASK IF YOU WOULD LIKE TO 5545 03:14:00,001 --> 03:14:02,000 ELIMINATE CO-PAYS OR 5546 03:14:02,001 --> 03:14:03,000 PRIVATE COMPANIES MAKE AN 5547 03:14:03,001 --> 03:14:04,000 ADDITIONAL $20 BILLION IN 10 YEARS. 5548 03:14:04,001 --> 03:14:05,000 WHICH IS THE BETTER CHOICE? 5549 03:14:05,001 --> 03:14:07,000 YOU ASK THE OVERWHELMING 5550 03:14:07,001 --> 03:14:08,000 MAJORITY OF OUR 5551 03:14:08,001 --> 03:14:11,000 WOULD THEY RATHER HAVE? 5552 03:14:11,001 --> 03:14:12,000 TO ELIMINATE THE CO-PAYS THEY'RE 5553 03:14:12,001 --> 03:14:13,000 PAYING TODAY OR CONTINUE TO 5554 03:14:13,001 --> 03:14:15,000 PROVIDE EXCESS PROFITS FOR THE 5555 03:14:15,001 --> 03:14:16,000 COMPANIES HERE THAT HAVE MADE SO 5556 03:14:16,001 --> 03:14:17,000 MUCH UNDER THE MEDICARE 5557 03:14:17,001 --> 03:14:19,000 ADVANTAGE PROGRAM AND, LASTLY, 5558 03:14:19,001 --> 03:14:22,000 OF COURSE, AND MOST IMPORTANTLY, 5559 03:14:22,001 --> 03:14:24,000 WE 5560 03:14:24,001 --> 03:14:26,000 LET ME MAKE TWO CASES TO YOU. 5561 03:14:26,001 --> 03:14:28,000 PEOPLE SAY, GIVE ME EXAMPLES OF 5562 03:14:28,001 --> 03:14:30,000 WHAT YOU'RE TALKING ABOUT ON WHY 5563 03:14:30,001 --> 03:14:32,000 THESE DIFFERENC 5564 03:14:32,001 --> 03:14:33,000 I'VE GOT A COUPLE OF EXAMPLES, 5565 03:14:33,001 --> 03:14:38,000 MR. PRESIDENT, FROM MY HOME 5566 03:14:38,001 --> 03:14:40,000 STATE THAT HIGHLIGHT THE POINT. 5567 03:14:40,001 --> 03:14:42,000 ONE, THE 5568 03:14:42,001 --> 03:14:45,000 NONPROFIT ORGANIZATION AS MOST 5569 03:14:45,001 --> 03:14:46,000 OF MY COLLEAGUES KNOW THAT DOES 5570 03:14:46,001 --> 03:14:47,000 CASEWORK ON BEHALF OF 5571 03:14:47,001 --> 03:14:48,000 INDIVIDUALS WHO NEED ASSISTANCE 5572 03:14:48,001 --> 03:14:51,000 DEALING WITH MEDICARE ADVANTAGE PLANS. 5573 03:14:51,001 --> 03:14:54,000 THEY GAVE ME -- I SAID ARE THERE 5574 03:14:54,001 --> 03:14:55,000 CASES OUT HERE THAT CAN 5575 03:14:55,001 --> 03:14:57,000 TWEEN MEDICARE AND MEDICARE ADVANTAGE? 5576 03:14:57,001 --> 03:14:58,000 SO THEY PROVIDED TWO 5577 03:14:58,001 --> 03:15:00,000 MY STATE. 5578 03:15:00,001 --> 03:15:01,000 I PRESUME MOST OF MY COLLEAGUES 5579 03:15:01,001 --> 03:15:02,000 COULD FIND CASES IN THEIR OWN 5580 03:15:02,001 --> 03:15:04,000 STATE. 5581 03:15:04,001 --> 03:15:06,000 A WOMAN LIVING IN MADISON, CONNECTICUT. 5582 03:15:06,001 --> 03:15:09,000 A CONNECTICUT. 5583 03:15:09,001 --> 03:15:10,000 SHE HAS LOU GEHRIG'S DISEASE, A.L.S. 5584 03:15:10,001 --> 03:15:12,000 WE'RE ALL FAMILIARITH A.L.S. 5585 03:15:12,001 --> 03:15:13,000 THE STORIES OF WHAT PEOPLE GO 5586 03:15:13,001 --> 03:15:14,000 THROUGH WITH THAT. 5587 03:15:14,001 --> 03:15:15,000 SHE WAS IN A MEDICARE ADVANTAGE 5588 03:15:15,001 --> 03:15:17,000 PLAN. 5589 03:15:17,001 --> 03:15:18,000 HEALTH CARE BECAUSE SHE IS SAID 5590 03:15:18,001 --> 03:15:19,000 TO BE 5591 03:15:19,001 --> 03:15:20,000 THAT WAS THE QUOTE, SHE IS 5592 03:15:20,001 --> 03:15:22,000 STABLE. 5593 03:15:22,001 --> 03:15:23,000 IT'S NOT A 5594 03:15:23,001 --> 03:15:26,000 DENIAL, AND SHE WAS HARDLY 5595 03:15:26,001 --> 03:15:28,000 STABLE WITH A.L.S. 5596 03:15:28,001 --> 03:15:29,000 C.M.A., THE CENTER FOR MEDICARE 5597 03:15:29,001 --> 03:15:32,000 ADVOCACY, HAD TO GO TO FEDERAL 5598 03:15:32,001 --> 03:15:35,000 COURT TO GET HER CASE -- HER 5599 03:15:35,001 --> 03:15:39,000 CARE COVERED DESPITE FIRM, 5600 03:15:39,001 --> 03:15:40,000 MEDICAL CONDITION AND THE CARE 5601 03:15:40,001 --> 03:15:41,000 OF HER DOCTORS. 5602 03:15:41,001 --> 03:15:43,000 SO HERE'S THE WOMAN AGAIN UNDER 5603 03:15:43,001 --> 03:15:44,000 MEDICARE ADVANTAGE WITH A.L.S. 5604 03:15:44,001 --> 03:15:46,000 BEING DECLARED BY MEDICARE 5605 03:15:46,001 --> 03:15:49,000 ADVANTAGE SHE WAS STABLE. 5606 03:15:49,001 --> 03:15:50,000 HER DOC 5607 03:15:50,001 --> 03:15:52,000 THE CASE. 5608 03:15:52,001 --> 03:15:55,000 SO WHEN MY 5609 03:15:55,001 --> 03:15:56,000 ABOUT A RATIONING OF CARE UNDER 5610 03:15:56,001 --> 03:15:58,000 THE PRESENT SYSTEM, THERE'S 5611 03:15:58,001 --> 03:16:00,000 SOMEONE AT MEDICARE ADVANTAGE, A 5612 03:16:00,001 --> 03:16:01,000 PRIVATFIRM MAKING A MEDICAL 5613 03:16:01,001 --> 03:16:03,000 DECISION BETWEEN SHE AND HER 5614 03:16:03,001 --> 03:16:05,000 DOCTOR THAT SHE WAS STABLE WHEN 5615 03:16:05,001 --> 03:16:08,000 THEY SAID ANYTHING BUT WAS THE 5616 03:16:08,001 --> 03:16:10,000 NOW, THEY EVENTUALLY GOT IT 5617 03:16:10,001 --> 03:16:11,000 OVERTURNED BUT THEY HAD TO GO TO 5618 03:16:11,001 --> 03:16:12,000 FEDERAL COURT TO GET I 5619 03:16:12,001 --> 03:16:13,000 OVERTURNED. 5620 03:16:13,001 --> 03:16:14,000 THAT WOULD NOT HAVE HAPPENED 5621 03:16:14,001 --> 03:16:15,000 UNDER MEDICAID. 5622 03:16:15,001 --> 03:16:16,000 HAD SHE BEEN JUST UNDER 5623 03:16:16,001 --> 03:16:18,000 MEDICARE, SHE WOULD HAVE GOTTEN 5624 03:16:18,001 --> 03:16:20,000 THAT HELP, NO QUESTIONS ASKED. 5625 03:16:20,001 --> 03:16:21,000 SO WHEN PEOPLE TELL ME THERE'S 5626 03:16:21,001 --> 03:16:22,000 NO DISTINCTION, THERE IS A LIVE 5627 03:16:22,001 --> 03:16:23,000 CASE FOR YOU. 5628 03:16:23,001 --> 03:16:25,000 LET ME GIVE YOU THE SECOND ONE. 5629 03:16:25,001 --> 03:16:26,000 A WOMAN FROM VERNON, 5630 03:16:26,001 --> 03:16:28,000 CONNECTICUT, AND HER HUSBAND 5631 03:16:28,001 --> 03:16:30,000 TRAVELED TO FLORIDA TO VISIT 5632 03:16:30,001 --> 03:16:32,000 THEIR DAUGHTER WHO WAS LIVING THERE. 5633 03:16:32,001 --> 03:16:34,000 ON THAT TRIP TO FLORIDA, WHEN 5634 03:16:34,001 --> 03:16:36,000 SHE GOT TO FLORIDA, 5635 03:16:36,001 --> 03:16:37,000 DOWN 5636 03:16:37,001 --> 03:16:39,000 INJURIES, PHYSICAL INJURIES. 5637 03:16:39,001 --> 03:16:40,000 WHILE BEING TREATED IN FLORIDA 5638 03:16:40,001 --> 03:16:41,000 AT THE HOSPITAL FOR THE 5639 03:16:41,001 --> 03:16:43,000 INJURIES, IT WAS DISCOVERED 5640 03:16:43,001 --> 03:16:44,000 HAD A BRAIN TUMOR WHICH IS THE 5641 03:16:44,001 --> 03:16:46,000 REASON SHE HAD THE FALL. 5642 03:16:46,001 --> 03:16:47,000 SHE HAD NO IDEA THIS BEFOREHAND. 5643 03:16:47,001 --> 03:16:50,000 MEDICARE ADVANTAGE PLAN COVERED 5644 03:16:50,001 --> 03:16:53,000 TREATMENT FO 5645 03:16:53,001 --> 03:16:54,000 EMERGENCY, WHICH MEDICARE 5646 03:16:54,001 --> 03:16:56,000 ADVANTAGE PLANS MUST COVER EVEN 5647 03:16:56,001 --> 03:16:57,000 IF OUT OF NETWORK, BY THE WAY, 5648 03:16:57,001 --> 03:16:58,000 BUT NOT ANY DIAGNOSIS OR 5649 03:16:58,001 --> 03:16:59,000 TREATMENT FOR THE CANCER, FOR 5650 03:16:59,001 --> 03:17:01,000 THERAIN TUMOR. 5651 03:17:01,001 --> 03:17:02,000 THE WOMAN HAD ANOTHER DAUGHTER 5652 03:17:02,001 --> 03:17:03,000 THAT LIVED IN UTAH, A NURSE 5653 03:17:03,001 --> 03:17:05,000 THERE, SO THEY TRAVELED FROM 5654 03:17:05,001 --> 03:17:08,000 FLORIDA TO UTAH WHERE THEY WENT 5655 03:17:08,001 --> 03:17:09,000 FOR THE CANCER TREATMENT FOR THE 5656 03:17:09,001 --> 03:17:11,000 BRAIN TUMOR. 5657 03:17:11,001 --> 03:17:12,000 WHILE UNDERGOING CHEMOTHERAPY, 5658 03:17:12,001 --> 03:17:13,000 THIS WOMAN HAD A 5659 03:17:13,001 --> 03:17:14,000 LIFE-THREATENING REACTION TO ONE 5660 03:17:14,001 --> 03:17:15,000 OF THE MEDICATIONS FROM WHICH 5661 03:17:15,001 --> 03:17:17,000 SHE ALMOST DIED. 5662 03:17:17,001 --> 03:17:19,000 THE MEDICARE ADVANTAGE 5663 03:17:19,001 --> 03:17:21,000 DENIED COVERAGE FOR ALL OF THIS 5664 03:17:21,001 --> 03:17:22,000 CARE BECAUSE IT W OUT OF NETWORK. 5665 03:17:22,001 --> 03:17:25,000 SHE WAS IN UTAH. 5666 03:17:25,001 --> 03:17:26,000 THEY SAID NO. 5667 03:17:26,001 --> 03:17:29,000 LEAVING THE CLIENT AND HER 5668 03:17:29,001 --> 03:17:31,000 HUSBAND 5669 03:17:31,001 --> 03:17:33,000 NOW, AGAIN, THE CENTER 5670 03:17:33,001 --> 03:17:36,000 MEDICARE ADVOCACY WENT TO COURT 5671 03:17:36,001 --> 03:17:38,000 AGAIN AND BATTLED IN COURT, AND 5672 03:17:38,001 --> 03:17:40,000 THEY WERE SUCCESSFUL 5673 03:17:40,001 --> 03:17:42,000 RECOVERING $90,000 OUT OF THE THE $100,000. 5674 03:17:42,001 --> 03:17:43,000 NOW, THIS WOMAN IS NOW DECEASED, 5675 03:17:43,001 --> 03:17:45,000 MR. PRESIDENT, BUT SHE AND HER 5676 03:17:45,001 --> 03:17:46,000 FAMILY WERE LEFT WITH OVER 5677 03:17:46,001 --> 03:17:47,000 OVER $10,000 IN BILLS, ALL OF 5678 03:17:47,001 --> 03:17:49,000 WHICH WOULD HAVE BEEN COVERED 5679 03:17:49,001 --> 03:17:52,000 UNDER TRADITIONAL MEDICARE, BUT 5680 03:17:52,001 --> 03:17:53,000 SHE HAD G 5681 03:17:53,001 --> 03:17:54,000 ADVANTAGE PLAN. 5682 03:17:54,001 --> 03:17:55,000 IN BOTH INSTANCES, THEY WOULD 5683 03:17:55,001 --> 03:17:57,000 HAVE AVOIDED HAVING TO BE IN 5684 03:17:57,001 --> 03:17:59,000 FEDERAL COURT, HAVING TO FIGHT 5685 03:17:59,001 --> 03:18:00,000 AS HARD AS THEY DID, GOING 5686 03:18:00,001 --> 03:18:03,000 THROUGH THE TRAUMA AND THE 5687 03:18:03,001 --> 03:18:04,000 BAD ENOUGH YOU'VE GOT TO WRESTLE 5688 03:18:04,001 --> 03:18:06,000 WITH CANCER. 5689 03:18:06,001 --> 03:18:07,000 BAD ENOUGH YOU 5690 03:18:07,001 --> 03:18:09,000 WITH A BRAIN TUMOR. 5691 03:18:09,001 --> 03:18:11,000 BUT THEN YOU GET SADDLED WITH 5692 03:18:11,001 --> 03:18:12,000 WITH $10 MEDICARE WOULD HAVE TAKEN 5693 03:18:12,001 --> 03:18:13,000 ADVANTAGE OF YOU. 5694 03:18:13,001 --> 03:18:14,000 THIS MEDICARE ADVANTAGE PROGRAM 5695 03:18:14,001 --> 03:18:15,000 DISADVANTAGED HER IN THE 5696 03:18:15,001 --> 03:18:16,000 PROCESS. 5697 03:18:16,001 --> 03:18:18,000 AND THESE ARE EXAMPLES OF HOW 5698 03:18:18,001 --> 03:18:22,000 PRIVATE MEDICARE ADVANTAGE DON'T 5699 03:18:22,001 --> 03:18:23,000 ALWAYS OPERATE 5700 03:18:23,001 --> 03:18:25,000 THEY'RE NOT ALWAYS THERE WHEN 5701 03:18:25,001 --> 03:18:26,000 YOU NEED THEM IF YOU'RE OUT OF 5702 03:18:26,001 --> 03:18:27,000 THE SAME AREA. 5703 03:18:27,001 --> 03:18:28,000 SO THERE ARE SIGNIFICANT 5704 03:18:28,001 --> 03:18:30,000 DIFFERENCES. 5705 03:18:30,001 --> 03:18:32,000 TRADITIONAL MEDICARE, YOU 5706 03:18:32,001 --> 03:18:35,000 WHAT SERVICES YOU GET. 5707 03:18:35,001 --> 03:18:37,000 AND I'LL ASK CONSENT TO PUT THIS 5708 03:18:37,001 --> 03:18:40,000 LIST OF SERVICES IN THE RECORD 5709 03:18:40,001 --> 03:18:41,000 SO PEOPLE CAN 5710 03:18:41,001 --> 03:18:42,000 PEOPLE HAVEN'T ALREADY DONE 5711 03:18:42,001 --> 03:18:45,000 THAT. 5712 03:18:45,001 --> 03:18:46,000 ALL NECESSARY HOSPITAL AND 5713 03:18:46,001 --> 03:18:47,000 DOCTORS' OFFICE VISITS ARE 5714 03:18:47,001 --> 03:18:48,000 COVERED IN MEDICARE. 5715 03:18:48,001 --> 03:18:49,000 YOU KNOW YOU CAN GET THESE 5716 03:18:49,001 --> 03:18:51,000 SERVICES FROM ANY MEDICARE 5717 03:18:51,001 --> 03:18:52,000 PROVIDER A 5718 03:18:52,001 --> 03:18:53,000 COUNTRY, NOT OUT OF NETWORK. 5719 03:18:53,001 --> 03:18:55,000 YOU GET THIS KIND OF HELP. 5720 03:18:55,001 --> 03:18:56,000 WHETHER IT BE IN UTAH, FLORIDA, 5721 03:18:56,001 --> 03:18:58,000 OR VERNON, CNECTICUT, WHERE 5722 03:18:58,001 --> 03:19:00,000 SHE WAS FROM, MEDICARE WOULD 5723 03:19:00,001 --> 03:19:01,000 HAVE PROVIDED THAT. 5724 03:19:01,001 --> 03:19:02,000 HERE THEY ARE BOUNCING AROUND 5725 03:19:02,001 --> 03:19:04,000 THE COUNTRY AND BEING DENIED AT 5726 03:19:04,001 --> 03:19:06,000 ONE PLACE AFTER ANOTHER UNDER MEDICARE ADVANTAGE. 5727 03:19:06,001 --> 03:19:07,000 THEY DON'T HAVE TO WORRY ABOUT A 5728 03:19:07,001 --> 03:19:09,000 PRIVATE INSURANCE PLAN PLAYING 5729 03:19:09,001 --> 03:19:11,000 GAMES WITH THEIR COVERAGE. 5730 03:19:11,001 --> 03:19:12,000 MEDICARE ADVANTAGE, THESE PLANS 5731 03:19:12,001 --> 03:19:15,000 RUN THE SHOW. 5732 03:19:15,001 --> 03:19:16,000 THEY CHANGE THE BENEFITS. 5733 03:19:16,001 --> 03:19:18,000 COST SHARING GOES ON. 5734 03:19:18,001 --> 03:19:20,000 THIS IS WHY MEDICARE ADVANTAGE 5735 03:19:20,001 --> 03:19:21,000 IS NOT LIKE TRADITIONAL 5736 03:19:21,001 --> 03:19:22,000 MEDICARE. 5737 03:19:22,001 --> 03:19:25,000 SO WHEN PEOPLE SAY IT'S JUST 5738 03:19:25,001 --> 03:19:26,000 LIKE MEDICARE, NO, IT'S NOT JUST 5739 03:19:26,001 --> 03:19:27,000 LIKE MEDICARE. 5740 03:19:27,001 --> 03:19:29,000 AND IF YOU DOUBT ME, THEN YOU 5741 03:19:29,001 --> 03:19:30,000 CALL THAT FAMILY IN 5742 03:19:30,001 --> 03:19:31,000 CONNECTICUT, OR YOU CALL THAT 5743 03:19:31,001 --> 03:19:32,000 WOMAN'S FAMILY FROM VERNON, 5744 03:19:32,001 --> 03:19:35,000 CONNECTICUT, ASK THEM WHETHER OR 5745 03:19:35,001 --> 03:19:36,000 NOT MEDICARE ADVANTAGE WAS JUS 5746 03:19:36,001 --> 03:19:38,000 LIKE MEDICARE. 5747 03:19:38,001 --> 03:19:39,000 YOU'LL GET AN 5748 03:19:39,001 --> 03:19:41,000 ABOUT WHAT THEY WENT THROUGH. 5749 03:19:41,001 --> 03:19:42,000 WE SHOULD BE CLEAR THAT WE'RE 5750 03:19:42,001 --> 03:19:44,000 NOT ELIMINATING MEDICARE ADVANTAGE. 5751 03:19:44,001 --> 03:19:45,000 AND AGAIN, I APPRECIATE SENATOR 5752 03:19:45,001 --> 03:19:47,000 BAUCUS MAKING THIS POINT. 5753 03:19:47,001 --> 03:19:48,000 IT NEEDS TO 5754 03:19:48,001 --> 03:19:49,000 OVER AGAIN. 5755 03:19:49,001 --> 03:19:50,000 WE'RE NOT ABOUT ELIMINATING IT 5756 03:19:50,001 --> 03:19:52,000 AT ALL. 5757 03:19:52,001 --> 03:19:53,000 WE ARE REDUCING THE OVERPAYMENTS 5758 03:19:53,001 --> 03:19:55,000 TO PRIVATE PLANS AND MAKING THE 5759 03:19:55,001 --> 03:19:58,000 SYSTEMORK MORE UNIFORMLY. 5760 03:19:58,001 --> 03:20:00,000 WE ACTUALLY GIVE THOSE PLANS 5761 03:20:00,001 --> 03:20:01,000 BONUS PAYMENTS FOR CARE, 5762 03:20:01,001 --> 03:20:03,000 COORDINATION AND QUALITY 5763 03:20:03,001 --> 03:20:04,000 IMPROVEMENTS, AND THEY CAN 5764 03:20:04,001 --> 03:20:07,000 USE -- THESE PLANS CAN USE THOSE 5765 03:20:07,001 --> 03:20:08,000 PAYMENTS TO 5766 03:20:08,001 --> 03:20:11,000 THEIR BENEFICIARIES. 5767 03:20:11,001 --> 03:20:14,000 SO HARDLY ELIMINATING IT AT ALL. 5768 03:20:14,001 --> 03:20:15,000 I HAVE SERIOUS RESERVATIONS 5769 03:20:15,001 --> 03:20:16,000 ABOUT HOW THIS PLAN OPERATES, 5770 03:20:16,001 --> 03:20:17,000 I'LL TELL YOU THAT, 5771 03:20:17,001 --> 03:20:19,000 MR. PRESIDENT, BUT I WOULD NOT 5772 03:20:19,001 --> 03:20:20,000 ADVOCATE ON THE FLOOR OF THE 5773 03:20:20,001 --> 03:20:22,000 UNITED STATES SENATE THE 5774 03:20:22,001 --> 03:20:24,000 ELIMINATION OF MEDICARE ADVANTAGE. 5775 03:20:24,001 --> 03:20:27,000 BUT I DO WANT TO MAKE IT WORK 5776 03:20:27,001 --> 03:20:28,000 BETTER AND I DO WANT TO CUT BACK 5777 03:20:28,001 --> 03:20:29,000 WHEN YOU HAVE OVERPAYMENTS 5778 03:20:29,001 --> 03:20:31,000 OCCURRING, AND I DON'T THINK 5779 03:20:31,001 --> 03:20:32,000 IT'S FAIR THAT 80% OF THE 5780 03:20:32,001 --> 03:20:34,000 SENIORS IN MY STATE OR ELSEWHERE 5781 03:20:34,001 --> 03:20:35,000 ARE PAYING $90 A YEAR EXTRA TO 5782 03:20:35,001 --> 03:20:37,000 COVER THIS PROGRAM AND GET NONE 5783 03:20:37,001 --> 03:20:38,000 OF THE HELP FROM IT, AND THAT 5784 03:20:38,001 --> 03:20:40,000 PEOPLE UNDER MEDICARE ADVANTAGE 5785 03:20:40,001 --> 03:20:41,000 COULD HAVE BEEN PROTECTED OR NOT 5786 03:20:41,001 --> 03:20:43,000 BEUSE THEY OPTED TO BE IN THAT 5787 03:20:43,001 --> 03:20:44,000 PLAN AND THEN FIND 5788 03:20:44,001 --> 03:20:46,000 ANYTHING BUT WHAT THEY THOUGHT IT 5789 03:20:46,001 --> 03:20:47,000 SO, MR. PRESIDENT, YOU'RE GOING 5790 03:20:47,001 --> 03:20:49,000 TO HEAR THESE ARGUMENTS OVER AND 5791 03:20:49,001 --> 03:20:51,000 OVER AGAIN ABOUT MEDICARE ADVANTAGE. 5792 03:20:51,001 --> 03:20:53,000 A LITTLE TRUTH IN ADVERTISING 5793 03:20:53,001 --> 03:20:54,000 NECESSARY HERE SO PEOPLE 5794 03:20:54,001 --> 03:20:57,000 UNDERSTAND IT'S NOT MEDICARE AND 5795 03:20:57,001 --> 03:20:59,000 IT'S NOT AN ADVANTAGE, NOT IN 5796 03:20:59,001 --> 03:21:00,000 ITS PRESENT SYSTEM, NOT AT ALL, 5797 03:21:00,001 --> 03:21:02,000 AND THAT'S WHAT WE HAVE BEEN 5798 03:21:02,001 --> 03:21:04,000 TRYINGO SAY OVER AND OVER AND 5799 03:21:04,001 --> 03:21:05,000 OVER AGAIN HERE SO THE PEOPLE 5800 03:21:05,001 --> 03:21:07,000 UNDERSTAND. THIS IS A GOOD BILL. 5801 03:21:07,001 --> 03:21:08,000 THIS IS 5802 03:21:08,001 --> 03:21:10,000 THIS TOOK A TREMENDOUS AMOUNT OF 5803 03:21:10,001 --> 03:21:12,000 WORK IN THE FINANCE COMMITTEE 5804 03:21:12,001 --> 03:21:13,000 THAT HAD THE RESPONSIBILITY IN 5805 03:21:13,001 --> 03:21:15,000 CRAFTING THESE PROVISIONS WHICH 5806 03:21:15,001 --> 03:21:17,000 ARE HIGHLY COMPLICATED AND VERY 5807 03:21:17,001 --> 03:21:19,000 DELICATE IN WHAT YOU DO, BUT 5808 03:21:19,001 --> 03:21:21,000 WHAT WE'VE DONE HERE IS PRESERVE 5809 03:21:21,001 --> 03:21:22,000 AND STRENGTHEN OUR MEDICARE 5810 03:21:22,001 --> 03:21:25,000 SYSTEM, EXPANDING THE BENEFITS 5811 03:21:25,001 --> 03:21:27,000 FOR PEOPLE, ELIMINATING CO-PAYS, 5812 03:21:27,001 --> 03:21:29,000 ALLOWING THOSE PREVENTATIVES, SCREENING SERVICES TO BE 5813 03:21:29,001 --> 03:21:30,000 AVAILABLE TO OUR ELDERLY, SEEING 5814 03:21:30,001 --> 03:21:32,000 TO IT THEY'LL HAVE THE 5815 03:21:32,001 --> 03:21:33,000 PRESCRIPTION DRUGS AT LOWER COSTS. 5816 03:21:33,001 --> 03:21:35,000 THAT'S ALL IN THIS BILL. 5817 03:21:35,001 --> 03:21:37,000 THAT A GREAT ADVANTAGE. 5818 03:21:37,001 --> 03:21:40,000 WHAT A TRAGEDY IT WOULD BE IF IN 5819 03:21:40,001 --> 03:21:41,000 THESE NEXT FEW DAYS WHEN WE HAVE 5820 03:21:41,001 --> 03:21:42,000 TO DEBATE ALL OF THIS WE WOULD 5821 03:21:42,001 --> 03:21:44,000 LOSE ALL OF THE WORK THAT HAS 5822 03:21:44,001 --> 03:21:45,000 BEEN DONE HERE TO MAKE THESE 5823 03:21:45,001 --> 03:21:46,000 KIND OF IMPROVEMENTS IN OUR 5824 03:21:46,001 --> 03:21:47,000 HEALTH CARE SYSTEM, AND I 5825 03:21:47,001 --> 03:21:48,000 COMMEND AGAIN MY COLLEAGUE FROM 5826 03:21:48,001 --> 03:21:50,000 MONTANA AND HIS COLLEAGUES IN 5827 03:21:50,001 --> 03:21:52,000 THE COMMITTEE THAT WORKED SO 5828 03:21:52,001 --> 03:21:54,000 HARD TO PUT THIS TOGETHER, THIS 5829 03:21:54,001 --> 03:21:55,000 BALANCE TOGETHER HERE THAT CAN 5830 03:21:55,001 --> 03:21:56,000 MA 5831 03:21:56,001 --> 03:21:58,000 PEOPLE'S LIVES. 5832 03:21:58,001 --> 03:22:00,000 SO W 5833 03:22:00,001 --> 03:22:03,000 ALSO WANT TO THANK OUR COLLEAGUE 5834 03:22:03,001 --> 03:22:04,000 FROM RHODE ISLAND FOR OFFERING 5835 03:22:04,001 --> 03:22:06,000 HIS AMENDMENT WHICH WE'RE GOING 5836 03:22:06,001 --> 03:22:07,000 TO BE CONSIDERINGT SOME POINT 5837 03:22:07,001 --> 03:22:09,000 HERE WHEN WE GET TO VOTE 5838 03:22:09,001 --> 03:22:10,000 OCCASIONALLY ON SOME MATTERS 5839 03:22:10,001 --> 03:22:11,000 AROUND HERE. 5840 03:22:11,001 --> 03:22:12,000 AND AGAIN, I HOPE AT SOME POINT 5841 03:22:12,001 --> 03:22:14,000 WE CAN START TO DO THAT. 5842 03:22:14,001 --> 03:22:16,000 WE'VE DONE IT A COUPLE OF TIMES, 5843 03:22:16,001 --> 03:22:17,000 BUT FRANKLY, THIS HAS BEEN OVER 5844 03:22:17,001 --> 03:22:18,000 A YEAR OF DEBATE AND DISCUSSION. 5845 03:22:18,001 --> 03:22:19,000 I THINK THE AMERICAN PEOPLE 5846 03:22:19,001 --> 03:22:20,000 WOULD LIKE TO SEE SOME ACTION 5847 03:22:20,001 --> 03:22:22,000 AND THEY DESERVE TO HAVE IT. 5848 03:22:22,001 --> 03:22:23,000 WE THINK WE HAV A GOOD BILL ON 5849 03:22:23,001 --> 03:22:26,000 THE CLASS ACT WHICH I KNOW HAS 5850 03:22:26,001 --> 03:22:27,000 BEEN HOTLY DEBATED AND 5851 03:22:27,001 --> 03:22:28,000 DISCUSSED. 5852 03:22:28,001 --> 03:22:29,000 IT'S GOING TO TAKE ON AN 5853 03:22:29,001 --> 03:22:30,000 IMPORTANT HEALTH INSURANCE 5854 03:22:30,001 --> 03:22:31,000 MARKET REFORM THAT WILL ENSURE 5855 03:22:31,001 --> 03:22:33,000 THAT AMERICANS WILL GET ACCESS 5856 03:22:33,001 --> 03:22:34,000 TO HEALTH CARE PROMISED BY THEIR 5857 03:22:34,001 --> 03:22:38,000 INSURANCE PLANS. 5858 03:22:38,001 --> 03:22:39,000 SOMEONE LOSES HIS OR H 5859 03:22:39,001 --> 03:22:40,000 THEY CAN 5860 03:22:40,001 --> 03:22:42,000 IT'S GOING TO IMPROVE THE 5861 03:22:42,001 --> 03:22:43,000 QUALITY OF HEALTH CARE AND FOCUS 5862 03:22:43,001 --> 03:22:44,000 OUR SYSTEM MORE ON P 5863 03:22:44,001 --> 03:22:45,000 AND WELLNESS. 5864 03:22:45,001 --> 03:22:47,000 ON TOP OF ALL THESE THINGS, IT'S 5865 03:22:47,001 --> 03:22:49,000 GOING TO REDUCE THE 5866 03:22:49,001 --> 03:22:52,000 AS WE'VE HEARD OVER AND OVER 5867 03:22:52,001 --> 03:22:54,000 AGAIN, C.B.O. IS TALKING ABOUT SAVING $ 5868 03:22:54,001 --> 03:22:55,000 TEN YEARS 5869 03:22:55,001 --> 03:22:56,000 THE SECOND. 5870 03:22:56,001 --> 03:22:57,000 YOU KNOW, I'VE GOT TO SAY 5871 03:22:57,001 --> 03:22:59,000 SOMETHING, MR. PRESIDENT. 5872 03:22:59,001 --> 03:23:00,000 THE OTHER DAYS WHEN WE GOT THE 5873 03:23:00,001 --> 03:23:01,000 NEWS THAT C.B.O. HAD SAID THAT 5874 03:23:01,001 --> 03:23:02,000 THE PREMIUMS ON THE INDIVIDUAL 5875 03:23:02,001 --> 03:23:03,000 PLANS, THE SMALL GROUP -- OR 5876 03:23:03,001 --> 03:23:05,000 SMALL BUSINESS PLANS AND THE 5877 03:23:05,001 --> 03:23:08,000 LARGE GROUP PLANS WERE ACTUALLY 5878 03:23:08,001 --> 03:23:10,000 GOING TO REDUCE PREMIUM COSTS BY 5879 03:23:10,001 --> 03:23:11,000 20% IN ONE AREA AND AS LITTLE AS 5880 03:23:11,001 --> 03:23:12,000 3% IN ANOTHER. 5881 03:23:12,001 --> 03:23:14,000 I WOULD HAVE THOUGHT THERE WOULD 5882 03:23:14,001 --> 03:23:15,000 HAVE BEEN 5883 03:23:15,001 --> 03:23:17,000 EVEN THOSE THAT OPPOSED THE BILL 5884 03:23:17,001 --> 03:23:18,000 WOULD HAVE SAID ISN'T THAT GREAT 5885 03:23:18,001 --> 03:23:19,000 NEWS? 5886 03:23:19,001 --> 03:23:21,000 WHAT YOU GOT HERE WAS ALMOST A 5887 03:23:21,001 --> 03:23:24,000 SENSE OF DEEP DISAPPOINTMENT 5888 03:23:24,001 --> 03:23:25,000 THAT C.B.O. HAD COME OUT 5889 03:23:25,001 --> 03:23:26,000 GIVEN US A REPORT HERE THAT 5890 03:23:26,001 --> 03:23:28,000 ACTUALLY PEOPLE WERE GOING TO 5891 03:23:28,001 --> 03:23:29,000 SAVE MONEY UNDER THIS BILL AND PROPOSAL. 5892 03:23:29,001 --> 03:23:30,000 AND THEN ALL OF A SUDDEN TO 5893 03:23:30,001 --> 03:23:32,000 ATTACK C.B.O. BECAUSE YOU DIDN'T 5894 03:23:32,001 --> 03:23:34,000 LIKE THE RESULTS COMING OUT OF C.B.O. 5895 03:23:34,001 --> 03:23:35,000 I'LL GUARANTEE YOU THAT 5896 03:23:35,001 --> 03:23:36,000 COME BACK AND SAID WE'RE GOING 5897 03:23:36,001 --> 03:23:37,000 TO INCREASE PREMIUMS, WE WOULD 5898 03:23:37,001 --> 03:23:39,000 ALL BE TALKING ABOUT THAT. 5899 03:23:39,001 --> 03:23:41,000 SO HERE WE GET REPORTS THAT 5900 03:23:41,001 --> 03:23:42,000 PREMIUM COSTS, REDUCE THE COSTS 5901 03:23:42,001 --> 03:23:44,000 OF THE FEDERAL BUDGET AS HAS 5902 03:23:44,001 --> 03:23:45,000 BEEN POINTED OUT. 5903 03:23:45,001 --> 03:23:48,000 AND NOW SENATOR WHITEHOUSE IS 5904 03:23:48,001 --> 03:23:49,000 GOING TO OFFER AN AMENDMENT THAT 5905 03:23:49,001 --> 03:23:51,000 MAKES 5906 03:23:51,001 --> 03:23:52,000 TALKING ABOUT USED 5907 03:23:52,001 --> 03:23:54,000 SOCIAL SECURITY, REDUCE THE 5908 03:23:54,001 --> 03:23:56,000 DEFICIT AND CONTRIBUTE TO THE 5909 03:23:56,001 --> 03:23:57,000 LONG-TERM SOLVENCY OF THE CLASS 5910 03:23:57,001 --> 03:23:58,000 ACT WILL BE FOR THAT PURPOSE AND 5911 03:23:58,001 --> 03:23:59,000 THAT PURPOSE ALONE. 5912 03:23:59,001 --> 03:24:01,000 AND THE THIRD PART OF HIS 5913 03:24:01,001 --> 03:24:02,000 AMENDMENT IS PARTICULARLY IMPORTANT. 5914 03:24:02,001 --> 03:24:04,000 MANY OF OUR COLLEAGUES HAVE COME 5915 03:24:04,001 --> 03:24:05,000 TO THE FLOOR IN THE LAST FEW 5916 03:24:05,001 --> 03:24:07,000 DAYS TO CLAIM THAT CLASS ACT 5917 03:24:07,001 --> 03:24:08,000 WILL BE A LONG-TERM DRAIN ON THE 5918 03:24:08,001 --> 03:24:09,000 BUDGET. 5919 03:24:09,001 --> 03:24:11,000 IT'S JUST NOT TRUE, 5920 03:24:11,001 --> 03:24:13,000 MR. PRESIDENT, THANKS TO OUR 5921 03:24:13,001 --> 03:24:15,000 COLLEAGUE FROM NEW HAMPSHIRE. 5922 03:24:15,001 --> 03:24:17,000 SENATOR GREG, THE CLASS ACT WILL 5923 03:24:17,001 --> 03:24:18,000 BE REQUIRED BY LAW TO BE SOLVENT 5924 03:24:18,001 --> 03:24:21,000 FOR 75 YEARS. 5925 03:24:21,001 --> 03:24:23,000 WHICH IS NOT IN OUR ORIGINAL PROPOSAL. 5926 03:24:23,001 --> 03:24:26,000 IT WAS ADDED IN THE HEALTH 5927 03:24:26,001 --> 03:24:28,000 COMMITTEE MARKUP BY 5928 03:24:28,001 --> 03:24:29,000 GREGG AND I THANK HIM FOR IT. 5929 03:24:29,001 --> 03:24:31,000 IT WAS UNANIMOUSLY ADOPTED BY 5930 03:24:31,001 --> 03:24:33,000 SENATOR GREGG IN OUR 5931 03:24:33,001 --> 03:24:35,000 THE C.B.O. SAYS IT PRODUCES PRODUCES $72 BILLION IN SINGS 5932 03:24:35,001 --> 03:24:37,000 FOR THE FEDERAL GOVERNMENT OVER 5933 03:24:37,001 --> 03:24:39,000 THE FIRST TEN YEARS OF ITS 5934 03:24:39,001 --> 03:24:40,000 EXISTENCE AND IT WILL SAVE 5935 03:24:40,001 --> 03:24:41,000 NEARLY $2 BILLION FROM MEDICAID. 5936 03:24:41,001 --> 03:24:42,000 THEY FURTHER ADDED LANGUAGE TO 5937 03:24:42,001 --> 03:24:44,000 THE BILL TO REQUIRE THE 5938 03:24:44,001 --> 03:24:45,000 SECRETARY TO MAINTAIN ENOUGH 5939 03:24:45,001 --> 03:24:47,000 RESERVES AFTER THE FIRST TEN 5940 03:24:47,001 --> 03:24:49,000 YEARS TO BE ABLE TO PAY OUT ANY 5941 03:24:49,001 --> 03:24:51,000 CLAIMS THAT MAY 5942 03:24:51,001 --> 03:24:54,000 AND WE HAVE INCLUDED LANGUAGE TO PREVENT FEDERAL APPROPRIATIONS 5943 03:24:54,001 --> 03:24:56,000 FROM BEING USED TO PAY BENEFITS 5944 03:24:56,001 --> 03:24:58,000 TO ENSURE THE PROGRAM IS SELFFUNDED. 5945 03:24:58,001 --> 03:25:00,000 AND FINALLY, AT THE 5946 03:25:00,001 --> 03:25:01,000 SEVERAL SENATORS, THE 5947 03:25:01,001 --> 03:25:02,000 DISTINGUISHED MAJORITY LEADER 5948 03:25:02,001 --> 03:25:03,000 MADE SURE THAT WE DID NOT LOSE 5949 03:25:03,001 --> 03:25:05,000 ANY OF THE SAVINGS FROM THE 5950 03:25:05,001 --> 03:25:07,000 CLASS ACT FOR ANY OTHER PURPOSE 5951 03:25:07,001 --> 03:25:08,000 OTHER THAN TO 5952 03:25:08,001 --> 03:25:09,000 ACT ITSELF. 5953 03:25:09,001 --> 03:25:11,000 THIS AMENDMENT OFFERED BY 5954 03:25:11,001 --> 03:25:12,000 SENATOR WHITEHOUSE WILL GIVE 5955 03:25:12,001 --> 03:25:13,000 SENATORS A CNCE TO COMMIT 5956 03:25:13,001 --> 03:25:15,000 THEMSELVES TO THAT PURPOSE. 5957 03:25:15,001 --> 03:25:17,000 SENATORS WHO CLAIM THE CLASS ACT 5958 03:25:17,001 --> 03:25:18,000 WILL HURT THE 5959 03:25:18,001 --> 03:25:20,000 COURSE SHOULD VOTE FOR THIS 5960 03:25:20,001 --> 03:25:21,000 AMENDMENT BECAUSE STATUTORILY IT 5961 03:25:21,001 --> 03:25:22,000 WILL PROHIBIT ANY OF THOSE FUNDS 5962 03:25:22,001 --> 03:25:24,000 FROM BEING 5963 03:25:24,001 --> 03:25:28,000 PURPOSE OTHER THAN FOR THE CLASS 5964 03:25:28,001 --> 03:25:29,000 ACT AND THE RECIPIE 5965 03:25:29,001 --> 03:25:30,000 WHO WANT TO USE IT. 5966 03:25:30,001 --> 03:25:31,000 SO I COMMEND HIM 5967 03:25:31,001 --> 03:25:33,000 AND WE THANK 5968 03:25:33,001 --> 03:25:34,000 WHEN THAT VOTE OCCURS, I WOULD 5969 03:25:34,001 --> 03:25:35,000 URGE MY COLLEAGUES TO VOTE FOR 5970 03:25:35,001 --> 03:25:36,000 THE WHITEHOUSE AMENDMENT. 5971 03:25:36,001 --> 03:25:38,000 MR. PRESIDENT, I LASTLY WOULD 5972 03:25:38,001 --> 03:25:39,000 LIKE TO ASK TO BE INCLUDED AS A 5973 03:25:39,001 --> 03:25:42,000 COSPONSOR ALONG WITH MY 5974 03:25:42,001 --> 03:25:44,000 COLLEAGUE FROM MARYLAND, SENATOR 5975 03:25:44,001 --> 03:25:46,000 MIKULSKI, OF SENATOR COBURN'S 5976 03:25:46,001 --> 03:25:47,000 AMENDMENT NUMBER 2789 WHICH ADDS 5977 03:25:47,001 --> 03:25:48,000 MEMBERS OF CONGRESS TO THE 5978 03:25:48,001 --> 03:25:52,000 PUBLIC OPTION. 5979 03:25:52,001 --> 03:25:53,000 WE HAD 5980 03:25:53,001 --> 03:25:55,000 THAT PROVISION TO THE "HELP" 5981 03:25:55,001 --> 03:25:56,000 COMMITTEE BILL. 5982 03:25:56,001 --> 03:25:58,000 SENATOR COBURN OFFERED THAT AMENDMENT. 5983 03:25:58,001 --> 03:26:01,000 SENATOR KENNEDY AND MYSELF AND 5984 03:26:01,001 --> 03:26:03,000 OTHERS VOTEDOR THAT AMENDMENT. 5985 03:26:03,001 --> 03:26:04,000 I THINK IT MAY HAVE SHOCKED THE 5986 03:26:04,001 --> 03:26:06,000 SENATOR FROM OKLAHOMA THAT WE 5987 03:26:06,001 --> 03:26:07,000 ACTUALLY VOTED FOR HIS AMENDMENT 5988 03:26:07,001 --> 03:26:08,000 AT THE TIME. 5989 03:26:08,001 --> 03:26:11,000 I KNOW THAT SENATOR BROWN HAS 5990 03:26:11,001 --> 03:26:13,000 BEEN ADDED AS A COSPONSOR. 5991 03:26:13,001 --> 03:26:16,000 I HAVE NO OBJECTION TO THAT 5992 03:26:16,001 --> 03:26:17,000 AMENDMENT. 5993 03:26:17,001 --> 03:26:18,000 THAT'S HOW MUCH THAT I THINK THE 5994 03:26:18,001 --> 03:26:19,000 PUBLIC OPTION WILL BE WORTH. 5995 03:26:19,001 --> 03:26:20,000 IF WE HAVE A PUBLIC OPTION IN 5996 03:26:20,001 --> 03:26:22,000 THIS PLAN -- AND MY HOPE IS THAT 5997 03:26:22,001 --> 03:26:23,000 WE WILL -- THEN I THINK THERE IS NOTHING WRONG WITH INSISTING 5998 03:26:23,001 --> 03:26:26,000 THAT MEMBERS OF CONGRESS BE 5999 03:26:26,001 --> 03:26:27,000 INCLUDED IN THAT PUBLIC OPTION 6000 03:26:27,001 --> 03:26:28,000 PROPOSAL. 6001 03:26:28,001 --> 03:26:29,000 AND SO HIS 6002 03:26:29,001 --> 03:26:31,000 THAT. 6003 03:26:31,001 --> 03:26:32,000 WE SUPPORT IT IN OUR COMMITTEE, 6004 03:26:32,001 --> 03:26:33,000 AND I'M PREPARED TO SUPPORT IT 6005 03:26:33,001 --> 03:26:35,000 AGAIN HERE ON THE FLOOR OF THE 6006 03:26:35,001 --> 03:26:36,000 UNITED STATES SENATE. 6007 03:26:36,001 --> 03:26:37,000 AND AGAIN, I POINT OUT THAT I 6008 03:26:37,001 --> 03:26:39,000 THINK THAT'S A WONDERFUL -- 6009 03:26:39,001 --> 03:26:42,000 JUST WISH WE COULD GET MEMBERS 6010 03:26:42,001 --> 03:26:44,000 AS WELL WHO ARE RELUCTANT TO 6011 03:26:44,001 --> 03:26:45,000 SUPPORT 6012 03:26:45,001 --> 03:26:47,000 THAT AS MEMBERS OF CONGRESS 6013 03:26:47,001 --> 03:26:49,000 TODAY, WE ALL HAVE PRETTY GOOD 6014 03:26:49,001 --> 03:26:51,000 HEALTH CARE PLANS UNDER THE 6015 03:26:51,001 --> 03:26:52,000 FEDERAL EMPLOYEES BENEFIT 6016 03:26:52,001 --> 03:26:53,000 PACKAGE, SOME 23 DIFFERENT 6017 03:26:53,001 --> 03:26:55,000 OPTI 6018 03:26:55,001 --> 03:26:56,000 AVAILABLE TO US ALONG WITH THE 6019 03:26:56,001 --> 03:26:58,000 EIGHT MILLION FEDERAL EMPLOYEES 6020 03:26:58,001 --> 03:26:59,000 IN THIS COUNTRY UNDER THOSE 6021 03:26:59,001 --> 03:27:01,000 PLANS. 6022 03:27:01,001 --> 03:27:02,000 I JUST WISH WE COULD GET OTHERS 6023 03:27:02,001 --> 03:27:07,000 TO RECOGNIZE HOWALUABLE THAT 6024 03:27:07,001 --> 03:27:08,000 IS TO ALL OF US AND OUR FELLOW 6025 03:27:08,001 --> 03:27:09,000 EMPLOYEES WHO ARE FEDERAL 6026 03:27:09,001 --> 03:27:10,000 EMPLOYEES. 6027 03:27:10,001 --> 03:27:11,000 UNFORTUNATELY,HAT DOESN'T SEEM 6028 03:27:11,001 --> 03:27:12,000 TO BE THE CASE, BUT 6029 03:27:12,001 --> 03:27:15,000 BEFORE THIS IS CONCLUDED WE'LL 6030 03:27:15,001 --> 03:27:17,000 HAVE FAR MORE SUPPORT FOR THIS 6031 03:27:17,001 --> 03:27:18,000 EFFORT THAT WE HAVE CRAFTED AND 6032 03:27:18,001 --> 03:27:19,000 PROVIDED TO OUR COLLEAGUES FOR 6033 03:27:19,001 --> 03:27:21,000 THEIR 6034 03:27:21,001 --> 03:27:22,000 AGAIN, I COMPLIMENT THE FINANCE 6035 03:27:22,001 --> 03:27:23,000 COMMIT 6036 03:27:23,001 --> 03:27:25,000 FRIEND FROM MONTANA FOR THE 6037 03:27:25,001 --> 03:27:27,000 HE HAS DONE ON THIS ISSUE. 6038 03:27:27,001 --> 03:27:28,000 IT'S VERY WELL THOUGHT OUT, VERY 6039 03:27:28,001 --> 03:27:30,000 BALANCED, VERY FAIR. 6040 03:27:30,001 --> 03:27:31,000 AND AGAIN, I'VE SAID THIS 6041 03:27:31,001 --> 03:27:32,000 AND OVER AGAIN. 6042 03:27:32,001 --> 03:27:34,000 I CHALLENGE ANY MEMBER TO COME 6043 03:27:34,001 --> 03:27:36,000 TO THE FLOOR AND IDENTIFY A 6044 03:27:36,001 --> 03:27:37,000 SINGLE GUARANTEED BENEFIT UNDER 6045 03:27:37,001 --> 03:27:41,000 MEDICARE THAT IS CUT OUT IN THIS BILL. 6046 03:27:41,001 --> 03:27:43,000 THERE IS NOT ONE 6047 03:27:43,001 --> 03:27:45,000 AND WAIT TO GO THIS DAY. 6048 03:27:45,001 --> 03:27:47,000 THREE DAYS HAVE GONE 6049 03:27:47,001 --> 03:27:48,000 IDENTIFY A SINGLE GUARANTEED 6050 03:27:48,001 --> 03:27:50,000 BENEFIT UNDER MEDICARE THAT WE CUT. 6051 03:27:50,001 --> 03:27:53,000 YOU WILL NOT FIND ONE, NOT ONE, MR. PRESIDENT. 6052 03:27:53,001 --> 03:27:54,000 MR. PRESIDENT, I SEE MY FRIEND 6053 03:27:54,001 --> 03:27:55,000 FLOOR, AND I KNOW 6054 03:27:55,001 --> 03:27:58,000 PROBABLY GONE OVER A LITTLE BIT 6055 03:27:58,001 --> 03:27:59,000 OF TIME HERE, 6056 03:27:59,001 --> 03:28:00,000 FLOOR. 6057 03:28:00,001 --> 03:28:01,000 THE PRESIDING OFFICER: THE 6058 03:28:01,001 --> 03:28:03,000 SENATOR FROM MONTANA IS 6059 03:28:03,001 --> 03:28:05,000 RECOGNIZED. 6060 03:28:05,001 --> 03:28:07,000 MR. BAUCUS: WE'RE KIND OF 6061 03:28:07,001 --> 03:28:08,000 PLAYING THINGS BY EAR. 6062 03:28:08,001 --> 03:28:09,000 I WOULD ASK UNANIMOUS CONSENT 6063 03:28:09,001 --> 03:28:11,000 THAT THE SENATOR FROM WYOMING BE 6064 03:28:11,001 --> 03:28:13,000 ALLOWED TO SPEAK -- BE 6065 03:28:13,001 --> 03:28:15,000 RECOGNIZED TO SPEAK FOR DEBATE 6066 03:28:15,001 --> 03:28:17,000 ONLY, AND AT A LATER POINT WE'LL 6067 03:28:17,001 --> 03:28:20,000 FIGURE OUT ALLOCATION OF TIME ON BOTH SIDES. 6068 03:28:20,001 --> 03:28:22,000 IF HE WISHES TO SPEAK NOW? 6069 03:28:22,001 --> 03:28:23,000 MR. ENZI: YES, MR. PRESIDENT, I 6070 03:28:23,001 --> 03:28:24,000 WOULD LIKE TO SPEAK. 6071 03:28:24,001 --> 03:28:25,000 THE PRESIDING OFFICER: THE 6072 03:28:25,001 --> 03:28:26,000 SENATOR FROM WYOMING IS 6073 03:28:26,001 --> 03:28:28,000 RECOGNIZED. 6074 03:28:28,001 --> 03:28:34,000 WITHOUT OBJECTION. 6075 03:28:34,001 --> 03:28:35,000 THE SENATOR FROM WYOMING. 6076 03:28:35,001 --> 03:28:36,000 MR. ENZI: MR. PRESIDENT, THANK 6077 03:28:36,001 --> 03:28:38,000 YOU. IT WAS MY UNDERSTANDING I WOULD 6078 03:28:38,001 --> 03:28:39,000 BE IN CHARGE OF THE NEXT 30 6079 03:28:39,001 --> 03:28:41,000 MINUTES AND THEN IT WOULD REVERT 6080 03:28:41,001 --> 03:28:43,000 TO THE OTHER SIDE FOR 30 MINUTES 6081 03:28:43,001 --> 03:28:46,000 AFR THAT. 6082 03:28:46,001 --> 03:28:48,000 AT SOME POINT, 6083 03:28:48,001 --> 03:28:49,000 MR. BAUCUS: THE NEXT 30 AFTER 6084 03:28:49,001 --> 03:28:51,000 THAT. THE PRESIDING OFFICER: WITHOUT 6085 03:28:51,001 --> 03:28:52,000 OBJECTION, SO ORDERED. MR. ENZI: IT'S ALSO MY 6086 03:28:52,001 --> 03:28:54,000 UNDERSTANDING THAT AT ANY TIME 6087 03:28:54,001 --> 03:28:55,000 THERE IS AN AGREEMENT FOR A 6088 03:28:55,001 --> 03:28:57,000 VOTE, WE'LL KIND OF CANCEL OUT 6089 03:28:57,001 --> 03:29:03,000 WHAT WE'RE DOING HERE, BUT THERE 6090 03:29:03,001 --> 03:29:07,000 IS NO AGREEMENT YET, AND I'M NOT 6091 03:29:07,001 --> 03:29:08,000 NOT -- SO I -- I WANTED TO THANK 6092 03:29:08,001 --> 03:29:12,000 THE SENATOR FROM CONNECTIC 6093 03:29:12,001 --> 03:29:13,000 SETTING UP MY SPEECH SO WELL. 6094 03:29:13,001 --> 03:29:15,000 HE SAID THAT THERE WASN'T 6095 03:29:15,001 --> 03:29:18,000 ANYPLACE THAT ANYBODY CAN SHOW 6096 03:29:18,001 --> 03:29:20,000 ANY DECLINE IN GUARANTEED 6097 03:29:20,001 --> 03:29:22,000 BENEFITS. 6098 03:29:22,001 --> 03:29:23,000 IN WHAT 6099 03:29:23,001 --> 03:29:24,000 TRY TO DO THAT. 6100 03:29:24,001 --> 03:29:26,000 OF COURSE, THE WORD GUARANTEED 6101 03:29:26,001 --> 03:29:27,000 BENEFITS REALLY DOESN'T SHOW UP 6102 03:29:27,001 --> 03:29:30,000 ANYWHERE IN WHAT WE' 6103 03:29:30,001 --> 03:29:31,000 BENEFITS DOES BUT NOT GUARANTEED BENEFITS. 6104 03:29:31,001 --> 03:29:37,000 AND IN MY OPINION, GETTING TO BE 6105 03:29:37,001 --> 03:29:39,000 IN A NURSING HOME OR BEING ABLE 6106 03:29:39,001 --> 03:29:41,000 TO SEE A DOCTOR, SOME OF THOSE 6107 03:29:41,001 --> 03:29:44,000 OUGHT TO BE KIND OF CONSIDERED 6108 03:29:44,001 --> 03:29:47,000 GUARANTEED BENEFITS, BUT ILL 6109 03:29:47,001 --> 03:29:49,000 GET -- BUT I'LL GET INTO THAT IN 6110 03:29:49,001 --> 03:29:50,000 MY SPEECH HERE AND COVER 6111 03:29:50,001 --> 03:29:51,000 THESE AREAS THAT 6112 03:29:51,001 --> 03:29:53,000 VERY IMPORTANT TO SENIORS, 6113 03:29:53,001 --> 03:29:54,000 BECAUSE I AM OPPOSED TO THE HALF 6114 03:29:54,001 --> 03:29:56,000 A TRILLION DOLLARS IN MEDICARE 6115 03:29:56,001 --> 03:29:58,000 CUTS IN 6116 03:29:58,001 --> 03:30:00,000 NOT GOING ONLY TO SOLVE 6117 03:30:00,001 --> 03:30:01,000 MEDICARE. 6118 03:30:01,001 --> 03:30:02,000 NOW, SOME OF MY DEMOCRATIC 6119 03:30:02,001 --> 03:30:04,000 COLLEAGUES HAVE ATTEMPTED TO 6120 03:30:04,001 --> 03:30:05,000 ARGUE THAT THIS BILL DOESN'T CUT 6121 03:30:05,001 --> 03:30:07,000 THE MEDICARE 6122 03:30:07,001 --> 03:30:09,000 THEY HAVE FURTHER SAID THAT SUCH 6123 03:30:09,001 --> 03:30:10,000 CUTS ARE JUSTIFIED AND WILL NOT 6124 03:30:10,001 --> 03:30:12,000 RM THE PROGRAM. 6125 03:30:12,001 --> 03:30:14,000 THEY HAVE ALSO ARGUED THAT NO 6126 03:30:14,001 --> 03:30:15,000 BENEFICIARIES WILL LOSE THEIR 6127 03:30:15,001 --> 03:30:16,000 BENEFITS, THEIR GUARANTEED 6128 03:30:16,001 --> 03:30:17,000 BENEFITS -- AND THEY'RE VERY 6129 03:30:17,001 --> 03:30:18,000 CAREFUL ON THAT AND I UNDERSTAND 6130 03:30:18,001 --> 03:30:19,000 WHY THEY ARE VERY CAREFUL ON 6131 03:30:19,001 --> 03:30:21,000 THAT BECAUSE THERE ARE OTHER 6132 03:30:21,001 --> 03:30:22,000 BENEFITS THAT ARE BEING CUT THAT 6133 03:30:22,001 --> 03:30:25,000 WILL BE CONSIDERED BY THOSE 6134 03:30:25,001 --> 03:30:30,000 PEOPLE WHO LOSE THAT BENEFIT TO 6135 03:30:30,001 --> 03:30:31,000 BE A GUARANTEED 6136 03:30:31,001 --> 03:30:33,000 UNFORTUNATELY, ALL OF THOSE 6137 03:30:33,001 --> 03:30:34,000 STATEMENTS ARE FALSE T. DOES NOT 6138 03:30:34,001 --> 03:30:35,000 MATTER HOW M 6139 03:30:35,001 --> 03:30:36,000 FALSE. 6140 03:30:36,001 --> 03:30:38,000 IT DOES NOT MATTER HOW MANY 6141 03:30:38,001 --> 03:30:40,000 TIMES MY COLLEAGUES REPOET THESE 6142 03:30:40,001 --> 03:30:42,000 CLAIMS, THEY DO NOT -- REPEAT 6143 03:30:42,001 --> 03:30:43,000 THESE CLAIMS, THEY DO NOT BECOME 6144 03:30:43,001 --> 03:30:45,000 ANY MORE ACCURATE. 6145 03:30:45,001 --> 03:30:46,000 THIS BILL CUTS $464 FROM 6146 03:30:46,001 --> 03:30:47,000 MEDICARE PROGRAM. 6147 03:30:47,001 --> 03:30:52,000 IT SLASHES PAYMENTS TO 6148 03:30:52,001 --> 03:30:53,000 HOSPITALS, NURSING 6149 03:30:53,001 --> 03:30:55,000 HEALTH AGENCIES AND HOSPICE. 6150 03:30:55,001 --> 03:30:58,000 THE MONEY FROM THESE CUTS DOES 6151 03:30:58,001 --> 03:30:59,000 NOT GO TO 6152 03:30:59,001 --> 03:31:01,000 THE MONEY GOES TO NEW PROGRAMS 6153 03:31:01,001 --> 03:31:03,000 FOR OTHERS. 6154 03:31:03,001 --> 03:31:04,000 THESE CUTS WILL AFFECT THE CARE 6155 03:31:04,001 --> 03:31:05,000 PROVIDED TO MEDICARE 6156 03:31:05,001 --> 03:31:06,000 BENE 6157 03:31:06,001 --> 03:31:07,000 THE AMERICAN HEALTH CARE 6158 03:31:07,001 --> 03:31:10,000 ASSOCIATION, WHICH REPRESENTS 6159 03:31:10,001 --> 03:31:11,000 NURSING HOMES, S 6160 03:31:11,001 --> 03:31:13,000 CUTS IN THE REID BILL WOULD 6161 03:31:13,001 --> 03:31:15,000 FORCE LAYOFFS, LOWER SALARIES, 6162 03:31:15,001 --> 03:31:17,000 REDUCE BENEFITS, AND ULTIMATELY 6163 03:31:17,001 --> 03:31:18,000 WOULD HURT PATIENTS' QUALITY OF 6164 03:31:18,001 --> 03:31:22,000 CARE. 6165 03:31:22,001 --> 03:31:23,000 A 6166 03:31:23,001 --> 03:31:24,000 EVEN MORE CUTS TO SAVE MEDICARE. 6167 03:31:24,001 --> 03:31:25,000 IT'S IN THE BILL. 6168 03:31:25,001 --> 03:31:27,000 THERE'S A COMMISSION IN THERE. 6169 03:31:27,001 --> 03:31:28,000 SO WITH THE SIDE DEALS, THOUGH, 6170 03:31:28,001 --> 03:31:30,000 THAT HAVE BEEN MADE WITH 6171 03:31:30,001 --> 03:31:33,000 LOBBYISTS, THE ONLY PLACE THESE 6172 03:31:33,001 --> 03:31:34,000 CUTS CAN COME FROM IS FROM 6173 03:31:34,001 --> 03:31:36,000 SENIORS, 6174 03:31:36,001 --> 03:31:38,000 A LITTLE MORE DETAIL LATER. 6175 03:31:38,001 --> 03:31:41,000 I'VE HEARD SIMILAR STATEMENTS 6176 03:31:41,001 --> 03:31:43,000 FROM HOME HEALTH 6177 03:31:43,001 --> 03:31:44,000 THAT'S MORE THAN $40 BILLION IN CUTS. 6178 03:31:44,001 --> 03:31:46,000 HOSPICE PROVIDERS, THAT'S 6179 03:31:46,001 --> 03:31:47,000 $8 BILLION IN CUTS. 6180 03:31:47,001 --> 03:31:48,000 AND HOSPITALS, THAT'S 6181 03:31:48,001 --> 03:31:49,000 $130 BILLION IN CUTS. 6182 03:31:49,001 --> 03:31:52,000 NOW, IF THESE MEDICARE CUTS GO 6183 03:31:52,001 --> 03:31:54,000 INTO EFFECT, IT COULD DRIVE MAN 6184 03:31:54,001 --> 03:31:57,000 PROGRAM. 6185 03:31:57,001 --> 03:31:59,000 THAT WILL MEAN PATIENTS DO NOT 6186 03:31:59,001 --> 03:32:00,000 HAVE 6187 03:32:00,001 --> 03:32:03,000 THEY NEED. 6188 03:32:03,001 --> 03:32:05,000 SOME OF MY DEMOCRATIC COLLEAGUES 6189 03:32:05,001 --> 03:32:06,000 THAT ACCUSED US OF TRYG TO 6190 03:32:06,001 --> 03:32:07,000 SCARE MEDICARE BENEFICIARIES. 6191 03:32:07,001 --> 03:32:08,000 IF SENIORS ARE SCARED BY OUR 6192 03:32:08,001 --> 03:32:10,000 STATEMENTS, THEY SHOULD BE 6193 03:32:10,001 --> 03:32:12,000 TERRIFIED BY WHAT THE 6194 03:32:12,001 --> 03:32:15,000 ADMINISTRATION HAS TO SAY ABOUT 6195 03:32:15,001 --> 03:32:16,000 THE DEMOCRATS' HEALTH REFORM 6196 03:32:16,001 --> 03:32:17,000 BILL. 6197 03:32:17,001 --> 03:32:19,000 THE ADMINISTRATION'S OWN CHIEF 6198 03:32:19,001 --> 03:32:20,000 ACTUARY, RICHARD FOSR, 6199 03:32:20,001 --> 03:32:22,000 RECENTLY WROTE THAT THE STEEP 6200 03:32:22,001 --> 03:32:23,000 MEDICARE CUTS IN THE 6201 03:32:23,001 --> 03:32:25,000 HOUSE-PASSED HEALTH REFORM BILL 6202 03:32:25,001 --> 03:32:27,000 WOULD MAKE IT DIFFICULT FOR MANY 6203 03:32:27,001 --> 03:32:29,000 PRIDERS TO REMAIN PROFITABLE 6204 03:32:29,001 --> 03:32:31,000 AND CAUSE TM TO END THEIR 6205 03:32:31,001 --> 03:32:33,000 PARTICIPATION IN MEDICARE. 6206 03:32:33,001 --> 03:32:37,000 HE WENT ON TO NOTE THAT THIS 6207 03:32:37,001 --> 03:32:40,000 COULD JEOPARDIZE MEDICARE'S 6208 03:32:40,001 --> 03:32:41,000 BENEFICIARIES' ACCESS TO CARE. 6209 03:32:41,001 --> 03:32:42,000 AS THE SENIOR SENATOR FROM 6210 03:32:42,001 --> 03:32:43,000 TENNESSEE NOTED YESTERDAY, IT'S 6211 03:32:43,001 --> 03:32:46,000 THE MEDICARE CUTS IN THE REID 6212 03:32:46,001 --> 03:32:47,000 BILL THAT ARE 6213 03:32:47,001 --> 03:32:49,000 SENIORS. MEDICARE BENEFICIARIES 6214 03:32:49,001 --> 03:32:53,000 UNDERSTAND THAT IF PROVIDERS ARE 6215 03:32:53,001 --> 03:32:54,000 NO LONGER ABLE TO TAKE MEDICARE 6216 03:32:54,001 --> 03:32:55,000 PATIENTS, THEY, THE SENIORS, 6217 03:32:55,001 --> 03:32:57,000 WILL NOT GET CARE. 6218 03:32:57,001 --> 03:32:59,000 A LOT OF GRANDMAS AND GRANDPAS 6219 03:32:59,001 --> 03:33:01,000 HAVE FIGURED IT OUT AND THEY'RE 6220 03:33:01,001 --> 03:33:03,000 NOT GOING TO STAND FOR IT. 6221 03:33:03,001 --> 03:33:04,000 NOW, THE CHAIRMAN OF THE FINANCE 6222 03:33:04,001 --> 03:33:06,000 COMMITTEE HAS REPEATEDLY SAID 6223 03:33:06,001 --> 03:33:09,000 THAT THIS BILL WILL NOT CUT OR 6224 03:33:09,001 --> 03:33:10,000 REDUCE ANY GUARANTEED MEDICARE 6225 03:33:10,001 --> 03:33:11,000 BENEFIT. 6226 03:33:11,001 --> 03:33:12,000 THAT STATEMENT SEEMS TO IGNORE 6227 03:33:12,001 --> 03:33:13,000 WHAT THIS BILL WILL DO TO 6228 03:33:13,001 --> 03:33:15,000 PROVIDERS. 6229 03:33:15,001 --> 03:33:17,000 IF A MEDICARE PATIENT CANNOT GET 6230 03:33:17,001 --> 03:33:19,000 INTO A NURSING HOME, THEY DON'T 6231 03:33:19,001 --> 03:33:23,000 HAVE NURSING HOME BENEFITS. 6232 03:33:23,001 --> 03:33:24,000 IF THEY CAN'T FIND A HOME HEALTH 6233 03:33:24,001 --> 03:33:25,000 AIDE WILLING TO TAKE MEDICARE 6234 03:33:25,001 --> 03:33:26,000 PATIENTS, THEY DON'T HAVE HEALTH 6235 03:33:26,001 --> 03:33:30,000 HOME BENEFITS. 6236 03:33:30,001 --> 03:33:33,000 WHICH YOU CAN'T GET A DOCTOR TO 6237 03:33:33,001 --> 03:33:34,000 SEE YOU, IS NOT HEALTH CARE 6238 03:33:34,001 --> 03:33:35,000 YOU DON'T HAVE BENEFITS IF YOU 6239 03:33:35,001 --> 03:33:38,000 CAN'T GET A PROVIDER TO TREAT 6240 03:33:38,001 --> 03:33:40,000 YOU AND, UNFORTUNATELY, THAT'S 6241 03:33:40,001 --> 03:33:42,000 EXACTLY WHAT THIS BILL WILL DO. 6242 03:33:42,001 --> 03:33:44,000 SOME OF MY DEMOCRATIC COLLEAGUES 6243 03:33:44,001 --> 03:33:45,000 HAVE ALSO ATTEMPTED TO JUSTIFY 6244 03:33:45,001 --> 03:33:48,000 THE MEDICARE CUTS IN THE REID 6245 03:33:48,001 --> 03:33:50,000 BILL BY ARGUING THAT MANY OF THE TRADE ASSOCIATIONS REPRESENTING 6246 03:33:50,001 --> 03:33:52,000 HEALTH CARE PROVIDERS HAVE 6247 03:33:52,001 --> 03:33:54,000 ENDORSED THIS BILL. 6248 03:33:54,001 --> 03:33:55,000 THEY'RE CORRECT THAT SEVERAL 6249 03:33:55,001 --> 03:33:57,000 WASHINGTON-BASED TRADE 6250 03:33:57,001 --> 03:34:00,000 ASSOCIATIONS AND THEIR LOBBYISTS 6251 03:34:00,001 --> 03:34:01,000 HAVE ENDORSED THE REID BILL. 6252 03:34:01,001 --> 03:34:02,000 IT'S PROBABLY WORTH EXPLORING 6253 03:34:02,001 --> 03:34:03,000 WHY SOME OF THE GROUPS HAVE 6254 03:34:03,001 --> 03:34:05,000 CHOSEN TO END 6255 03:34:05,001 --> 03:34:07,000 LEGISLATION. 6256 03:34:07,001 --> 03:34:09,000 IN SOME CASES, MOTIVATIONS ARE OBVIOUS. 6257 03:34:09,001 --> 03:34:11,000 SOME DRUG MANUFACTURERS ARE 6258 03:34:11,001 --> 03:34:13,000 SELF-INTEREST AND GREED. 6259 03:34:13,001 --> 03:34:15,000 THEY NEGOTIATED A SECRET DEAL 6260 03:34:15,001 --> 03:34:16,000 WITH THE WHITE HOUSE THAT WILL 6261 03:34:16,001 --> 03:34:21,000 ACTUALLY INCREASE HOW MEDICARE 6262 03:34:21,001 --> 03:34:24,000 SPENDS ON BRAND-NAME DRUGS. BRAND-NAME DRUGS. 6263 03:34:24,001 --> 03:34:26,000 THEY DIDN'T TOUCH THE GER ERICS, 6264 03:34:26,001 --> 03:34:28,000 THEY'RE INTERESTED -- GENERICS, 6265 03:34:28,001 --> 03:34:29,000 THEY'RE INTERESTED IN THE 6266 03:34:29,001 --> 03:34:31,000 BRAND-NAME DGS. 6267 03:34:31,001 --> 03:34:32,000 UNDER THE DEAL, THE DRUG 6268 03:34:32,001 --> 03:34:33,000 MANUFACTURERS WILL PROVIDE 6269 03:34:33,001 --> 03:34:34,000 DISCOUNTS ON BRAND-NAME 6270 03:34:34,001 --> 03:34:36,000 PRESCRIPTION DRUGS WHEN THE 6271 03:34:36,001 --> 03:34:37,000 SENIORS WILL IN THE MEDICARE 6272 03:34:37,001 --> 03:34:39,000 COVERAGE GAP, KNOWN AS THE 6273 03:34:39,001 --> 03:34:41,000 DOUGHNUT HOLE, NOW, THEY MAKE 6274 03:34:41,001 --> 03:34:43,000 THE PAYMENTS DIRECTLY TO THE CUSTOMER. 6275 03:34:43,001 --> 03:34:44,000 IT DOESN'T GO THROUGH MEDICARE, 6276 03:34:44,001 --> 03:34:45,000 DIRECTLY TO THE CUSTOMER. 6277 03:34:45,001 --> 03:34:47,000 THAT WAY THEY CAN 6278 03:34:47,001 --> 03:34:50,000 CUSTOMER CONTACT AND KEEP THEM 6279 03:34:50,001 --> 03:34:51,000 ADDICTED TO THE BRAND NAME. 6280 03:34:51,001 --> 03:34:52,000 GENERICS ARE CHEAPER. 6281 03:34:52,001 --> 03:34:55,000 A LOT OF PEOPLE WHEN THEY GO 6282 03:34:55,001 --> 03:34:56,000 INTO THE DOUGHNUT HOLE SWITCH TO GENERICS. 6283 03:34:56,001 --> 03:35:00,000 THAT SAVES THEM MONEY AND IT 6284 03:35:00,001 --> 03:35:02,000 SAVES US BECAUSE WHEN THEY GET THROUGH 6285 03:35:02,001 --> 03:35:03,000 THE DOUGHNUT HOLE, THEY WILL 6286 03:35:03,001 --> 03:35:05,000 STAY WITH WHATEVER THEY'RE ON IN 6287 03:35:05,001 --> 03:35:07,000 THE DOUGHNUT HOLE. 6288 03:35:07,001 --> 03:35:08,000 SO IF THEY'RE FORCED TO STAY ON 6289 03:35:08,001 --> 03:35:09,000 A BRAND NAME TO GET A LITTLE 6290 03:35:09,001 --> 03:35:11,000 EXTRA DISCOUNT AS THEY GO 6291 03:35:11,001 --> 03:35:13,000 THROUGH THE DOUGHNUT HOLE, 6292 03:35:13,001 --> 03:35:14,000 THEY'LL STAY WITH THE BRAND NAME 6293 03:35:14,001 --> 03:35:17,000 WHEN THE 6294 03:35:17,001 --> 03:35:18,000 FOR IT WHEN IT GOES ABOVE THE 6295 03:35:18,001 --> 03:35:20,000 DOUGHNUT HOLE, WHICH IS THE REST 6296 03:35:20,001 --> 03:35:23,000 OF THE YEAR. 6297 03:35:23,001 --> 03:35:25,000 THAT COULD BE A HUGE NUMBER. 6298 03:35:25,001 --> 03:35:29,000 SO WHILE IT LOOKS GENEROUS 6299 03:35:29,001 --> 03:35:31,000 THE DRUG COMPANIES, BEWARE. 6300 03:35:31,001 --> 03:35:33,000 THEIR GENEROSITY IS SUSPECT WITH 6301 03:35:33,001 --> 03:35:35,000 WHAT THEY WILL MAKE WHEN IT GETS 6302 03:35:35,001 --> 03:35:36,000 THROUGH THE DOUGHNUT HOLE 6303 03:35:36,001 --> 03:35:37,000 UNDER THE TERMS OF THE 6304 03:35:37,001 --> 03:35:39,000 SWEETHEART DEAL BETWEEN THE 6305 03:35:39,001 --> 03:35:41,000 WHITE HOUSE AND THE DRUG MAKERS, 6306 03:35:41,001 --> 03:35:42,000 DISCOUNTS ARE PROVIDED FOR THESE 6307 03:35:42,001 --> 03:35:44,000 BRAND-NAME DRUGS. 6308 03:35:44,001 --> 03:35:45,000 THIS WILL ENCOURAGE SENIORS TO 6309 03:35:45,001 --> 03:35:47,000 CONTINUE TO GET THOSE MORE 6310 03:35:47,001 --> 03:35:50,000 EXPENSIVE DRUGS AND IT WILL 6311 03:35:50,001 --> 03:35:52,000 ACTUALLY COST THE TAXPAYERS 6312 03:35:52,001 --> 03:35:54,000 $15 BILLION BECAUSE THE DEAL 6313 03:35:54,001 --> 03:35:56,000 WILL ACTUALLY INCREASE MEDICARE 6314 03:35:56,001 --> 03:35:58,000 COSTS. 6315 03:35:58,001 --> 03:36:00,000 IN OTHER CASES, PROVIDER GROUPS 6316 03:36:00,001 --> 03:36:02,000 WERE PROMISED SPECIAL DEALS IF 6317 03:36:02,001 --> 03:36:04,000 THEY AGREED TO SUPPORT THE REID 6318 03:36:04,001 --> 03:36:05,000 BILL, OR WHATEVER BILL WE WERE 6319 03:36:05,001 --> 03:36:06,000 WORKING ON AT THAT TIME. 6320 03:36:06,001 --> 03:36:08,000 FOR INSTANCE, 6321 03:36:08,001 --> 03:36:10,000 REPORTS HAVE DESCRIBED HOW THE 6322 03:36:10,001 --> 03:36:12,000 AMERICAN MEDICAL ASSOCIATION HAS 6323 03:36:12,001 --> 03:36:13,000 PROMISED -- WAS PROMISED A 6324 03:36:13,001 --> 03:36:15,000 PERMANENT FIX TO THE MEDICARE 6325 03:36:15,001 --> 03:36:17,000 PAYMENT FORMULA FOR DOCTORS IF 6326 03:36:17,001 --> 03:36:18,000 THEY AGREED T 6327 03:36:18,001 --> 03:36:20,000 BILL. 6328 03:36:20,001 --> 03:36:22,000 OR A ONE-YEAR FIX IF THERE WAS 6329 03:36:22,001 --> 03:36:26,000 AN END TO JUNK LAWSUITS. 6330 03:36:26,001 --> 03:36:27,000 UNDER CURRENT LAW, 6331 03:36:27,001 --> 03:36:29,000 MEDICARE PAYMENTS ARE SCHEDULED 6332 03:36:29,001 --> 03:36:30,000 TO BE CUT BY MORE THAN 40% OVER 6333 03:36:30,001 --> 03:36:32,000 THE NEXT DECADE. THAT'S ALREADY IN PLACE. 6334 03:36:32,001 --> 03:36:33,000 THAT'S NOT A PART OF THE BILL. 6335 03:36:33,001 --> 03:36:35,000 THE COST OF FIXING THIS FLAWED 6336 03:36:35,001 --> 03:36:37,000 GOVERNMENT 6337 03:36:37,001 --> 03:36:38,000 BE MORE THAN 6338 03:36:38,001 --> 03:36:40,000 WE KNOW THAT BECAUSE WE'VE 6339 03:36:40,001 --> 03:36:41,000 DEBATED IT ON THE FLOOR AND WE DECIDED THAT WE WERE GOING TO 6340 03:36:41,001 --> 03:36:43,000 HAVE TO PAY FOR THAT IF WE WERE 6341 03:36:43,001 --> 03:36:46,000 GOING TO DO IT. 6342 03:36:46,001 --> 03:36:47,000 LET'S SEE, WITH $464 BILLION IN 6343 03:36:47,001 --> 03:36:48,000 MEDICARE MONEY THAT WE'RE USING 6344 03:36:48,001 --> 03:36:50,000 ON OTHER THINGS. 6345 03:36:50,001 --> 03:36:52,000 THAT'S WHY I KEEP SAYING THAT 6346 03:36:52,001 --> 03:36:55,000 MEDICARE MONEY ONLY OUGHT TO GO 6347 03:36:55,001 --> 03:36:57,000 TO MEDICARE BENEFITS. 6348 03:36:57,001 --> 03:37:00,000 AND THAT $250 BILLION IN FIXING 6349 03:37:00,001 --> 03:37:01,000 THE DOCTORS 6350 03:37:01,001 --> 03:37:02,000 POSSIBLE FOR PEOPLE TO SEE THE 6351 03:37:02,001 --> 03:37:03,000 DOCTORS. 6352 03:37:03,001 --> 03:37:05,000 NOW, I CAN UNDERSTAND WHY 6353 03:37:05,001 --> 03:37:07,000 DOCTORS WANT TO FIX THIS FLAWED 6354 03:37:07,001 --> 03:37:08,000 GOVERNMENT PRICE-CONTROL SYSTEM, 6355 03:37:08,001 --> 03:37:10,000 AND THAT'S WHAT IT IS. 6356 03:37:10,001 --> 03:37:13,000 THEY'RE TELLING THE DOCTORS WHAT 6357 03:37:13,001 --> 03:37:15,000 THEY C CHARGE A CUSTOMER, 6358 03:37:15,001 --> 03:37:16,000 REGARDLESS OF HOW LONG A TIME 6359 03:37:16,001 --> 03:37:18,000 IT'S GOING TO TAKE THEM TO TAKE 6360 03:37:18,001 --> 03:37:20,000 CARE OF THAT PATIENT. 6361 03:37:20,001 --> 03:37:21,000 AND 6362 03:37:21,001 --> 03:37:23,000 DISCOVERED THAT IT COSTS MORE 6363 03:37:23,001 --> 03:37:25,000 AND IF THEY CONTINUE TO DO THAT, 6364 03:37:25,001 --> 03:37:26,000 THEY HAVE TO GO OUT OF BUSINESS. 6365 03:37:26,001 --> 03:37:27,000 THAT'S KIND OF A SMALL BUSINESS 6366 03:37:27,001 --> 03:37:28,000 PHILOSOPHY. 6367 03:37:28,001 --> 03:37:29,000 YOU TAKE IN LESS MONEY THAN WHA 6368 03:37:29,001 --> 03:37:34,000 IT COSTS YOU TO BE IN BUSINESS, 6369 03:37:34,001 --> 03:37:35,000 YOU'RE OUT OF BUSINESS. 6370 03:37:35,001 --> 03:37:39,000 SO I DON'T THINK THE 6371 03:37:39,001 --> 03:37:41,000 KIND OF A GOVERNMENT PRICE-CONTROL SYSTEM. 6372 03:37:41,001 --> 03:37:46,000 AND AS A RESULT, 40% OF THE 6373 03:37:46,001 --> 03:37:47,000 DOCT 6374 03:37:47,001 --> 03:37:49,000 MEDICAID, AND IT'S -- IT'S 6375 03:37:49,001 --> 03:37:51,000 GROWING IN PERCENTAGE NOW ON 6376 03:37:51,001 --> 03:37:52,000 MEDICARE THE SAME WAY. 6377 03:37:52,001 --> 03:37:54,000 WHEN YOU FIX THE PRICE, SOME 6378 03:37:54,001 --> 03:37:55,000 PEOPLE CAN'T AFFORD TO PROVIDE 6379 03:37:55,001 --> 03:37:57,000 IT FOR THAT. 6380 03:37:57,001 --> 03:37:59,000 THEY CAN'T TAKE THOSE PATIENTS. 6381 03:37:59,001 --> 03:38:01,000 TALKING TO A FRIEND OF MINE FROM 6382 03:38:01,001 --> 03:38:03,000 FLORIDA WHO SAID, EVERY TIME YOU 6383 03:38:03,001 --> 03:38:05,000 CALL A DOCTOR NOW, THEY SAY, ARE 6384 03:38:05,001 --> 03:38:06,000 YOU O 6385 03:38:06,001 --> 03:38:08,000 IF YOU SAY YOU'RE ON MEDICARE, 6386 03:38:08,001 --> 03:38:10,000 THEY SAY, "WE'RE NOT TAKING ANY NEW PATIENTS." 6387 03:38:10,001 --> 03:38:11,000 IF YOU CAN'T SEE A DOCTOR, YOU 6388 03:38:11,001 --> 03:38:13,000 DON'T HAVE A BENEFIT. 6389 03:38:13,001 --> 03:38:15,000 NOW, IT SHOWS THE EXACT PROBLEMS 6390 03:38:15,001 --> 03:38:18,000 IS A RESULT FROM LETTING 6391 03:38:18,001 --> 03:38:20,000 CONTROLS TO SET PAYMENT RATES. 6392 03:38:20,001 --> 03:38:21,000 WHAT I DON'T UNDERSTAND IS WHY 6393 03:38:21,001 --> 03:38:23,000 THE A.M.A. CONTINUES TO SUPPORT 6394 03:38:23,001 --> 03:38:25,000 THE BILL WHEN THEY GOT NOTHING 6395 03:38:25,001 --> 03:38:28,000 FOR THEIR DEAL. 6396 03:38:28,001 --> 03:38:29,000 WE DIDN'T FIX THE 6397 03:38:29,001 --> 03:38:30,000 PROBLEM AND WE HAVEN'T FIXED THE 6398 03:38:30,001 --> 03:38:32,000 JUNK LAWSUITS PROBLEM. 6399 03:38:32,001 --> 03:38:34,000 I REMEMBER 6400 03:38:34,001 --> 03:38:35,000 APPEARING AT THE NATIONAL 6401 03:38:35,001 --> 03:38:38,000 CONVENTION OF 6402 03:38:38,001 --> 03:38:41,000 MEDICAL ASSOCIATION AND 6403 03:38:41,001 --> 03:38:42,000 PROMISING THAT THE 6404 03:38:42,001 --> 03:38:44,000 TORT REFORM, THAT THERE WOULD BE 6405 03:38:44,001 --> 03:38:46,000 AN TONED THESE JUNK LAWSUITS. 6406 03:38:46,001 --> 03:38:47,000 ALL OF OUR ATTEMPTS, EITHER IN 6407 03:38:47,001 --> 03:38:50,000 THE "HELP" COMMITTEE OR IN THE 6408 03:38:50,001 --> 03:38:53,000 FINANCE COMMITTEE TO EVEN -- 6409 03:38:53,001 --> 03:38:56,000 EVEN BRING THAT UP HAVE BEEN 6410 03:38:56,001 --> 03:38:57,000 EITHER VOTED DOWN OR DENIE, AND 6411 03:38:57,001 --> 03:38:58,000 AS A RESULT, THERE'S NOTHING IN 6412 03:38:58,001 --> 03:39:01,000 THIS BILL THAT'S GOING TO SOLVE 6413 03:39:01,001 --> 03:39:04,000 THAT PROBLEM. 6414 03:39:04,001 --> 03:39:06,000 NOW, THE BILL DOES NOTHING TO 6415 03:39:06,001 --> 03:39:07,000 FIX THE MEDICARE PAYMENT FORMULA 6416 03:39:07,001 --> 03:39:11,000 FOR THE DOCTORS. 6417 03:39:11,001 --> 03:39:14,000 INSTEAD, IT CUTS $464 BILLION 6418 03:39:14,001 --> 03:39:16,000 FROM MEDICARE AND USES THAT 6419 03:39:16,001 --> 03:39:18,000 EVEN IF THESE CUTS CAN BE MADE 6420 03:39:18,001 --> 03:39:20,000 WITHOUT HURTING SENIORS, THE 6421 03:39:20,001 --> 03:39:24,000 REPUBLICANS ARE SAYING USE THE 6422 03:39:24,001 --> 03:39:25,000 MONEY ONLY 6423 03:39:25,001 --> 03:39:27,000 MEDICARE MONEY FOR MEDICARE. 6424 03:39:27,001 --> 03:39:29,000 MEDICARE FUNDS SHOULD BE USED TO 6425 03:39:29,001 --> 03:39:31,000 FIX MEDICARE'S PROBLEMS, SUCH AS 6426 03:39:31,001 --> 03:39:35,000 THIS FLAWED PAYMENT FORMULA 6427 03:39:35,001 --> 03:39:36,000 KEEPS DOCTORS FROM TAKING 6428 03:39:36,001 --> 03:39:37,000 SENIORS. 6429 03:39:37,001 --> 03:39:38,000 TAKING HUNDREDS OF BILLIONS OF 6430 03:39:38,001 --> 03:39:40,000 DOLLARS OUT OF A MEDICARE 6431 03:39:40,001 --> 03:39:42,000 PROGRAM NOW WILL ONLY GUARANTEE 6432 03:39:42,001 --> 03:39:44,000 THAT IT WILL BE MUCH HARDER TO 6433 03:39:44,001 --> 03:39:46,000 PERMANENTLY FIX THE DOCTOR 6434 03:39:46,001 --> 03:39:48,000 PAYMENT ISSUE IN THE FUTURE. 6435 03:39:48,001 --> 03:39:50,000 I CAN UNDERSTAND WHY THE A.M.A. 6436 03:39:50,001 --> 03:39:52,000 CONTINUES TO SUPPORT -- 6437 03:39:52,001 --> 03:39:54,000 I CANNOT UNDERSTAND WHY THE 6438 03:39:54,001 --> 03:39:57,000 A.M.A. CONTINUES TO 6439 03:39:57,001 --> 03:40:00,000 TERRIBLE DEAL FOR DOCTORS. 6440 03:40:00,001 --> 03:40:01,000 IF YOU CAN'T SEE A DOCTOR, YOUR 6441 03:40:01,001 --> 03:40:03,000 BENEFITS, YOUR GUARANTEED 6442 03:40:03,001 --> 03:40:04,000 BENEFITS HAVE BEEN CUT. 6443 03:40:04,001 --> 03:40:06,000 APPARENTLY, THE MEMBERS OF THE 6444 03:40:06,001 --> 03:40:08,000 A.M.A. DON'T LIKE THE DEAL EITHER. 6445 03:40:08,001 --> 03:40:09,000 AT A RECENT CONVENTION, UP TO 6446 03:40:09,001 --> 03:40:11,000 40% OF THE CURRENT MEMBERSHIP OF 6447 03:40:11,001 --> 03:40:12,000 THE A.M.A. VOTED TO REJECT THIS 6448 03:40:12,001 --> 03:40:15,000 AL. 6449 03:40:15,001 --> 03:40:17,000 I KNOW THAT'S NOT A MAJORITY, 6450 03:40:17,001 --> 03:40:18,000 BUT MOST ASSOCIATIONS SURVIVE BY 6451 03:40:18,001 --> 03:40:19,000 CONSENSUS AGREEMENTS. 6452 03:40:19,001 --> 03:40:21,000 THAT MEANS THAT ALMOST ALL OF 6453 03:40:21,001 --> 03:40:23,000 THEIR MEMBERSHIP AGREES WITH THE 6454 03:40:23,001 --> 03:40:25,000 TACK THAT THEY'RE TAKING. 6455 03:40:25,001 --> 03:40:27,000 NOT JUST SLIGHTLY MORE THAN 6456 03:40:27,001 --> 03:40:28,000 HALF. 6457 03:40:28,001 --> 03:40:30,000 NOW THEIR 6458 03:40:30,001 --> 03:40:35,000 THAN 20% OF ALL DOCTORS. 6459 03:40:35,001 --> 03:40:40,000 IT'S A DWINDLING ASSOCIATION. 6460 03:40:40,001 --> 03:40:42,000 LET'S SEE, SO LE SO LESS THAN 20% OF 6461 03:40:42,001 --> 03:40:43,000 THE DOCTORS, HAD 40% THAT 6462 03:40:43,001 --> 03:40:44,000 OPPOSED IT. 6463 03:40:44,001 --> 03:40:46,000 WE'RE GETTING DOWN TO SOME 6464 03:40:46,001 --> 03:40:47,000 PRETTY SMALL PERCENTAGES OF ONES 6465 03:40:47,001 --> 03:40:48,000 THAT SUPPORTED WHAT THE A.M.A. 6466 03:40:48,001 --> 03:40:49,000 DID IN THEIR DEAL. 6467 03:40:49,001 --> 03:40:50,000 NOW, FINALLY, MANY PROVIDER 6468 03:40:50,001 --> 03:40:52,000 GROUPS HAVE BEEN RELUCTANT TO 6469 03:40:52,001 --> 03:40:53,000 SPEAKUT AGAINST THIS BILL 6470 03:40:53,001 --> 03:40:55,000 BECAUSE THEY'VE RECEIVED THREATS 6471 03:40:55,001 --> 03:40:57,000 FROM THE WHITE HOUSE AND 6472 03:40:57,001 --> 03:40:58,000 CONGRESSIONAL DEMOCRATS. 6473 03:40:58,001 --> 03:41:01,000 NURSING HOMES, HOME HEALTH 6474 03:41:01,001 --> 03:41:02,000 AGENCIES 6475 03:41:02,001 --> 03:41:04,000 HAVE ALL REPORTEDLY BEEN 6476 03:41:04,001 --> 03:41:05,000 THREATENED WITH FURTHER CUTS -- 6477 03:41:05,001 --> 03:41:07,000 FURTHER CUTS -- IF THEY SPEAK 6478 03:41:07,001 --> 03:41:09,000 OUT AGAINST THE BILL. 6479 03:41:09,001 --> 03:41:11,000 IS THAT FREEDOM OF SPEECH OR IS 6480 03:41:11,001 --> 03:41:12,000 IT JUST BAD ETHICS? 6481 03:41:12,001 --> 03:41:14,000 THEY'VE REPORTEDLY BEEN TOLD 6482 03:41:14,001 --> 03:41:16,000 THAT ANY PUBLIC STATEMENTS OF 6483 03:41:16,001 --> 03:41:19,000 OPPOSITION TO THE REID BILL WILL 6484 03:41:19,001 --> 03:41:20,000 LEAD TO EVEN MORE SEVERE CUTS. 6485 03:41:20,001 --> 03:41:22,000 THESE PROVIDERS HAVE HAD TO MAKE 6486 03:41:22,001 --> 03:41:25,000 THE CHOICE TO SILENTLY ACCEPT 6487 03:41:25,001 --> 03:41:28,000 DEVASTATING CUTS RHER 6488 03:41:28,001 --> 03:41:29,000 OPPOSE THEM AND RISK BEING 6489 03:41:29,001 --> 03:41:31,000 UTTERLY DESTROYED. 6490 03:41:31,001 --> 03:41:33,000 NOW, ONE OF THE MEDICARE 6491 03:41:33,001 --> 03:41:34,000 ADVANTAGE PROVIDERS IS HUMANA, 6492 03:41:34,001 --> 03:41:36,000 AND I'LL USE THEM AS AN EXAMPLE. 6493 03:41:36,001 --> 03:41:37,000 C.M.S. SAID THEY COULDN'T LET 6494 03:41:37,001 --> 03:41:39,000 THEIR CUSTOMERS KNOW WHAT WAS 6495 03:41:39,001 --> 03:41:42,000 ABOUT TO HAPPEN AND CHASTISED 6496 03:41:42,001 --> 03:41:45,000 THEM FOR SENDING OUT A LETTER. 6497 03:41:45,001 --> 03:41:46,000 I THOUGHT THE 6498 03:41:46,001 --> 03:41:51,000 TO KNOW AND THAT WE WERE IN A 6499 03:41:51,001 --> 03:41:52,000 NEW ERA OF TRANSPARENCY. 6500 03:41:52,001 --> 03:42:01,000 THAT DOESN'T SOUND VERY 6501 03:42:01,001 --> 03:42:02,000 TRANSPARENT TO ME. 6502 03:42:02,001 --> 03:42:03,000 SO HOW CAN THAT HAPPEN I 6503 03:42:03,001 --> 03:42:04,000 AMERICA? 6504 03:42:04,001 --> 03:42:05,000 AT ANY RATE, I HOPE MY 6505 03:42:05,001 --> 03:42:06,000 COLLEAGUES AND THE AMERICAN 6506 03:42:06,001 --> 03:42:08,000 PEOPLE WILL TAKE THESE FACTS 6507 03:42:08,001 --> 03:42:10,000 INTO ACCOUNT WHEN THEY HEAR 6508 03:42:10,001 --> 03:42:13,000 SENATORS TALK ABOUT PROVIDER 6509 03:42:13,001 --> 03:42:14,000 GROUPS SUPPORTING THIS BILL. 6510 03:42:14,001 --> 03:42:18,000 PROVIDER SUPPORT FOR THIS BILL 6511 03:42:18,001 --> 03:42:20,000 IS BEING DRIVEN PRIMARILY BY 6512 03:42:20,001 --> 03:42:21,000 GREED OR STUPIDITY OR FEAR. 6513 03:42:21,001 --> 03:42:22,000 WE KNOW THIS BILL 6514 03:42:22,001 --> 03:42:23,000 THE PROBLEMS IN THE AMERICAN 6515 03:42:23,001 --> 03:42:26,000 HEALTH CARE SYSTEM. 6516 03:42:26,001 --> 03:42:28,000 IT WILL NOT LOWER HEALTH CARE COSTS. 6517 03:42:28,001 --> 03:42:29,000 IT WILL NOT LOWER INSURANCE 6518 03:42:29,001 --> 03:42:31,000 PREMIUMS. 6519 03:42:31,001 --> 03:42:33,000 IT WILL STILL LEAVE 25 MILLION 6520 03:42:33,001 --> 03:42:37,000 PEOPLE UNINSURED. 6521 03:42:37,001 --> 03:42:38,000 WHAT THIS BILL WILL DO IS SPEND 6522 03:42:38,001 --> 03:42:39,000 $2.5 TRILLION AND GUARANTEE A 6523 03:42:39,001 --> 03:42:43,000 MUCH BIGGER ROLE FOR THE 6524 03:42:43,001 --> 03:42:44,000 GOVERNMENT IN DIG AT IN DICTATING HOW 6525 03:42:44,001 --> 03:42:46,000 HEALTH CARE WILL BE PROVIDED IN THIS COUNTRY. 6526 03:42:46,001 --> 03:42:47,000 IF YOU'RE NOT UNDER MEDICARE, 6527 03:42:47,001 --> 03:42:50,000 YES, YOUR GOVERNMENT IS GOING TO 6528 03:42:50,001 --> 03:42:52,000 TELL YOU WHAT IS ADEQUAT COVERAGE AND THEY'RE GOING TO 6529 03:42:52,001 --> 03:42:53,000 FORCE YOU TO BUY IT OR PAY A 6530 03:42:53,001 --> 03:42:55,000 PENALTY. 6531 03:42:55,001 --> 03:42:56,000 NOW, GIVEN THE RECENT 6532 03:42:56,001 --> 03:42:58,000 EXPERIENCES THE DOCTORS HAVE HAD 6533 03:42:58,001 --> 03:43:00,000 WITH MEDICARE PRICE CONTROLS, 6534 03:43:00,001 --> 03:43:01,000 THIS IS NOT AN OUTCOME THAT 6535 03:43:01,001 --> 03:43:03,000 BODES WELL FOR THE AMERICA'S 6536 03:43:03,001 --> 03:43:05,000 HEALTH CARE PROVIDERS OR THEIR 6537 03:43:05,001 --> 03:43:08,000 PATIENTS. 6538 03:43:08,001 --> 03:43:10,000 AND I REMIND EVERYBODY THAT IN 6539 03:43:10,001 --> 03:43:14,000 AUGUST, THERE WAS AN UPROAR AND 6540 03:43:14,001 --> 03:43:15,000 NOW, WE DON'T NOTICE IT AS MUCH 6541 03:43:15,001 --> 03:43:16,000 BECAUSE WE'RE NOT GOING TO GET 6542 03:43:16,001 --> 03:43:17,000 TO GO HOME THIS WEEKEND AND TALK 6543 03:43:17,001 --> 03:43:18,000 TO OUR CONSTITUENTS. 6544 03:43:18,001 --> 03:43:19,000 THAT MIGHT BE BY DESIGN BECAUSE 6545 03:43:19,001 --> 03:43:22,000 WE ALREADY KNOW WHAT OUR 6546 03:43:22,001 --> 03:43:23,000 CONSTITUENTS ARE SAYING 6547 03:43:23,001 --> 03:43:26,000 THEY'RE SAYING THIS BILL IS A 6548 03:43:26,001 --> 03:43:30,000 BAD DEAL FOR US. WHERE'S THE PROMISE THAT YOU 6549 03:43:30,001 --> 03:43:31,000 WERE GOING TO CUT COSTS FOR US? 6550 03:43:31,001 --> 03:43:35,000 WHERE ARE THE OTHER PROMISES 6551 03:43:35,001 --> 03:43:38,000 THAT WERE MADE WITH THIS HEALTH 6552 03:43:38,001 --> 03:43:39,000 CARE REFORM 6553 03:43:39,001 --> 03:43:41,000 I WOULD MENTION THAT THE C.B.O. 6554 03:43:41,001 --> 03:43:43,000 FOUND THAT PREMIUMS IN THE 6555 03:43:43,001 --> 03:43:49,000 INDIVIDUAL MARKET WILL RISE BY 6556 03:43:49,001 --> 03:43:50,000 10% TO 13% 6557 03:43:50,001 --> 03:43:52,000 DID NOTHING. 6558 03:43:52,001 --> 03:43:53,000 THAT'S C.B.O. 6559 03:43:53,001 --> 03:43:55,000 FAMILY POLICIES UNDER THE STATUS 6560 03:43:55,001 --> 03:43:58,000 QUO ARE PROJECTED TO COST 6561 03:43:58,001 --> 03:43:59,000 $13,100 ON THE AVERAGE, BUT 6562 03:43:59,001 --> 03:44:01,000 UNDER THIS HEALTH CARE BILL 6563 03:44:01,001 --> 03:44:02,000 SHOULD JUMP TO $15,200. 6564 03:44:02,001 --> 03:44:04,000 THAT'S NOT VERY GOOD NEWS FOR 6565 03:44:04,001 --> 03:44:06,000 THE PEOPLE IN MY STATE OR ANY 6566 03:44:06,001 --> 03:44:08,000 OTHER STATE. 6567 03:44:08,001 --> 03:44:10,000 NO BIG COST RISE IN U.S. 6568 03:44:10,001 --> 03:44:12,000 PREMIUMS IS SEEN IN THE STUDY, 6569 03:44:12,001 --> 03:44:14,000 SAID THE "NEW YORK TIMES." 6570 03:44:14,001 --> 03:44:17,000 "T WASHINGTON POST" DECLARED, 6571 03:44:17,001 --> 03:44:20,000 "S BOOST." 6572 03:44:20,001 --> 03:44:21,000 THE WHITE HOUSE CROWED THAT THE 6573 03:44:21,001 --> 03:44:23,000 C.B.O. REPORT WAS MORE GOOD NEWS 6574 03:44:23,001 --> 03:44:24,000 ABOUT WHAT REFORM WILL 6575 03:44:24,001 --> 03:44:27,000 FAMILIES STRUGGLING TO KEEP UP 6576 03:44:27,001 --> 03:44:29,000 WITH SKYROCKETING PREMIUMS UNDER 6577 03:44:29,001 --> 03:44:31,000 THE BROKEN STA 6578 03:44:31,001 --> 03:44:32,000 FINANCE CHAIRMAN, THE SENAT 6579 03:44:32,001 --> 03:44:33,000 FROM MONTANA, C 6580 03:44:33,001 --> 03:44:34,000 SENATE FLOOR THAT HEALTH CARE 6581 03:44:34,001 --> 03:44:37,000 REFORM IS FUNDAMENTALLY ABOUT 6582 03:44:37,001 --> 03:44:38,000 LOWERING HEALTH CARE COSTS 6583 03:44:38,001 --> 03:44:39,000 YEAH. 6584 03:44:39,001 --> 03:44:40,000 LOWERING COSTS IS WHAT HEALTH 6585 03:44:40,001 --> 03:44:42,000 CARE REFORM IS DESIGNED TO DO. 6586 03:44:42,001 --> 03:44:44,000 LOWERING COSTS. 6587 03:44:44,001 --> 03:44:45,000 BUT THEN HE SAID, 6588 03:44:45,001 --> 03:44:47,000 ACHIEVE THIS OBJECTIVE 6589 03:44:47,001 --> 03:44:51,000 EXCEPT IT WON'T. 6590 03:44:51,001 --> 03:44:52,000 C.B.O. SAYS IT 6591 03:44:52,001 --> 03:44:54,000 EXPECTS INSURANCE SPONSORED?? 6592 03:44:54,001 --> 03:44:56,000 INSURANCE COSTS TO REMAIN 6593 03:44:56,001 --> 03:44:58,000 ROUGHLY IN LINE WITH QUO. 6594 03:44:58,001 --> 03:44:59,000 THAT IS A FAILURE UNDER THIS 6595 03:44:59,001 --> 03:45:02,000 BILL. 6596 03:45:02,001 --> 03:45:04,000 MEANWHILE FIXING THE INDIVIDUAL 6597 03:45:04,001 --> 03:45:06,000 MARKET I 6598 03:45:06,001 --> 03:45:09,000 AND UNSTABLE LARGELY BECAUSE IT 6599 03:45:09,001 --> 03:45:11,000 DOES NOT ENJOY THE FAVORABLE TAX 6600 03:45:11,001 --> 03:45:12,000 TREATMENT GIVEN TO YO JOB-BAS 6601 03:45:12,001 --> 03:45:14,000 COVERAGE. 6602 03:45:14,001 --> 03:45:15,000 IF YOU'RE BUYING INSURANCE ON 6603 03:45:15,001 --> 03:45:18,000 YOUR OWN, YOU'RE NOT GETTING A 6604 03:45:18,001 --> 03:45:19,000 TAX BREAK, IF A COMPANY BUYS 6605 03:45:19,001 --> 03:45:21,000 INSURANCE FOR THE PEOPLE WHO 6606 03:45:21,001 --> 03:45:23,000 WORK FOR THEM, THEY GET BREAK. 6607 03:45:23,001 --> 03:45:25,000 IN MY 10 STEPS TO SOLVE HEALTH 6608 03:45:25,001 --> 03:45:26,000 CARE, I MENTIONED AND WORKED ON 6609 03:45:26,001 --> 03:45:28,000 MAKING THAT FAIR. 6610 03:45:28,001 --> 03:45:30,000 YOU'VE GOT TO BE FAIR FOR BOTH 6611 03:45:30,001 --> 03:45:39,000 SIDES. 6612 03:45:39,001 --> 03:45:41,000 THE 6613 03:45:41,001 --> 03:45:42,000 FAIR FOR BOTH SIDES. 6614 03:45:42,001 --> 03:45:46,000 THIS BILL DOESN'T MAKE IT FAIR 6615 03:45:46,001 --> 03:45:51,000 FOR BOTH SIDES. 6616 03:45:51,001 --> 03:45:52,000 NOW 6617 03:45:52,001 --> 03:45:54,000 THE INDIVIDUAL MARKET AND THAT 6618 03:45:54,001 --> 03:45:57,000 IS EXPENSIVE AND IT'S LARGELY 6619 03:45:57,001 --> 03:45:58,000 UNSTABLE, AS I'LL SAY AGAIN, BUT 6620 03:45:58,001 --> 03:46:01,000 IT'S DUE TO THE FAVORABLE TAX 6621 03:46:01,001 --> 03:46:02,000 TREATMENT GIVEN TO JOB-BASED 6622 03:46:02,001 --> 03:46:05,000 COVERAGE, WHICH IS SUPPOSED TO 6623 03:46:05,001 --> 03:46:06,000 BE THE PURPOSE OF REFORM. 6624 03:46:06,001 --> 03:46:09,000 C.B.O. CONFIRMS THAT NEW 6625 03:46:09,001 --> 03:46:11,000 COVERAGE MANDATES WILL PROVIDE 6626 03:46:11,001 --> 03:46:14,000 PREMIUMS HIGHER. 6627 03:46:14,001 --> 03:46:16,000 DEMOCRATS ARE DECLARING VICTORY, 6628 03:46:16,001 --> 03:46:17,000 AND THAT THE CLAIMS DON'T COUNT 6629 03:46:17,001 --> 03:46:19,000 BECAUSE THEY'RE OFFSET BY NEW 6630 03:46:19,001 --> 03:46:21,000 GOVERNMENT SUBSIDIES. 6631 03:46:21,001 --> 03:46:23,000 57% OF THE PEOPLE WHO BUY 6632 03:46:23,001 --> 03:46:26,000 INSURANCE THROUGH THE BILL'S NEW 6633 03:46:26,001 --> 03:46:28,000 EXCHANGES THAT WILL SUB PLANT 6634 03:46:28,001 --> 03:46:29,000 TODAY'S MARKET WILL REQUIRE 6635 03:46:29,001 --> 03:46:32,000 SUBSIDIES THAT REQUIRE 6636 03:46:32,001 --> 03:46:34,000 TWO-THIRDS OF THE TOTAL PREMIUM. 6637 03:46:34,001 --> 03:46:37,000 THE BILL WILL INCREASE THE 6638 03:46:37,001 --> 03:46:39,000 COSTS, BUT DISGUISE THE COSTS. 6639 03:46:39,001 --> 03:46:41,000 HIGHER COSTS CAN BE CONJURED 6640 03:46:41,001 --> 03:46:43,000 AWAY BECAUSE THEY'RE SUDDENLY ON 6641 03:46:43,001 --> 03:46:48,000 THE GOVERNMENT BALANCE SHEET. 6642 03:46:48,001 --> 03:46:49,000 THE REID BILL HAS $371.9 BILLION 6643 03:46:49,001 --> 03:46:51,000 IN NEW HEALTH TAXES THAT 6644 03:46:51,001 --> 03:46:52,000 APPARENTLY ARE NOT A NEW COST 6645 03:46:52,001 --> 03:46:53,000 BECAUSE THEY CAN BE PASSED ALONG 6646 03:46:53,001 --> 03:46:55,000 TO CONSUMERS. 6647 03:46:55,001 --> 03:47:03,000 OR PERHAPS WILL BE HIDDEN IN LOST WAGES. 6648 03:47:03,001 --> 03:47:06,000 THIS IS THE PALIO-LIBERAL SCHOOL 6649 03:47:06,001 --> 03:47:08,000 OF BRUTE WEALTH, AWAY FROM THE 6650 03:47:08,001 --> 03:47:09,000 REPEATED WHITE HOUSE CLAIMS THAT 6651 03:47:09,001 --> 03:47:10,000 REFORM IS ALL ABOUT BENDING THE 6652 03:47:10,001 --> 03:47:12,000 COST CURVE. 6653 03:47:12,001 --> 03:47:14,000 THE ONLY THING BENT HERE IS THE 6654 03:47:14,001 --> 03:47:15,000 BUDGET TRUTH. 6655 03:47:15,001 --> 03:47:16,000 MOREOVER C.B.O. IS ALMOST 6656 03:47:16,001 --> 03:47:19,000 CERTAINLY UNDERESTIMATI THE 6657 03:47:19,001 --> 03:47:22,000 COST INCREASES BASED ON ITS 6658 03:47:22,001 --> 03:47:24,000 COUNTY-BY COUNTY ACTUARIAL DATA 6659 03:47:24,001 --> 03:47:26,000 THE INSURER WELLPOINT HAS 6660 03:47:26,001 --> 03:47:28,000 CALCULATED THAT THIS BILL WOULD 6661 03:47:28,001 --> 03:47:29,000 CAUSE SOME PREMIUMS TO TRIPLE IN 6662 03:47:29,001 --> 03:47:30,000 THE INDIVIDUAL MARKET. 6663 03:47:30,001 --> 03:47:33,000 I DON'T GO BY WELLPOINT. 6664 03:47:33,001 --> 03:47:34,000 I GO BY WHAT I FOUND OUT IN 6665 03:47:34,001 --> 03:47:36,000 WYOMING ITSELF. 6666 03:47:36,001 --> 03:47:38,000 AND THAT 6667 03:47:38,001 --> 03:47:41,000 PARTICULARLY FOR THE YOUNG 6668 03:47:41,001 --> 03:47:42,000 PEOPLE IN OUR 6669 03:47:42,001 --> 03:47:44,000 THOSE WHO ARE YOUNG AND HEALTHY 6670 03:47:44,001 --> 03:47:46,000 WILL SEE 300% INCREASE. 6671 03:47:46,001 --> 03:47:47,000 I THINK THEY' GOING TO NOTICE 6672 03:47:47,001 --> 03:47:48,000 THAT. 6673 03:47:48,001 --> 03:47:53,000 I DON'T THINK THEY'RE GOING TO 6674 03:47:53,001 --> 03:47:54,000 BE HAPPY WITH IT. 6675 03:47:54,001 --> 03:47:55,000 OTHER ASSOCIATIONS HAVE COME TO 6676 03:47:55,001 --> 03:47:57,000 SIMILAR CON 6677 03:47:57,001 --> 03:47:59,000 AND THE REASON FOR THAT IS THE 6678 03:47:59,001 --> 03:48:01,000 COMMUNITY RATING, WHICH FORCES 6679 03:48:01,001 --> 03:48:03,000 INSURERS TO CHARGE NEARLY 6680 03:48:03,001 --> 03:48:04,000 UNIFORM RATES REGARDLESS OF 6681 03:48:04,001 --> 03:48:06,000 CUSTOMER HEALTH STATUS OR HABITS. 6682 03:48:06,001 --> 03:48:07,000 HABITS IS AN IMPORTANT ONE ON 6683 03:48:07,001 --> 03:48:09,000 THAT. 6684 03:48:09,001 --> 03:48:11,000 C.B.O. DOESN'T THINK THIS WILL 6685 03:48:11,001 --> 03:48:14,000 HAVE MUCH OF AN EFFECT, BUT 6686 03:48:14,001 --> 03:48:18,000 COSTS INEVITABLY RISE WHEN 6687 03:48:18,001 --> 03:48:19,000 INSUREINSURERS ARE NOT ABLE TO PRICE 6688 03:48:19,001 --> 03:48:21,000 BASED ON RISK. 6689 03:48:21,001 --> 03:48:23,000 THAT'S WHY TODAY SOME 35 STATES 6690 03:48:23,001 --> 03:48:26,000 IMPOSE NO LIMITS ON PREMIUM 6691 03:48:26,001 --> 03:48:29,000 VARIATION AN SIX ALLOWED WIDE 6692 03:48:29,001 --> 03:48:31,000 DIFFERENCES AMONG CONSUMERS. 6693 03:48:31,001 --> 03:48:32,000 NOW, THAT'S NOT JUST WELLPOINT 6694 03:48:32,001 --> 03:48:34,000 THAT'S SAYING THAT. 6695 03:48:34,001 --> 03:48:35,000 I HAVE SOME PEER-REVIEWED 6696 03:48:35,001 --> 03:48:38,000 DOCUMENTS THAT ALSO SHOW THAT 6697 03:48:38,001 --> 03:48:39,000 SAME THING FROM PEOPLE FROM 6698 03:48:39,001 --> 03:48:41,000 DIFFERENT COLLEGES. 6699 03:48:41,001 --> 03:48:43,000 THEY HAVE FOUND THAT STATE 6700 03:48:43,001 --> 03:48:45,000 COMMUNITY RATING LAWS RAISED 6701 03:48:45,001 --> 03:48:49,000 PREMIUMS IN THE INDIVIDUAL 6702 03:48:49,001 --> 03:48:52,000 MARKET BY 21% TO 33% FOR FAMILIES. 6703 03:48:52,001 --> 03:48:54,000 AND 10% TO 17% FOR SINGLES. 6704 03:48:54,001 --> 03:48:56,000 IN NEW JERSEY, WHICHLSO 6705 03:48:56,001 --> 03:48:59,000 REQUIRES INSURERS TO ACCEPT ALL 6706 03:48:59,001 --> 03:49:01,000 COMERS, SO-CALLED GUARANTEED 6707 03:49:01,001 --> 03:49:03,000 ISSUE, PREMIUMS INCREASED BY AS 6708 03:49:03,001 --> 03:49:05,000 MUCH AS 227%. LET'S SEE. 6709 03:49:05,001 --> 03:49:08,000 WE JUST HAD SOME ELECTIONS IN 6710 03:49:08,001 --> 03:49:10,000 NEW JERSEY AND THINGS DIDN'T GO 6711 03:49:10,001 --> 03:49:13,000 WELL THERE. 6712 03:49:13,001 --> 03:49:15,000 PROBABLYASN'T JUST TYPE TWO INSURANCE COST. 6713 03:49:15,001 --> 03:49:16,000 THERE ARE PLENTY OF ALTERNATIVE 6714 03:49:16,001 --> 03:49:19,000 THAT'S REALLY WOULD REDUCE THE 6715 03:49:19,001 --> 03:49:22,000 COST OF INSURANCE. 6716 03:49:22,001 --> 03:49:23,000 NOW ACCORDING TO C.B.O. 6717 03:49:23,001 --> 03:49:25,000 IS ACCORDING TO CONGRESSIONAL 6718 03:49:25,001 --> 03:49:27,000 BUDGET OFFICE, WHICH WE QUOTE A 6719 03:49:27,001 --> 03:49:30,000 LOT, THEY DID A AN 6720 03:49:30,001 --> 03:49:31,000 THE RELATIVELY MODEST HOUSE 6721 03:49:31,001 --> 03:49:32,000 G.O.P. BILL. 6722 03:49:32,001 --> 03:49:37,000 THE REPUBLICANS IN THE HOUSE, 6723 03:49:37,001 --> 03:49:38,000 THEY WERE LIMITED TO JUST AN AMENDMENT. 6724 03:49:38,001 --> 03:49:41,000 THERE WERE THREE AMENDMENTS 6725 03:49:41,001 --> 03:49:42,000 TOTAL IN A ONE-DAY DEBATE AND 6726 03:49:42,001 --> 03:49:46,000 PASSAGE OF THE HEALTH CARE BILL OVER THERE. 6727 03:49:46,001 --> 03:49:48,000 THAT ROWED A LOT OF -- ROUSED A 6728 03:49:48,001 --> 03:49:51,000 LOT 6729 03:49:51,001 --> 03:49:54,000 IF YOU ONLY GET ONE AMENDMENT, 6730 03:49:54,001 --> 03:49:55,000 THEY AVOIDED WHAT WE'VE DONE. 6731 03:49:55,001 --> 03:49:57,000 WE HAVE FOUR DIFFERENT BILLS OUT 6732 03:49:57,001 --> 03:49:59,000 THERE THAT SOLVES WHAT THE 6733 03:49:59,001 --> 03:50:03,000 PRESIDENT SAID HE WANTED SOLVED, 6734 03:50:03,001 --> 03:50:05,000 AND THAT DOESN'T INCLUDE THE 6735 03:50:05,001 --> 03:50:07,000 WYDEN-BENNETT BILL THAT THE 6736 03:50:07,001 --> 03:50:08,000 PRESIDENT ALSO SAID THAT HE 6737 03:50:08,001 --> 03:50:11,000 WANTED, THAT'S NOT INCLUDED IN THIS BILL. 6738 03:50:11,001 --> 03:50:12,000 THE HOUSE PUT TOGETHER, IT IS 6739 03:50:12,001 --> 03:50:14,000 RELATIVELY MODEST. 6740 03:50:14,001 --> 03:50:16,000 IT WOULD REDUCE PREMIUMS 6741 03:50:16,001 --> 03:50:22,000 TO 8% IN THE INDIVIDUAL MARKET 6742 03:50:22,001 --> 03:50:23,000 IN 2016 AND 20% -- 10% 6743 03:50:23,001 --> 03:50:25,000 BUSINESSES. 6744 03:50:25,001 --> 03:50:28,000 THE G.O.P. REFORMS WOULD DO SO 6745 03:50:28,001 --> 03:50:30,000 WITHOUT IMPOSING HUGE NEW TAXES. 6746 03:50:30,001 --> 03:50:32,000 WE'VE CONCENTRATED THE LAST FEW 6747 03:50:32,001 --> 03:50:33,000 DAYS TALKING 6748 03:50:33,001 --> 03:50:35,000 MONEY THAT'S BEING STOLEN TO 6749 03:50:35,001 --> 03:50:37,000 PROVIDE FOR THE CHANGES. 6750 03:50:37,001 --> 03:50:40,000 WE HAVEN'T TALKED YET ABOUT THE 6751 03:50:40,001 --> 03:50:41,000 EXTRA TAXES THAT ARE GOING 6752 03:50:41,001 --> 03:50:42,000 PUT INTO PLACE. 6753 03:50:42,001 --> 03:50:44,000 THAT'S THE OTHER HALF OF THE 6754 03:50:44,001 --> 03:50:46,000 PACKAGE. 6755 03:50:46,001 --> 03:50:48,000 BUT 6756 03:50:48,001 --> 03:50:52,000 BECAUSE THIS BILL, THEY SAY, IS 6757 03:50:52,001 --> 03:50:53,000 REALLY ABOUT LOWERING COSTS. 6758 03:50:53,001 --> 03:50:54,000 NO, IT'S ABOUT PUTTING 6759 03:50:54,001 --> 03:51:03,000 WASHINGTON IN CHARGE OF HEALTH 6760 03:51:03,001 --> 03:51:05,000 INSURANCE AT 6761 03:51:05,001 --> 03:51:07,000 I SEE THAT THE SENATOR FROM 6762 03:51:07,001 --> 03:51:09,000 WYOMING IS HERE AND WE HAVE 10 6763 03:51:09,001 --> 03:51:11,000 MINUTES REMAINING ON OUR TIME IF 6764 03:51:11,001 --> 03:51:13,000 THE SENATOR WOULD LIKE TO MAKE 6765 03:51:13,001 --> 03:51:15,000 SOME ADDITIONAL COMMENTS. 6766 03:51:15,001 --> 03:51:16,000 HE AND I HAVE BEEN TRAVELING 6767 03:51:16,001 --> 03:51:19,000 WYOMING AND HEARING THE COMMENTS 6768 03:51:19,001 --> 03:51:20,000 FROM OUR PEOPLE. 6769 03:51:20,001 --> 03:51:22,000 THE PRESIDING OFFICER: 7 1/2 6770 03:51:22,001 --> 03:51:24,000 MINUTES. 6771 03:51:24,001 --> 03:51:26,000 MR. ENZI: 7 1/2 MINUTES. 6772 03:51:26,001 --> 03:51:27,000 I'LL YIELD THE TIME TO MY 6773 03:51:27,001 --> 03:51:28,000 COLLEAGUE. 6774 03:51:28,001 --> 03:51:29,000 THE PRESIDING OFFICER: THE 6775 03:51:29,001 --> 03:51:31,000 SENATOR FROM WYOMING IS RECOGNIZED. 6776 03:51:31,001 --> 03:51:33,000 MR. BARR MUCH, MR. PRESIDENT. 6777 03:51:33,001 --> 03:51:35,000 I WOULD ACTUALLY ASK MY 6778 03:51:35,001 --> 03:51:36,000 COLLEAGUEROM WYOMING, WHO I 6779 03:51:36,001 --> 03:51:39,000 HAVE THE PRIVILEGE OF SERVING 6780 03:51:39,001 --> 03:51:42,000 WITH, BECAUSE I SAW A -- A STORY 6781 03:51:42,001 --> 03:51:45,000 TODAY, A LARGE STORY, I"U.S.A. 6782 03:51:45,001 --> 03:51:48,000 TODAY", AND THIS STORY SAYS, 6783 03:51:48,001 --> 03:51:50,000 "SENATE KEEPS MEDICARE CUTIN 6784 03:51:50,001 --> 03:51:51,000 THE BILL." 6785 03:51:51,001 --> 03:51:55,000 THIS IS GOING TO CONTINUE. 6786 03:51:55,001 --> 03:51:58,000 AND WHAT IT SAID 6787 03:51:58,001 --> 03:52:01,000 DEMOCRATS CLOSED RANKS THURSDAY 6788 03:52:01,001 --> 03:52:03,000 BEHIND $460 BILLION IN 6789 03:52:03,001 --> 03:52:06,000 POLITICALLY RISKY MEDICARE CUTS 6790 03:52:06,001 --> 03:52:09,000 AT THE HEART OF HEALTH CARE LEGISLATION." 6791 03:52:09,001 --> 03:52:10,000 IT GOES ON TO SAY, "APPROVAL 6792 03:52:10,001 --> 03:52:12,000 WOULD HAVE STRIPPED OUT MONEY TO 6793 03:52:12,001 --> 03:52:14,000 PAY FOR EXPANDING COVERAGE FOR 6794 03:52:14,001 --> 03:52:15,000 MILLIONS TO TENS OF MILLIONS OF 6795 03:52:15,001 --> 03:52:18,000 UNINSURED AMERICANS." 6796 03:52:18,001 --> 03:52:20,000 SO I READ THIS AND IT SAYS THAT 6797 03:52:20,001 --> 03:52:24,000 THE REPUBLICANS TRIED TO KEEP 6798 03:52:24,001 --> 03:52:25,000 THE MEDICARE MONEY FOR PEOPLE ON 6799 03:52:25,001 --> 03:52:30,000 MEDICARE, BUT THE DEMOCRATS WANT 6800 03:52:30,001 --> 03:52:32,000 TO TAKE $460 BIION AWAY FROM 6801 03:52:32,001 --> 03:52:35,000 SENIORS WHO DEPEND UPON MEDICARE 6802 03:52:35,001 --> 03:52:37,000 AND USE IT TO START A WHOLE NEW GOVERNMENT PROGRAM. 6803 03:52:37,001 --> 03:52:39,000 AM I READING THIS CORRECTLY? 6804 03:52:39,001 --> 03:52:40,000 MR. ENZI: THAT'S THE WAY I READ IT. 6805 03:52:40,001 --> 03:52:42,000 THAT'S THE WAY THAT THE PEOPLE 6806 03:52:42,001 --> 03:52:44,000 IN WYOMING ARE READING IT. 6807 03:52:44,001 --> 03:52:46,000 AND THAT'S 6808 03:52:46,001 --> 03:52:47,000 PEOPLE ALL OVER THE COUNTRY ARE READING. 6809 03:52:47,001 --> 03:52:49,000 PARTICULARLY SENIORS. 6810 03:52:49,001 --> 03:52:50,000 IT'S THE SENIORS THAT ARE REALLY 6811 03:52:50,001 --> 03:52:52,000 UPSET ABOUT WHAT'S HAPPENING. 6812 03:52:52,001 --> 03:52:54,000 AND IT'S EASY TO SEE WHY. 6813 03:52:54,001 --> 03:52:56,000 EVEN THOUGH 6814 03:52:56,001 --> 03:52:58,000 THIS IS -- THIS IS GOOD BILL, 6815 03:52:58,001 --> 03:52:59,000 THEY'RE SAYING, WAIT A MINUTE. 6816 03:52:59,001 --> 03:53:01,000 NOW, WAIT A MINUTE. 6817 03:53:01,001 --> 03:53:04,000 I KNOW PEOPLE IN THE NURSING 6818 03:53:04,001 --> 03:53:05,000 HOME AND I KNOW PEOPLE -- I 6819 03:53:05,001 --> 03:53:08,000 REMEMBER -- SOME OF THEM ARE 6820 03:53:08,001 --> 03:53:09,000 SAYING, I'M IN A NURSING HOME. 6821 03:53:09,001 --> 03:53:12,000 I HEAR WHAT'S GOING TO HAPPEN TO 6822 03:53:12,001 --> 03:53:13,000 MY NURSING HOME IF THESE CUTS GO 6823 03:53:13,001 --> 03:53:14,000 INTO PLACE? 6824 03:53:14,001 --> 03:53:16,000 AS I SAID CONTINUALLY, WE CAN 6825 03:53:16,001 --> 03:53:17,000 CA 6826 03:53:17,001 --> 03:53:18,000 BUT THE SENIORS ARE SAYING, 6827 03:53:18,001 --> 03:53:19,000 THOSE ARE CUTS. 6828 03:53:19,001 --> 03:53:21,000 THOSE ARE CUTS IN MY BENEFITS. 6829 03:53:21,001 --> 03:53:23,000 THOSE ARE CUTS IN WHAT I EXPECT. 6830 03:53:23,001 --> 03:53:24,000 AND THAT'S 6831 03:53:24,001 --> 03:53:26,000 BEEN GETTING 6832 03:53:26,001 --> 03:53:28,000 SO WHETHER YOU CALL IT 6833 03:53:28,001 --> 03:53:29,000 GUARANTEED BENEFITS OR JUST 6834 03:53:29,001 --> 03:53:32,000 PLAIN OLD BENEFITS, OR WHATEVER 6835 03:53:32,001 --> 03:53:33,000 IT IS, THEY'RE SAYING, YEAH, 6836 03:53:33,001 --> 03:53:35,000 WE'RE BEING CUT. 6837 03:53:35,001 --> 03:53:38,000 MR. BARRASSO: MR. PRESIDENT, I 6838 03:53:38,001 --> 03:53:40,000 WOULD SAY THAT WHEN MY COLLEAGUE 6839 03:53:40,001 --> 03:53:41,000 FROM WYOMING AND I HELD TOWN 6840 03:53:41,001 --> 03:53:43,000 HALL MEETINGS AROUND THE STATE 6841 03:53:43,001 --> 03:53:44,000 OF WYOMING, PEOPLE SAID, DON'T 6842 03:53:44,001 --> 03:53:45,000 CUT OUR MEDICARE. 6843 03:53:45,001 --> 03:53:47,000 BUT YOU KNOW WHAT? 6844 03:53:47,001 --> 03:53:48,000 I SEE THIS BILL CUTTING OUR 6845 03:53:48,001 --> 03:53:49,000 MEDICARE AND SPECIFICALLY RIGHT 6846 03:53:49,001 --> 03:53:51,000 NOW THERE ARE THOUSANDS AND 6847 03:53:51,001 --> 03:53:54,000 THOUSANDS OF PEOPLE IN WYOMING 6848 03:53:54,001 --> 03:53:55,000 WHO ARE ON A PROGRAM CALLED 6849 03:53:55,001 --> 03:53:57,000 MEDICARE ADVANTAGE. 6850 03:53:57,001 --> 03:53:59,000 AND THE 6851 03:53:59,001 --> 03:54:00,000 PROGRAM AND THAT'S WHY SO MANY 6852 03:54:00,001 --> 03:54:02,000 AMERICANS HAVE SIGNED UP FOR THE 6853 03:54:02,001 --> 03:54:05,000 PROGRAM. 6854 03:54:05,001 --> 03:54:07,000 AS A MATTER OF FACT ABOUT ONE IN 6855 03:54:07,001 --> 03:54:08,000 FOUR AMERICANS WHO DEPEND UPON 6856 03:54:08,001 --> 03:54:12,000 MEDICARE FOR THEIR HEALTH CARE 6857 03:54:12,001 --> 03:54:13,000 IN THIS COUNTRY HAVE CHOSEN 6858 03:54:13,001 --> 03:54:15,000 MEDICARE ADVANTAGE BECAUSE 6859 03:54:15,001 --> 03:54:16,000 THERE'S SOME ADVANTAGES OF BEING 6860 03:54:16,001 --> 03:54:18,000 IN THIS PROGRAM CALLED MEDICARE 6861 03:54:18,001 --> 03:54:21,000 ADVANTAGE. 6862 03:54:21,001 --> 03:54:23,000 DENTAL VISION, HEARING, FITNESS. 6863 03:54:23,001 --> 03:54:25,000 ALSO AS A PRACTICING DOCTOR FOR 6864 03:54:25,001 --> 03:54:27,000 25 YEARS TAKING CARE OF FAMILIES 6865 03:54:27,001 --> 03:54:29,000 IN WYOMING, WHAT I SAW PEOPLE IN 6866 03:54:29,001 --> 03:54:31,000 WYOMING, THE REASON THEY LIKED 6867 03:54:31,001 --> 03:54:33,000 THIS IF THEY WERE ON MEDICARE, 6868 03:54:33,001 --> 03:54:35,000 BECAUSE IT DEALT WITH PREVENTION 6869 03:54:35,001 --> 03:54:36,000 AND IT HELPED COORDINATE CARE. 6870 03:54:36,001 --> 03:54:38,000 ONE OF THE THINGS THAT MEDICARE 6871 03:54:38,001 --> 03:54:40,000 DOESN'T DO AS WELL IS REALLY 6872 03:54:40,001 --> 03:54:42,000 COORDINATE CARE AND WORK WITH PREVENTION. 6873 03:54:42,001 --> 03:54:44,000 WELL, WE KNOW HOW IMPORTANT 6874 03:54:44,001 --> 03:54:46,000 PREVENTION IS IN HELPING PEOPLE 6875 03:54:46,001 --> 03:54:48,000 KEEP DOWN THE COST OF THEIR 6876 03:54:48,001 --> 03:54:50,000 CARE, HOW LONG -- HOW GOOD IT IS 6877 03:54:50,001 --> 03:54:51,000 IN TERMS OF GIVING PEOPLE 6878 03:54:51,001 --> 03:54:53,000 OPPORTUNITIES TO STAY HEALTHY. 6879 03:54:53,001 --> 03:54:54,000 I MEANS THAT WHY THEY CALL IT 6880 03:54:54,001 --> 03:54:56,000 PREVENTION. 6881 03:54:56,001 --> 03:54:59,000 WELL, THE -- THEILL IN FRONT 6882 03:54:59,001 --> 03:55:00,000 OF US, AS I SEE, AND I ASK MY 6883 03:55:00,001 --> 03:55:01,000 SENATE COLLEAGUE FROM WYOMING, 6884 03:55:01,001 --> 03:55:04,000 TO ME THIS IS A BILL THAT'S 6885 03:55:04,001 --> 03:55:06,000 GOING TO CUT $120 BILLION FROM 6886 03:55:06,001 --> 03:55:08,000 MEDICARE ADVANTAGE, THE PROGRAM 6887 03:55:08,001 --> 03:55:10,000 THAT THE PEOPLE IN OUR STATE LIKE. 6888 03:55:10,001 --> 03:55:11,000 MR. ENZI: MR. 6889 03:55:11,001 --> 03:55:12,000 SENATOR FROM WYOMING IS 6890 03:55:12,001 --> 03:55:14,000 ABSOLUTELY CORRECT. 6891 03:55:14,001 --> 03:55:16,000 AND WE'RE GETTING A LOT OF 6892 03:55:16,001 --> 03:55:18,000 CALLS, E-MAILS, AND LETTERS 6893 03:55:18,001 --> 03:55:19,000 ABOUT THAT. 6894 03:55:19,001 --> 03:55:20,000 ANOTHER -- ANOTHER THING THAT 6895 03:55:20,001 --> 03:55:22,000 THE PRESIDENT PROMISED, OF 6896 03:55:22,001 --> 03:55:25,000 COURSE, IS THAT EVERYBODY WOULD 6897 03:55:25,001 --> 03:55:26,000 HAVE CATASTROPHIC COVERAGE. 6898 03:55:26,001 --> 03:55:28,000 IT KIND OF FASCINATES ME THAT 6899 03:55:28,001 --> 03:55:30,000 THE WYOMING PEOPLE AND THE 6900 03:55:30,001 --> 03:55:31,000 PEOPLE ACROSS THE COUNTRY HAVE 6901 03:55:31,001 --> 03:55:33,000 FIGURED OUT THAT MEDICARE 6902 03:55:33,001 --> 03:55:35,000 DOESN'T HAVE CATASTROPHIC COVERAGE. 6903 03:55:35,001 --> 03:55:36,000 BUT MEDICARE ADVANTAGE PROVIDES 6904 03:55:36,001 --> 03:55:38,000 CATASTROPHIC COVERAGE AS WELL AS 6905 03:55:38,001 --> 03:55:40,000 A NUMBER OF OTHER THINGS THAT 6906 03:55:40,001 --> 03:55:42,000 MEDICARE DOESN'T COVER. 6907 03:55:42,001 --> 03:55:44,000 AND I THINK THEY REALIZE TOO 6908 03:55:44,001 --> 03:55:47,000 THAT IF 6909 03:55:47,001 --> 03:55:49,000 AWAY, YES, THEY CAN GET MEDIGAP, 6910 03:55:49,001 --> 03:55:51,000 BUT IT IS MORE EXPENSIVE AND 6911 03:55:51,001 --> 03:55:54,000 IT'S ALSO INTERESTING THAT THE 6912 03:55:54,001 --> 03:55:56,000 AARP SELLS MEDI-GAP. 6913 03:55:56,001 --> 03:55:57,000 MR. BARRASSO: I HEARD SOMEBODY 6914 03:55:57,001 --> 03:55:58,000 SAID THAT MEDICARE ADVANTAGE 6915 03:55:58,001 --> 03:55:59,000 ISN'T REALLY -- ISN'T REALLY 6916 03:55:59,001 --> 03:56:00,000 MEDICARE. 6917 03:56:00,001 --> 03:56:01,000 BUT IF YOU JUST TURN TO THE 6918 03:56:01,001 --> 03:56:06,000 CENTERS FOR MEDICARE AND 6919 03:56:06,001 --> 03:56:08,000 MEDICAID SERVICES 20 OFFICIAL 6920 03:56:08,001 --> 03:56:10,000 GOVERNMENT HANDBOOK -- YOU KNOW, 6921 03:56:10,001 --> 03:56:12,000 WE'RE GOING TO GO INTO 2010 IN 6922 03:56:12,001 --> 03:56:17,000 JUST NEXT MONTH, IF YOU GO TO 6923 03:56:17,001 --> 03:56:20,000 THE OFFICIAL HANDBOOK IN THE -- 6924 03:56:20,001 --> 03:56:22,000 IT IS CALLED "MEDICARE AND YOU." 6925 03:56:22,001 --> 03:56:24,000 IT SAYS THAT A MEDICARE 6926 03:56:24,001 --> 03:56:27,000 ADVANTAGE PLAN IS ANOTHER HEALTH 6927 03:56:27,001 --> 03:56:28,000 COVERAGE CHOICE YOU MAY HAVE AS 6928 03:56:28,001 --> 03:56:30,000 PART OF MEDICARE. 6929 03:56:30,001 --> 03:56:32,000 IT'S A CHOICE YOU MAY HAVE AS 6930 03:56:32,001 --> 03:56:34,000 PART OF MEDICARE AND PEOPLE WHO 6931 03:56:34,001 --> 03:56:35,000 ACTUALLY LOOK AT THIS, THEY 6932 03:56:35,001 --> 03:56:37,000 CHOOSE THIS. 6933 03:56:37,001 --> 03:56:39,000 THEY MAKE THE CHOICE BECAUSE 6934 03:56:39,001 --> 03:56:40,000 THEY SAY, HEY, THIS IS A GOOD 6935 03:56:40,001 --> 03:56:41,000 DEAL FOR ME. 6936 03:56:41,001 --> 03:56:43,000 AN 6937 03:56:43,001 --> 03:56:44,000 THEY WANT TO GET VALUE FOR THEIR 6938 03:56:44,001 --> 03:56:45,000 MONEY. 6939 03:56:45,001 --> 03:56:46,000 A RECENT POLL SAID IN TERMS OF 6940 03:56:46,001 --> 03:56:48,000 AMERICANS WHEN THEY SEND MONEY 6941 03:56:48,001 --> 03:56:50,000 TO CONGRESS, HOW MUCH OF THAT DO 6942 03:56:50,001 --> 03:56:52,000 THEY GET IN VALUE? 6943 03:56:52,001 --> 03:56:53,000 THEY THINK ABOUT 50 CENTS ON THE 6944 03:56:53,001 --> 03:56:54,000 DOLLAR. 6945 03:56:54,001 --> 03:56:57,000 THAT'S A NATIONAL GALLUP POLL. 6946 03:56:57,001 --> 03:56:59,000 A GALLUP POLL ON THIS FOR A 6947 03:56:59,001 --> 03:57:01,000 LONG, LONG TIME, AND IT IS THE 6948 03:57:01,001 --> 03:57:02,000 HIGHEST NUMBER EVER OF WHAT 6949 03:57:02,001 --> 03:57:04,000 AMERICANS THINK IN TERMS OF THE 6950 03:57:04,001 --> 03:57:05,000 FACT THAT THEY'RE GETTING VERY 6951 03:57:05,001 --> 03:57:07,000 LITTLE VALUE FOR THEIR TAX 6952 03:57:07,001 --> 03:57:08,000 CONSIDER FOR THEIR TAX DOLLARS. 6953 03:57:08,001 --> 03:57:10,000 THEY SEE GAMES BEING PLAYED. 6954 03:57:10,001 --> 03:57:11,000 AND THAT'S WHAT I HEAR WHEN I 6955 03:57:11,001 --> 03:57:12,000 HAVE TELEPHONE TOWN HALL 6956 03:57:12,001 --> 03:57:15,000 MEETINGS IN WYOMING. 6957 03:57:15,001 --> 03:57:19,000 THEY KNOW THAT SENATOR REID'S 6958 03:57:19,001 --> 03:57:20,000 BILL STEALS $464 BILLION FROM 6959 03:57:20,001 --> 03:57:23,000 MEDICARE. 6960 03:57:23,001 --> 03:57:25,000 THEY KNOW THAT IT RAIDS THE 6961 03:57:25,001 --> 03:57:26,000 HEALTH CARE PROGRAM THAT THEY 6962 03:57:26,001 --> 03:57:28,000 DEPEND UPON. 6963 03:57:28,001 --> 03:57:31,000 NOT TO MAKE MEDICARE STRONGER, 6964 03:57:31,001 --> 03:57:34,000 KNOTS TO MAKE MEDICARE MORE 6965 03:57:34,001 --> 03:57:35,000 SOLVENT, BUT, AS MY COLLEAGUE 6966 03:57:35,001 --> 03:57:39,000 FROM WYOMING TELLS ME, TO CREATE 6967 03:57:39,001 --> 03:57:41,000 A BRAND-NEW ENTITLEMENT PROGRAM. 6968 03:57:41,001 --> 03:57:42,000 THEY ARE RAIDING MEDICARE TO 6969 03:57:42,001 --> 03:57:46,000 START ANOTHER GOVERNMENT PROGRAM 6970 03:57:46,001 --> 03:57:48,000 THAT IS -- THAT ITSELF IS GOING 6971 03:57:48,001 --> 03:57:49,000 TO BE INSOLVENT. 6972 03:57:49,001 --> 03:57:50,000 AND SO I ASK MY COLLEUE FROM 6973 03:57:50,001 --> 03:57:51,000 WYOMING, ARE YOU SEEING WHAT I'M 6974 03:57:51,001 --> 03:57:54,000 SEEING? 6975 03:57:54,001 --> 03:57:56,000 MR. ENZI: I'M SEEING. 6976 03:57:56,001 --> 03:57:57,000 I'M NOTICING THAT SOME PEOPLE 6977 03:57:57,001 --> 03:57:59,000 DON'T KNOW WHAT AN E 6978 03:57:59,001 --> 03:58:01,000 ACTUALLY IS. 6979 03:58:01,001 --> 03:58:03,000 THAT'S A BILL 6980 03:58:03,001 --> 03:58:05,000 FOREVER THAT THE SECRETARY OF 6981 03:58:05,001 --> 03:58:10,000 HEALTH AND HUMAN SERVICES HAS TO 6982 03:58:10,001 --> 03:58:11,000 MAKE SURE GETS PAID IN 6983 03:58:11,001 --> 03:58:12,000 PERPETUITY UNLESS THERE IS SOME 6984 03:58:12,001 --> 03:58:13,000 OTHER MAJOR CONGRESSIONAL ACTION 6985 03:58:13,001 --> 03:58:15,000 THAT HAPPENS. 6986 03:58:15,001 --> 03:58:16,000 WE KEEP PAYING THAT BILL OVER 6987 03:58:16,001 --> 03:58:18,000 AND OVER AND OVER AGAIN. 6988 03:58:18,001 --> 03:58:20,000 AND I THINK THE SENATOR FROM 6989 03:58:20,001 --> 03:58:22,000 WYOMING RECOGNIZES ENTITLEMENTS 6990 03:58:22,001 --> 03:58:23,000 AND SOME OF THE DIFFICULTIES 6991 03:58:23,001 --> 03:58:24,000 THAT THERE ARE INVOLVED WITH 6992 03:58:24,001 --> 03:58:26,000 THAT. 6993 03:58:26,001 --> 03:58:29,000 MR. BARRASSO: WELL, IT'S INTERESTING, MR. PRESIDENT, 6994 03:58:29,001 --> 03:58:30,000 BECAUSE AN ARTICLE IN BLOOMBERG 6995 03:58:30,001 --> 03:58:32,000 YESTERDAY SAID THAT THE KAISER 6996 03:58:32,001 --> 03:58:34,000 FAMILY FOUNDATION POLL RELEASED 6997 03:58:34,001 --> 03:58:36,000 THIS PAST MONTH FOUND THAT 60% 6998 03:58:36,001 --> 03:58:39,000 OF SENIORS SAID THAT THEY'D BE 6999 03:58:39,001 --> 03:58:40,000 BETTER OFF -- 60% OF SENIORS 7000 03:58:40,001 --> 03:58:43,000 SAID THEY'D BE BETTER OFF IF 7001 03:58:43,001 --> 03:58:44,000 CONGRESS DID NOT CHANGE THE 7002 03:58:44,001 --> 03:58:45,000 HEALTH CARE SYSTEM. 7003 03:58:45,001 --> 03:58:47,000 JUST NOT CHANGE AT 7004 03:58:47,001 --> 03:58:50,000 WELL, WE KNOW WE NEED TO DO SOME CHANGES. 7005 03:58:50,001 --> 03:58:51,000 BUT THIS MASSIVE BILL, THIS 7006 03:58:51,001 --> 03:58:52,000 2,000-PAGE BILL THAT WEIGHS 7007 03:58:52,001 --> 03:58:53,000 20 POUNDS IS NOT THE RIGHT 7008 03:58:53,001 --> 03:58:55,000 CHANGE THAT WE NEED. 7009 03:58:55,001 --> 03:58:56,000 AND FOR OUR SENIORS, PEOPLE WHO 7010 03:58:56,001 --> 03:58:59,000 RELY ON MEDICARE FOR THEIR 7011 03:58:59,001 --> 03:59:04,000 HEALTH CARE, TO JUST ABSOLUTELY 7012 03:59:04,001 --> 03:59:05,000 RAID DZ 4-DZ 64 BILLION -- 7013 03:59:05,001 --> 03:59:07,000 -- $6,464,000,000,000 FROM 7014 03:59:07,001 --> 03:59:09,000 MEDICARE, ALMOST A HALF TRILLION 7015 03:59:09,001 --> 03:59:11,000 DOLLARS, THE BABY BOOMERS, MORE 7016 03:59:11,001 --> 03:59:14,000 AND MORE ADDED TO THE MEDICARE 7017 03:59:14,001 --> 03:59:16,000 ROLLS EVERY DAY, TO RAID THIS 7018 03:59:16,001 --> 03:59:17,000 PROGRAM TO START A NEW PROGRAM 7019 03:59:17,001 --> 03:59:18,000 IS NOT RIGHT PRESCRIPTION FOR 7020 03:59:18,001 --> 03:59:20,000 AMERICA. 7021 03:59:20,001 --> 03:59:22,000 IT'S NOT WHAT OUR SENIORS WANT. 7022 03:59:22,001 --> 03:59:24,000 IT'S NOT WHAT THEY SIGNED UP FOR. 7023 03:59:24,001 --> 03:59:25,000 IT'S NOT WHY THEY'RE CHOOSING 7024 03:59:25,001 --> 03:59:26,000 MEDICARE ADVANTAGE. 7025 03:59:26,001 --> 03:59:28,000 IT'S BECAUSE IT'S A CHOICE THAT 7026 03:59:28,001 --> 03:59:31,000 THEY MAKE AND THAT'S WHY WE 7027 03:59:31,001 --> 03:59:33,000 RIGHT NOW HAVE 11 MILLION 7028 03:59:33,001 --> 03:59:36,000 AMERICANS WHO ARE ON MEDICARE ADVANTAGE. 7029 03:59:36,001 --> 03:59:38,000 WE HAVE 11 MILLION SENIORS. 7030 03:59:38,001 --> 03:59:39,000 THAT REPRESENTS ALMOST 7031 03:59:39,001 --> 03:59:42,000 ONE-QUARTER OF ALL MEDICARE 7032 03:59:42,001 --> 03:59:44,000 PATIENTS IN TH COUNTRY. 7033 03:59:44,001 --> 03:59:47,000 MR. ENZI: WE'RE BEING NOTIFIED 7034 03:59:47,001 --> 03:59:48,000 WE'LL CONTINUE THIS AT A LATER 7035 03:59:48,001 --> 03:59:49,000 TIME. 7036 03:59:49,001 --> 03:59:50,000 AND I HAVE SEVERAL LETTERS FROM 7037 03:59:50,001 --> 03:59:52,000 WYOMING ORGANIZATIONS THAT WANT 7038 03:59:52,001 --> 03:59:54,000 TO BE PUT IN THE RECORD, TOO. 7039 03:59:54,001 --> 03:59:55,000 WE'LL DO THAT AT A LATER TIME. 7040 03:59:55,001 --> 04:00:45,000 I THANK THE PRESIDENT AND I 7041 04:00:45,001 --> 04:00:46,000 YIELD THE FLOOR. 7042 04:00:46,001 --> 04:00:47,000 MR. DODD: MR. PRESIDENT? 7043 04:00:47,001 --> 04:00:48,000 THE PRESIDING OFFICER: THE 7044 04:00:48,001 --> 04:00:49,000 SENATOR FROM CONNECTICUT IS 7045 04:00:49,001 --> 04:00:52,000 RECOGNIZED. 7046 04:00:52,001 --> 04:00:54,000 MOMENTS AGO, I STARTED TO 7047 04:00:54,001 --> 04:00:55,000 DESCRIBE AN AMENDMENT THAT WOULD 7048 04:00:55,001 --> 04:00:58,000 BE OFFERED BY OUR COLLEAGUE FROM 7049 04:00:58,001 --> 04:01:01,000 RHODE ISLAND, SENATOR 7050 04:01:01,001 --> 04:01:03,000 WHITEHOUSE, REGARDING THE CLASS ACT. 7051 04:01:03,001 --> 04:01:05,000 LET ME TAKE A MOMENT OR SO. 7052 04:01:05,001 --> 04:01:07,000 FIRST OF ALL, A LITTLE BIT OF BACKGROUND. 7053 04:01:07,001 --> 04:01:10,000 THE CLASS ACT IS A PROPOSAL THAT 7054 04:01:10,001 --> 04:01:12,000 WAS ORIGINALLY CONCEIVED BY OUR 7055 04:01:12,001 --> 04:01:13,000 FORMER COLLEAGUE AND DEAR FRIEND 7056 04:01:13,001 --> 04:01:14,000 TED KENNEDY OF MASSACHUSETTS 7057 04:01:14,001 --> 04:01:17,000 YEARS AGO. 7058 04:01:17,001 --> 04:01:19,000 THE IDEA BEHIND IT BEING WE 7059 04:01:19,001 --> 04:01:20,000 OUGHT TO TRY TO FIGURE OUT A WAY 7060 04:01:20,001 --> 04:01:23,000 TO SUPPORT PEOPLE IN THIS 7061 04:01:23,001 --> 04:01:24,000 COUNTRY WHO END UP WITH 7062 04:01:24,001 --> 04:01:26,000 DISABILITIES, BUT THEIR 7063 04:01:26,001 --> 04:01:28,000 STABILITIES ARE NOT SO DRAMATIC 7064 04:01:28,001 --> 04:01:30,000 THAT IT WOULD DEPRIVE THEM OF 7065 04:01:30,001 --> 04:01:31,000 THE OPPORTUNITY OF CONTINUING 7066 04:01:31,001 --> 04:01:33,000 WORK, BUT ARE SERIOUS ENOUGH 7067 04:01:33,001 --> 04:01:36,000 THAT THEY WOULD REQUI 7068 04:01:36,001 --> 04:01:38,000 ADDITIONAL HELP IN ORDER TO 7069 04:01:38,001 --> 04:01:40,000 PROVIDE BASIC STANDARDS OF 7070 04:01:40,001 --> 04:01:41,000 LIVING CONDITIONS, EITHER A 7071 04:01:41,001 --> 04:01:42,000 DRIVER OR SOME HELP ON FOOD 7072 04:01:42,001 --> 04:01:45,000 ASSISTANCE, WHATEVER IT MA BE. 7073 04:01:45,001 --> 04:01:46,000 D SO THE IDEA WAS BECAUSE 7074 04:01:46,001 --> 04:01:48,000 UNDER PRESENT DISABILITY 7075 04:01:48,001 --> 04:01:49,000 FORMULAS WHICH ARE BASIC 7076 04:01:49,001 --> 04:01:51,000 INCOME REPLACEMENT BIL, THAT 7077 04:01:51,001 --> 04:01:52,000 IN ORDER TO GET SOME HEL 7078 04:01:52,001 --> 04:01:55,000 YOU'RE DISABLED, YOU ALMOST HAVE 7079 04:01:55,001 --> 04:01:57,000 TO GO THROUGH AND IMPOVERISH 7080 04:01:57,001 --> 04:01:59,000 YOURSELF TO QUALIFY FOR THEM AND 7081 04:01:59,001 --> 04:02:00,000 THEN BE RESTRAINED BY HOW MUCH 7082 04:02:00,001 --> 04:02:04,000 YOU CAN ACTUALLY EARN OUTSIDE IF 7083 04:02:04,001 --> 04:02:05,000 SO WHILE IT HAS BEEN A GOOD 7084 04:02:05,001 --> 04:02:08,000 PROGRAM, IT'S CERTAINLY HELPED A 7085 04:02:08,001 --> 04:02:10,000 LOT OF PEOPLE, IN 7086 04:02:10,001 --> 04:02:12,000 ARE CATCH-22'S IN IT, IN THE 7087 04:02:12,001 --> 04:02:14,000 SENSE THAT TO QUALIFY FOR IT, 7088 04:02:14,001 --> 04:02:16,000 YOU HAVE TO DIVEST WHATEVER YOU 7089 04:02:16,001 --> 04:02:17,000 HAVE ACQUIRED OR EARNED TO 7090 04:02:17,001 --> 04:02:18,000 IMPOVESH YOURSELF TO QUALIFY 7091 04:02:18,001 --> 04:02:19,000 FOR IT. 7092 04:02:19,001 --> 04:02:21,000 AND THEN EVEN THOUGH YOU MAY BE 7093 04:02:21,001 --> 04:02:23,000 CAPABLE OF CONTINUING TO 7094 04:02:23,001 --> 04:02:25,000 YOU'RE LIMITED ON HOW MUCH YOU 7095 04:02:25,001 --> 04:02:27,000 CAN ACTUALLY EARN UNDER THOSE PROGRAMS. 7096 04:02:27,001 --> 04:02:28,000 AND SO IT WAS THE VISION OF 7097 04:02:28,001 --> 04:02:31,000 SENATOR TEND YEARS AGO TO TRY TO 7098 04:02:31,001 --> 04:02:33,000 COME UP WITH A DIFFERENT IDEA 7099 04:02:33,001 --> 04:02:36,000 NOT TO REPLACE THAT BUT AN IDEA 7100 04:02:36,001 --> 04:02:38,000 THAT MIGHT ALLOW FOR 7101 04:02:38,001 --> 04:02:40,000 E DISABLED TO BE ABLE TO GET 7102 04:02:40,001 --> 04:02:42,000 SOME HELP DURING THAT PERIOD OF 7103 04:02:42,001 --> 04:02:43,000 DISABILITY, HOWEVER LONG IT 7104 04:02:43,001 --> 04:02:46,000 MIGHT LAST, WITHOUT NECESSARILY 7105 04:02:46,001 --> 04:02:49,000 HAVING TO THEN IMPOVERISH 7106 04:02:49,001 --> 04:02:50,000 YOURSELF 7107 04:02:50,001 --> 04:02:52,000 OUTSIDE EARNINGS, GIVEN THE FACT 7108 04:02:52,001 --> 04:02:53,000 THAT YOU MAY BE ABLE TO CONTINUE 7109 04:02:53,001 --> 04:02:58,000 TO PERFORM AND IN FACT WOULD 7110 04:02:58,001 --> 04:02:59,000 SO THE I 7111 04:02:59,001 --> 04:03:00,000 THIS, PARTICULARLY IN LIGHT OF 7112 04:03:00,001 --> 04:03:01,000 THE FACT THAT YOU DON'T WANT TO 7113 04:03:01,001 --> 04:03:03,000 NECESSARILY BE ADDING A COST TO 7114 04:03:03,001 --> 04:03:05,000 TAXPAYERS, AND SO IT WAS HIS 7115 04:03:05,001 --> 04:03:08,000 IDEA TO COME UP 7116 04:03:08,001 --> 04:03:12,000 VOLUNTARY PROGRAM, TOTALLY VOLUNTARY THAT INDIVIDUALS WOULD 7117 04:03:12,001 --> 04:03:13,000 HAVE TO CONTRIBUTE TO -- OUT OF 7118 04:03:13,001 --> 04:03:15,000 THEIR OWN POCKETBOOKS, NOT OUT 7119 04:03:15,001 --> 04:03:17,000 OF THE TAXPAYERS' POCKETBOOKS, 7120 04:03:17,001 --> 04:03:20,000 BY PUTTING ASIDE RESOURCES ON 7121 04:03:20,001 --> 04:03:22,000 MONTHLY BASIS OVER A PERIOD OF 7122 04:03:22,001 --> 04:03:23,000 YEARS -- FIVE IN THE CASE OF 7123 04:03:23,001 --> 04:03:25,000 THIS BILL -- WHERE THE PLAN 7124 04:03:25,001 --> 04:03:27,000 WOULD BECOME VESTED IN A SENSE, 7125 04:03:27,001 --> 04:03:29,000 AND THEN TO CONTRIBUTE THAT 7126 04:03:29,001 --> 04:03:32,000 AMOUNT THEREAFTER, AND THEN IN 7127 04:03:32,001 --> 04:03:35,000 SUCH CASE AS 7128 04:03:35,001 --> 04:03:36,000 DISABLED AND THEIR CRITERIA THAT 7129 04:03:36,001 --> 04:03:38,000 WOULD DETERMINE WHETHER OR NOT 7130 04:03:38,001 --> 04:03:41,000 YOU'VE MET 7131 04:03:41,001 --> 04:03:43,000 WOULD THEN QUALIFY BASED UPON 7132 04:03:43,001 --> 04:03:44,000 THE FACT THAT YOU PAID INTO THIS 7133 04:03:44,001 --> 04:03:46,000 PROGRAM CONTINUOUSLY WITHOUT 7134 04:03:46,001 --> 04:03:51,000 EXCEPTION OF YOUR OWN MONEY TO 7135 04:03:51,001 --> 04:03:53,000 RECEIVE AS MUCH 7136 04:03:53,001 --> 04:03:55,000 PROVIDING ASSISTANCE TO YOU SO 7137 04:03:55,001 --> 04:03:56,000 THAT YOU MIGHT GET 7138 04:03:56,001 --> 04:03:58,000 ABLE TO CONTINUE TO OPERATE 7139 04:03:58,001 --> 04:04:00,000 WITHOUT HAVING TO IMPOVERISH 7140 04:04:00,001 --> 04:04:01,000 YOURSELF OR PUT LIMITATIONS ON 7141 04:04:01,001 --> 04:04:03,000 YOUR WORK. 7142 04:04:03,001 --> 04:04:07,000 AND THAT WOULD PROVIDE AS MUCH 7143 04:04:07,001 --> 04:04:08,000 AS AROUND $18,000 TO $20,000 A 7144 04:04:08,001 --> 04:04:09,000 YEAR FOR THOSE INDIVIDUALS WHO 7145 04:04:09,001 --> 04:04:12,000 NE IT. 7146 04:04:12,001 --> 04:04:14,000 BUT AGAIN, ENTIRELY VOLUNTARY 7147 04:04:14,001 --> 04:04:17,000 YOUR MONEY, NO PUBLIC MONEY, NO 7148 04:04:17,001 --> 04:04:18,000 TAXPAYER MONEY GOES INTO THE 7149 04:04:18,001 --> 04:04:19,000 PLAN. 7150 04:04:19,001 --> 04:04:20,000 FIVE MILLION PEO 7151 04:04:20,001 --> 04:04:22,000 MR. PRESIDENT, UNDER THE AGE OF 7152 04:04:22,001 --> 04:04:26,000 65 LIVING IN THE COMMUNITY HAVE 7153 04:04:26,001 --> 04:04:28,000 LONG-TERM CARE NEEDS. 7154 04:04:28,001 --> 04:04:29,000 AND OVER 70,000 WORKERS WITH 7155 04:04:29,001 --> 04:04:30,000 SEVERE DISABILITIES IN THE 7156 04:04:30,001 --> 04:04:31,000 NATION TODAY WHO NEED DAILY 7157 04:04:31,001 --> 04:04:35,000 ASSISTANCE TO MAINTAIN THEIR 7158 04:04:35,001 --> 04:04:37,000 JOBS AND 7159 04:04:37,001 --> 04:04:39,000 LONG-TERM CARE SUPPORT AND 7160 04:04:39,001 --> 04:04:40,000 SERVICES ARE AN AREA THAT IS NOT 7161 04:04:40,001 --> 04:04:42,000 CURRENTLY AFFORDABLE OR 7162 04:04:42,001 --> 04:04:43,000 ACCESSIBLE FOR MILLIONS OF OUR 7163 04:04:43,001 --> 04:04:47,000 FELLOW CITIZENS. 7164 04:04:47,001 --> 04:04:50,000 IT IS ESTIMATED THAT 65% OF ALL 7165 04:04:50,001 --> 04:04:52,000 THOSE WHO ARE 65 TODAY 7166 04:04:52,001 --> 04:04:55,000 WILL SPEND SOME TIME AT HOME IN 7167 04:04:55,001 --> 04:04:58,000 NEED OF LONG-TERM CARE SERVICES 7168 04:04:58,001 --> 04:05:00,000 WHICH COSTS CAN RUN ROUGHLY 7169 04:05:00,001 --> 04:05:02,000 AROUND $18,000 A YEAR. 7170 04:05:02,001 --> 04:05:04,000 1.5 MILLION PEOPLE TODAY ARE IN 7171 04:05:04,001 --> 04:05:06,000 NURSING HOMES AND ROUGHLY NINE 7172 04:05:06,001 --> 04:05:08,000 MILLION OF OUR FELLOW ELDERLY 7173 04:05:08,001 --> 04:05:09,000 AMERICANS WILL NEED HELP WITH 7174 04:05:09,001 --> 04:05:12,000 ACTIVIES OF DAILY LIVING 7175 04:05:12,001 --> 04:05:14,000 DURING THE CURRENT 7176 04:05:14,001 --> 04:05:18,000 BY THE YEAR 2030, MR. PRESIDENT, 7177 04:05:18,001 --> 04:05:20,000 THAT NUMBER WILL INCREASE TO 7178 04:05:20,001 --> 04:05:21,000 14 MILLION, AS WE WATCH 7179 04:05:21,001 --> 04:05:23,000 BOOM POPULATION AND THEREAFTER, 7180 04:05:23,001 --> 04:05:25,000 ALONG WITH THE QUALITY OF CARE 7181 04:05:25,001 --> 04:05:26,000 AND LONGEVITY TABLES EXTENDING 7182 04:05:26,001 --> 04:05:27,000 THE LIFE OF INDIVIDUALS, AND 7183 04:05:27,001 --> 04:05:29,000 WHILE THAT LIFE WILL BE EXTENDED 7184 04:05:29,001 --> 04:05:31,000 AND HOPEFULLY THE QUALITY 7185 04:05:31,001 --> 04:05:33,000 IMPROVE, WE ALL ACCEPT THE 7186 04:05:33,001 --> 04:05:35,000 NOTION THAT AS WE GET OLDER, WE 7187 04:05:35,001 --> 04:05:36,000 HAVE GREER NEEDS PHYSICALLY, 7188 04:05:36,001 --> 04:05:38,000 AND THAT CERTAINLY IS SOMETHING 7189 04:05:38,001 --> 04:05:39,000 ANYONE OVER THE AGE OF 65 CAN 7190 04:05:39,001 --> 04:05:40,000 TELL YOU. 7191 04:05:40,001 --> 04:05:44,000 AND SO AS THE YEARS PROGRESS, 7192 04:05:44,001 --> 04:05:45,000 THE QUALITY OF CARE, LONGEVITY 7193 04:05:45,001 --> 04:05:47,000 TABLES 7194 04:05:47,001 --> 04:05:49,000 PEOPLE WHO WILL NEED SOME FORM 7195 04:05:49,001 --> 04:05:52,000 OF SERVICES OR ANOTHER WILL JUMP 7196 04:05:52,001 --> 04:05:53,000 FROM NINE MILLION TODAY TO 7197 04:05:53,001 --> 04:05:54,000 ROUGHLY 14 MILLION. 7198 04:05:54,001 --> 04:05:55,000 AND THOSE NUMBERS ARE APT TO 7199 04:05:55,001 --> 04:05:56,000 INCREASE. 7200 04:05:56,001 --> 04:06:00,000 MANY PEOPLE THAT NEED LONG-TERM 7201 04:06:00,001 --> 04:06:03,000 SERVICES, 7202 04:06:03,001 --> 04:06:05,000 SUPPORT RELY ON UNPAID FAMILY 7203 04:06:05,001 --> 04:06:06,000 AND FRIENDS TO PROVIDE THAT 7204 04:06:06,001 --> 04:06:09,000 CARE. 7205 04:06:09,001 --> 04:06:10,000 THEY'VE GOT 7206 04:06:10,001 --> 04:06:11,000 GRANDCHILDREN WHO ARE AROUND TO 7207 04:06:11,001 --> 04:06:13,000 PROVIDE THAT KIND OF ASSISTANCE. 7208 04:06:13,001 --> 04:06:15,000 A LOT CAN, OF COURSE. 7209 04:06:15,001 --> 04:06:17,000 BUT ULTIMATELY, MANY OF THESE 7210 04:06:17,001 --> 04:06:19,000 INDIVIDUALS WILL HAVE TO IMUPON 7211 04:06:19,001 --> 04:06:20,000 ISSUE THEMSELVES TO QUALIFY FOR MEDICAID. 7212 04:06:20,001 --> 04:06:21,000 YOU KNOW WHAT HAPPENS? 7213 04:06:21,001 --> 04:06:23,000 THEY TRANSFER THE HOUSE, THEY 7214 04:06:23,001 --> 04:06:25,000 TRANSFER THEIR ASSETS, THEY LOVE 7215 04:06:25,001 --> 04:06:26,000 EVERYTHING OVER TO THE 7216 04:06:26,001 --> 04:06:28,000 CHILDREN OR SOMEPLACE ELSE SO 7217 04:06:28,001 --> 04:06:31,000 THAT THEY QUALIFY FOR THAT TITLE 7218 04:06:31,001 --> 04:06:34,000 THEY BECOME 7219 04:06:34,001 --> 04:06:35,000 LEAST ON PAPER SO THEY CAN THEN 7220 04:06:35,001 --> 04:06:37,000 QUALIFY FOR THAT ASSISTANCE. 7221 04:06:37,001 --> 04:06:39,000 MEDICAID WHICH REMAINS THE 7222 04:06:39,001 --> 04:06:42,000 PRIMARY PAYER FOR THESE SERVICES. 7223 04:06:42,001 --> 04:06:44,000 THE CLASS ACT IS DESIGNED TO 7224 04:06:44,001 --> 04:06:46,000 AVOID THAT. 7225 04:06:46,001 --> 04:06:48,000 IT CAN IN AS MANY CASES AS 7226 04:06:48,001 --> 04:06:50,000 POSSIBLE BY PROVIDING A LIFETIME 7227 04:06:50,001 --> 04:06:53,000 CASH BENEFIT, VOLUNTARY, TOTALLY 7228 04:06:53,001 --> 04:06:55,000 PAID FOR BY 7229 04:06:55,001 --> 04:06:57,000 OFFERS SENIORS AND PEOPLE WITH 7230 04:06:57,001 --> 04:06:59,000 DISABILITIES SOME PROTECTION 7231 04:06:59,001 --> 04:07:01,000 AGAINST THE COSTS OF PAYING FOR 7232 04:07:01,001 --> 04:07:03,000 LONG-TERM CARE SERVICES AND 7233 04:07:03,001 --> 04:07:04,000 SUPPORTS AND HELP THEM OBTAIN 7234 04:07:04,001 --> 04:07:07,000 SERVICES AND SUPPORTS THAT WILL 7235 04:07:07,001 --> 04:07:08,000 ENABLE THEM TO REMAIN IN THEIR 7236 04:07:08,001 --> 04:07:09,000 HOMES, RESIDE IN THEIR 7237 04:07:09,001 --> 04:07:10,000 COMMUNITIES, AND IN MANY CASES 7238 04:07:10,001 --> 04:07:13,000 CONTINUE TO 7239 04:07:13,001 --> 04:07:17,000 LET ME TELL YOU HOW THE PROGRAM 7240 04:07:17,001 --> 04:07:19,000 WORKS. 7241 04:07:19,001 --> 04:07:22,000 CLASS -- THE PGRAM IS 7242 04:07:22,001 --> 04:07:23,000 VOLUNTARY, TOTALLY VOLUNTARY, 7243 04:07:23,001 --> 04:07:24,000 SELF-FUNDED INSURANCE PROGRAM 7244 04:07:24,001 --> 04:07:26,000 WITH ENROLLMENT FOR PEOPLE WHO 7245 04:07:26,001 --> 04:07:27,000 ARE CURRENTLY EMPLOYED. 7246 04:07:27,001 --> 04:07:28,000 AFFORDABLE PREMIUMS WILL BE PAID 7247 04:07:28,001 --> 04:07:29,000 THROUGH PAYROLL DEDUCTIONS IF 7248 04:07:29,001 --> 04:07:31,000 THE INDIVIDUAL'S EMPLOYER 7249 04:07:31,001 --> 04:07:32,000 DECIDES TO PARTICIPATE IN THE PROGRAM. 7250 04:07:32,001 --> 04:07:34,000 TOTALLY VOLUNTARY. 7251 04:07:34,001 --> 04:07:36,000 NOTHING REQUIRED WHATSOEVER. 7252 04:07:36,001 --> 04:07:38,000 IF THE EMPLOYER DOESN'T WANT TO 7253 04:07:38,001 --> 04:07:40,000 HAVE TO FIND SOME OTHER WAY TO DO IT. 7254 04:07:40,001 --> 04:07:41,000 IF THE 7255 04:07:41,001 --> 04:07:44,000 IT TO BE A PAYROLL DEDUCTION, 7256 04:07:44,001 --> 04:07:46,000 THEY CAN DO THAT, PURELY VOLUNTARY. 7257 04:07:46,001 --> 04:07:49,000 PARTICIPATION BY WORKERS, AGAIN, 7258 04:07:49,001 --> 04:07:51,000 ENTIRELY VOLUNTARY. 7259 04:07:51,001 --> 04:07:53,000 SELFEMPLOYED PEOPLE OR THOSE 7260 04:07:53,001 --> 04:07:54,000 WHOSE EMPLOYERS DO NOT OFFER THE 7261 04:07:54,001 --> 04:07:56,000 BENEFIT WILL ALSO BE ABL TO 7262 04:07:56,001 --> 04:08:00,000 JOIN THIS PROGRAM THROUGH A 7263 04:08:00,001 --> 04:08:02,000 GOVERNMENT PAYMENT MECHANISM. 7264 04:08:02,001 --> 04:08:03,000 INDIVIDUALS QUALIFY TO 7265 04:08:03,001 --> 04:08:05,000 SELFBENEFITS WHEN THEY NEED HELP 7266 04:08:05,001 --> 04:08:06,000 WITH CERTAIN ACTIVITIES OFAILY 7267 04:08:06,001 --> 04:08:07,000 LIVING AND THEY HAVE PAID 7268 04:08:07,001 --> 04:08:09,000 PREMIUMS FOR AT LEAST FIVE YEARS 7269 04:08:09,001 --> 04:08:11,000 AND HAVE WORKED FOR AT LEAST 7270 04:08:11,001 --> 04:08:13,000 THREE OF THOSE FIVE YEARS. 7271 04:08:13,001 --> 04:08:16,000 BENEFICIARIERECEIVE LIFETIME 7272 04:08:16,001 --> 04:08:20,000 CASH BENEFITS BASED ON THE 7273 04:08:20,001 --> 04:08:23,000 DEGREE OF IMPAIRMENT EXPECTED TO 7274 04:08:23,001 --> 04:08:26,000 AVERAGE ROUGHLY $75 A DAY OR $27,000 A YEAR. 7275 04:08:26,001 --> 04:08:28,000 BENEFITS CAN BE USED TO MAINTAIN 7276 04:08:28,001 --> 04:08:29,000 INDEPENDENCE AT HOME OR IN THE 7277 04:08:29,001 --> 04:08:31,000 COMMUNITY AND SHOULD BE 7278 04:08:31,001 --> 04:08:33,000 SUFFICIENT TO COVER TYPICAL 7279 04:08:33,001 --> 04:08:34,000 COSTS OF HOME CARE SERVICES 7280 04:08:34,001 --> 04:08:36,000 ADULT DAYCARE. 7281 04:08:36,001 --> 04:08:43,000 BENEFITS CAN ALSO BE USED TO 7282 04:08:43,001 --> 04:08:46,000 OFFSET THE COSTS OF 7283 04:08:46,001 --> 04:08:48,000 LIVING AND HOME HEALTH 7284 04:08:48,001 --> 04:08:50,000 THE ISSUE IS RAISED ABOUT ARE WE 7285 04:08:50,001 --> 04:08:52,000 GOING TO BE PROTECTED UNDER THIS PROGRAM. 7286 04:08:52,001 --> 04:08:54,000 ALL CLASS ACT BENEFITS ARE PAID 7287 04:08:54,001 --> 04:08:55,000 BY VOLUNTARY PARTICIPANTS, NOT 7288 04:08:55,001 --> 04:08:57,000 TAXPAYERS. 7289 04:08:57,001 --> 04:08:59,000 THE CLASS ACT ACTUALLY WILL SAVE 7290 04:08:59,001 --> 04:09:00,000 TAXPAYER DOLLARS BY REDUCING 7291 04:09:00,001 --> 04:09:02,000 MEDICAID COSTS. 7292 04:09:02,001 --> 04:09:03,000 ACCORDING TO THE C.B.O., ALMOST 7293 04:09:03,001 --> 04:09:06,000 ALMOST $2 BILLION. 7294 04:09:06,001 --> 04:09:08,000 THE CLASS ACT PREMIUMS MUST BE 7295 04:09:08,001 --> 04:09:11,000 SET AT A LEVEL SUFFICIENT TO 7296 04:09:11,001 --> 04:09:12,000 GUARANTEE ACTUARIAL 7297 04:09:12,001 --> 04:09:15,000 THE PROGRAM. 7298 04:09:15,001 --> 04:09:16,000 WE THANK SENATOR GREGG OF NEW 7299 04:09:16,001 --> 04:09:17,000 HAMPSHIRE FOR REQUIRING THAT 7300 04:09:17,001 --> 04:09:18,000 AMENDMENT IN THE DEBATE OF THE 7301 04:09:18,001 --> 04:09:19,000 CLASS ACT BILL WHEN IT CAME UP 7302 04:09:19,001 --> 04:09:21,000 IN OUR COMMITTEE. 7303 04:09:21,001 --> 04:09:22,000 THE CURRENT CLASS ACT INCLUDES 7304 04:09:22,001 --> 04:09:25,000 SIGNIFICANT IMPROVEMENTS OVER 7305 04:09:25,001 --> 04:09:27,000 EARLIER VERSIONS SUCH AS 7306 04:09:27,001 --> 04:09:29,000 ELIGIBILITY STANDARDS, A NEW 7307 04:09:29,001 --> 04:09:30,000 RESERVE REQUIREMENT AND AN 7308 04:09:30,001 --> 04:09:32,000 ABSOLUTE PROHIBITION ON THE USE 7309 04:09:32,001 --> 04:09:33,000 OF TAXPAYER DOLLARS TO PAY 7310 04:09:33,001 --> 04:09:34,000 BENEFITS. 7311 04:09:34,001 --> 04:09:35,000 THE CONGRESSIONAL BUDGET OFFICE 7312 04:09:35,001 --> 04:09:40,000 DETERMINED THAT THE IMPROVED 7313 04:09:40,001 --> 04:09:41,000 PROGRAM IS TOTALLY ACTUARIALLY SOUND. 7314 04:09:41,001 --> 04:09:43,000 THIS BILL, THE 7315 04:09:43,001 --> 04:09:45,000 PROTECTION AND AFFORDABLE CARE 7316 04:09:45,001 --> 04:09:47,000 ACT, OUR OVERALL BILL, CREATES A 7317 04:09:47,001 --> 04:09:48,000 VOLUNTARY INS 7318 04:09:48,001 --> 04:09:50,000 UNDER THE PROGRAM, WORKING 7319 04:09:50,001 --> 04:09:51,000 PEOPLE PAY PREMIUMS, AS I SAID, 7320 04:09:51,001 --> 04:09:52,000 FOR AT LEAST FIVE YEARS BEFORE 7321 04:09:52,001 --> 04:09:54,000 IT WOULD VEST. 7322 04:09:54,001 --> 04:09:55,000 AFTER THAT POINT, IF THE 7323 04:09:55,001 --> 04:09:57,000 INDIVIDUAL WHO HAS PAID 7324 04:09:57,001 --> 04:09:59,000 FIVE YEARS AND WORKED FOR AT 7325 04:09:59,001 --> 04:10:01,000 LEAST THREE OFHOSE FIVE YEARS 7326 04:10:01,001 --> 04:10:03,000 DEVELOPS A DISABILITY, THEY CAN 7327 04:10:03,001 --> 04:10:07,000 RECEIVE A CASH BENEFIT OF NO 7328 04:10:07,001 --> 04:10:08,000 LESS THAN $50 A DAY, AS MUCH 7329 04:10:08,001 --> 04:10:09,000 AS $75, FOR AS LONG AS THAT 7330 04:10:09,001 --> 04:10:11,000 DISABILITY PERSISTS. 7331 04:10:11,001 --> 04:10:14,000 CONTRARY TO POPULAR BELIEF, 7332 04:10:14,001 --> 04:10:15,000 MR. PRESIDENT, MEDICARE AND MOST 7333 04:10:15,001 --> 04:10:16,000 PRIVATE HEALTH INSURANCE ONLY 7334 04:10:16,001 --> 04:10:19,000 PAY FOR LONG-TERM CARE FOR A 7335 04:10:19,001 --> 04:10:20,000 SHORT PERIOD OF TIME, MEANING 7336 04:10:20,001 --> 04:10:22,000 THAT MOST PEOPLEAY OUT OF 7337 04:10:22,001 --> 04:10:24,000 THEIR OWN INCOME OR ASSETS OR 7338 04:10:24,001 --> 04:10:26,000 THEIR FAMILY'S ASSETS TO PROVIDE 7339 04:10:26,001 --> 04:10:28,000 THESE KIND OF BENEFITS. 7340 04:10:28,001 --> 04:10:30,000 THOSE WITH THE 7341 04:10:30,001 --> 04:10:33,000 NEEDS WILL FREQUENTLY EXHAUST AS 7342 04:10:33,001 --> 04:10:36,000 I SAID A MOMENT AGO THESE ASSETS 7343 04:10:36,001 --> 04:10:37,000 THAT THEY HAVE TO RELY ON 7344 04:10:37,001 --> 04:10:38,000 MEDICAID. 7345 04:10:38,001 --> 04:10:39,000 THUS IMPOVERISHING THEMSELVES IN 7346 04:10:39,001 --> 04:10:41,000 ORDER TO 7347 04:10:41,001 --> 04:10:44,000 THE CLASS ACT PROVIDES ESSENTIAL 7348 04:10:44,001 --> 04:10:47,000 OPTIONS FOR 65% OF THOSE AGED 65 7349 04:10:47,001 --> 04:10:50,000 AND OLDER WHO NEED LONG-TERM 7350 04:10:50,001 --> 04:10:51,000 CARE SERVICES AT SOME POINT IN 7351 04:10:51,001 --> 04:10:54,000 THEIR LIVES AS I MENTIONED 7352 04:10:54,001 --> 04:10:55,000 EARLIER, AND FOR THE 70,000 7353 04:10:55,001 --> 04:10:57,000 WORKERS WITH SEVERE DISABILITY 7354 04:10:57,001 --> 04:10:58,000 IN THE NATION TODAY WHO NEED 7355 04:10:58,001 --> 04:10:59,000 DAILY ASSISTANCE TO MAINTAIN 7356 04:10:59,001 --> 04:11:00,000 THEIR JOBS AND THEIR 7357 04:11:00,001 --> 04:11:03,000 INDEPENDENCE. 7358 04:11:03,001 --> 04:11:05,000 OOZE I SAID, THE PROGRAM -- AS I 7359 04:11:05,001 --> 04:11:06,000 SAID, THE PROGRAM IS NOT -- IS 7360 04:11:06,001 --> 04:11:09,000 NOT FINANCIALLY STABLE. 7361 04:11:09,001 --> 04:11:11,000 IT AMOUNTS TO NOTHING MORE THAN 7362 04:11:11,001 --> 04:11:12,000 A PONZI SCHEME AS 7363 04:11:12,001 --> 04:11:14,000 CALLED IT. 7364 04:11:14,001 --> 04:11:15,000 SOME SAY THIS WILL CREATE A NEW 7365 04:11:15,001 --> 04:11:17,000 GOVERNMENT ENTITLEMENT PROGRAM. 7366 04:11:17,001 --> 04:11:18,000 IT IS NOT A GOVERNMENT ENTITLE 7367 04:11:18,001 --> 04:11:20,000 PROGRAM. ANYTHING BUT. 7368 04:11:20,001 --> 04:11:21,000 THE CLASS ACT DOES NOT INFER 7369 04:11:21,001 --> 04:11:22,000 RIGHTS OR OBLIG 7370 04:11:22,001 --> 04:11:24,000 GOVERNMENT FUNDING NOR DOES IT 7371 04:11:24,001 --> 04:11:25,000 AFFECT RECEIPT OF OR ELIGIBILITY 7372 04:11:25,001 --> 04:11:28,000 FOR OTHER BENEFITS. 7373 04:11:28,001 --> 04:11:29,000 THE PROGRAM STANDS ON ITS OWN 7374 04:11:29,001 --> 04:11:30,000 FINANCIAL FEET. 7375 04:11:30,001 --> 04:11:33,000 AS I SAID EARLIER, IT HAS BEEN 7376 04:11:33,001 --> 04:11:35,000 DETERMINED BY THE C.B.O. TO BE 7377 04:11:35,001 --> 04:11:37,000 ACTUARIALLY SOUND FOR THE NEXT 75 YEARS. 7378 04:11:37,001 --> 04:11:38,000 THE CLASS ACT IS SOLVENT 7379 04:11:38,001 --> 04:11:39,000 ACCORDING TO THE CONGRESSIONAL 7380 04:11:39,001 --> 04:11:41,000 BUDGET OFFICE AS I MENTIONED. 7381 04:11:41,001 --> 04:11:43,000 THE PROGRAM WOULD RUN ON ONLY 7382 04:11:43,001 --> 04:11:45,000 ITS OWN CASH FLOWS. 7383 04:11:45,001 --> 04:11:48,000 C.B.O. ESTIMATES THE AVERAGE 7384 04:11:48,001 --> 04:11:50,000 MONTHLY PREMIUM OF $123 FOR AN 7385 04:11:50,001 --> 04:11:52,000 AVERAGE DAILY CASH BENEFIT OF 7386 04:11:52,001 --> 04:11:54,000 OF $75 FOR THOSE WHO QLIFY. 7387 04:11:54,001 --> 04:11:57,000 IT MAY NOT SEEM LIKE MUCH, $75 A 7388 04:11:57,001 --> 04:11:59,000 DAY, BUT OVER A YEAR, THAT WOULD 7389 04:11:59,001 --> 04:12:02,000 PROVIDE NEEDED, NEEDED 7390 04:12:02,001 --> 04:12:04,000 ASSISTANCE FOR THOSE WHO HAVE 7391 04:12:04,001 --> 04:12:07,000 ACHIEVED OR SUFFER UNDER THOSE DISABILITIES. 7392 04:12:07,001 --> 04:12:09,000 C.B.O. USED A VERY CONSERVATIVE 7393 04:12:09,001 --> 04:12:11,000 PARTICIPATION RATE. 7394 04:12:11,001 --> 04:12:14,000 C.B.O. ASSUMES PARCIPATION 7395 04:12:14,001 --> 04:12:17,000 RATES THAT DO NOT CONSIDER CLASS 7396 04:12:17,001 --> 04:12:18,000 BUT OFFER A LIFETIME CASH BENEFIT. 7397 04:12:18,001 --> 04:12:21,000 ENDORSED BY THE GOVERNMENT AND 7398 04:12:21,001 --> 04:12:24,000 PROVIDE A CONVENIENT WAY FOR 7399 04:12:24,001 --> 04:12:26,000 EMPLOYEES TO AUTOENROLL THROUGH 7400 04:12:26,001 --> 04:12:28,000 THEIR EMPLOYERS WITH A VOLUNTARY OPTOUT. 7401 04:12:28,001 --> 04:12:29,000 ALL OF THESE 7402 04:12:29,001 --> 04:12:31,000 INCREASE PARTICIPATION RATES 7403 04:12:31,001 --> 04:12:32,000 WHICH RESULT IN LOWER PREMIUMS, 7404 04:12:32,001 --> 04:12:34,000 ENURAGE ENROLLMENT, AND MAKE 7405 04:12:34,001 --> 04:12:36,000 THE PROGRAM EVEN STRONGER FINANCIALLY. 7406 04:12:36,001 --> 04:12:37,000 THE SOLVENCY OF THE PROGRAM IS 7407 04:12:37,001 --> 04:12:38,000 BOLSTERED BY FLEXIBILITY TO 7408 04:12:38,001 --> 04:12:40,000 ADJUST THE PROGRAM. 7409 04:12:40,001 --> 04:12:42,000 IN THEIR NOVEMBER 25 LETTER TO 7410 04:12:42,001 --> 04:12:43,000 THE CONGRESS, THE C.B.O. 7411 04:12:43,001 --> 04:12:45,000 ACKNOWLEDGES THAT THE 7412 04:12:45,001 --> 04:12:46,000 LEGISLATION 7413 04:12:46,001 --> 04:12:50,000 THE HEALTH AND HUMAN SERVICES 7414 04:12:50,001 --> 04:12:53,000 SECRETARY TO ADJUST PREMIUMS AND 7415 04:12:53,001 --> 04:12:54,000 BENEFITS WHERE OR EVER NEEDED. 7416 04:12:54,001 --> 04:12:56,000 THIS PROVIDES A LEVER TO ENSURE 7417 04:12:56,001 --> 04:12:58,000 THAT THE PROGRAM STAYS SOLVENT 7418 04:12:58,001 --> 04:13:00,000 EVEN IF REAL LIFE DOES 7419 04:13:00,001 --> 04:13:04,000 PERFECTLY MIRROR THE MODELS OF 7420 04:13:04,001 --> 04:13:06,000 THE C.B.O., AS GOOD AS THEY ARE. THE CONGRE 7421 04:13:06,001 --> 04:13:07,000 DISCUSSES THE CLASS ACT WOULD 7422 04:13:07,001 --> 04:13:09,000 FUNCTION JUST LIKE ANY OTHER 7423 04:13:09,001 --> 04:13:12,000 PRIVATE LONG-TERM CARE INSURANCE 7424 04:13:12,001 --> 04:13:14,000 PROGRAM WHICH FINANCES 7425 04:13:14,001 --> 04:13:15,000 BENEFITS -- WHICH FINANCES 7426 04:13:15,001 --> 04:13:18,000 BENEFIT PAYMENTS FOR A PREMIUM 7427 04:13:18,001 --> 04:13:19,000 RESERVE AND INTEREST INCOME OFF 7428 04:13:19,001 --> 04:13:21,000 THAT RESERVE. 7429 04:13:21,001 --> 04:13:22,000 DUE TO BUDGET SCOREKEEPING, THE 7430 04:13:22,001 --> 04:13:24,000 CONGRESSIONAL BUDGET OFFICE 7431 04:13:24,001 --> 04:13:26,000 FINDS THAT PREMIUM REVENUE 7432 04:13:26,001 --> 04:13:28,000 EXCEEDS BENEFIT PAYMENTS IN THE 7433 04:13:28,001 --> 04:13:29,000 THIRD DECADE BUT DOES NOT TAKE 7434 04:13:29,001 --> 04:13:32,000 INTO CONSIDERATION ACCUMULATED 7435 04:13:32,001 --> 04:13:33,000 RESERVES AND INCOME OFF THOSE 7436 04:13:33,001 --> 04:13:35,000 RESERVES THAT KEEP THE PROGRAM 7437 04:13:35,001 --> 04:13:36,000 FISCALLY INDEPENDENT. 7438 04:13:36,001 --> 04:13:38,000 BEYOND BEING SELFSUPPORTING AND 7439 04:13:38,001 --> 04:13:40,000 VOLUNTARY, MR. PRE 7440 04:13:40,001 --> 04:13:42,000 PROGRAM CAN ACTUALLY GENERATE 7441 04:13:42,001 --> 04:13:45,000 SAVINGS IN MEDICAID. 7442 04:13:45,001 --> 04:13:48,000 DIRECT OFFSET OF THE $75 DAILY 7443 04:13:48,001 --> 04:13:49,000 BENEFIT IS APPLIED TOWARD ANY 7444 04:13:49,001 --> 04:13:51,000 MEDICAID LONG-TERM CARE COSTS. 7445 04:13:51,001 --> 04:13:52,000 BEYOND THAT, THE CLASS ACT 7446 04:13:52,001 --> 04:13:54,000 PROGRAM WILL HELP PEOPLE LIVE 7447 04:13:54,001 --> 04:13:56,000 INDEPENDENTLY AT HOME OR IN 7448 04:13:56,001 --> 04:13:57,000 THEIR COMMUNITY, AND WHEN PEOPLE 7449 04:13:57,001 --> 04:13:58,000 WITH DISABILITIES GET THE 7450 04:13:58,001 --> 04:14:02,000 SERVICES THEY NEED, THEY ARE 7451 04:14:02,001 --> 04:14:03,000 LESS LIKELY TO SND DOWN TO GET 7452 04:14:03,001 --> 04:14:04,000 MEDICA 7453 04:14:04,001 --> 04:14:07,000 ENTER A NURSING HOME OR 7454 04:14:07,001 --> 04:14:08,000 HOSPITAL, ALL OF WHICH GENERATE 7455 04:14:08,001 --> 04:14:10,000 ADDITION 7456 04:14:10,001 --> 04:14:11,000 AND, OF COURSE, WHAT WE DON'T 7457 04:14:11,001 --> 04:14:13,000 CALCULATE HERE -- BECAUSE I 7458 04:14:13,001 --> 04:14:15,000 DON'T KNOW HOW YOU WOULD 7459 04:14:15,001 --> 04:14:16,000 CALCULATE IT -- IS THAT 7460 04:14:16,001 --> 04:14:18,000 OF INDEPENDENCE. 7461 04:14:18,001 --> 04:14:20,000 I SUSPECT MAYBE ALL OF US KNOW 7462 04:14:20,001 --> 04:14:21,000 PEOPLE WHO ARE ON MEDICAID, AND 7463 04:14:21,001 --> 04:14:22,000 TH FRUSTRATION PARTICULARLY F 7464 04:14:22,001 --> 04:14:26,000 SOMEONE WHO IS OTHERWISE HLTHY 7465 04:14:26,001 --> 04:14:27,000 BUT SUFFERS 7466 04:14:27,001 --> 04:14:29,000 THEY WOULD LIKE TO WORK AND WANT 7467 04:14:29,001 --> 04:14:30,000 TO KEEP INDEPENDENT, AND YET IF 7468 04:14:30,001 --> 04:14:31,000 YOU GO TO THE MEDICAID PROGRAM, 7469 04:14:31,001 --> 04:14:33,000 THERE ARE HUGE RESTRAINTS ON 7470 04:14:33,001 --> 04:14:35,000 YOUR ABILITY TO DO SO. 7471 04:14:35,001 --> 04:14:38,000 AND SO BY THIS PROGRAM, ASIDE 7472 04:14:38,001 --> 04:14:42,000 FROM FINANCIALLY REDUCING 7473 04:14:42,001 --> 04:14:43,000 MEDICAID COSTS, WE'RE 7474 04:14:43,001 --> 04:14:44,000 ACTUALLY -- WE'RE ACTUALLY 7475 04:14:44,001 --> 04:14:47,000 PROVIDING THAT ADDITIONAL SENSE 7476 04:14:47,001 --> 04:14:48,000 OF HUMAN DIGNITY AND DECENCY, 7477 04:14:48,001 --> 04:14:50,000 THAT JUST BECAUSE YOU HAVE A 7478 04:14:50,001 --> 04:14:52,000 DISABILITY AND YOU NEED HELP 7479 04:14:52,001 --> 04:14:54,000 DOESN'T MEAN YOU DON'T WANT TO 7480 04:14:54,001 --> 04:14:56,000 BE SELF-SUFFICIENT AND KEEP WORKING. 7481 04:14:56,001 --> 04:14:57,000 YOU HAVE THE GRATIFICATION OF 7482 04:14:57,001 --> 04:14:59,000 KNOWING YOU'RE CONTRIBUTING IN 7483 04:14:59,001 --> 04:15:00,000 SOME WAY, OTHER THAN BEING 7484 04:15:00,001 --> 04:15:02,000 SHUTTERED AWAY, HAVING 7485 04:15:02,001 --> 04:15:04,000 IMPOVERISHED YOURSELF BY GETTING 7486 04:15:04,001 --> 04:15:05,000 RID OF ALL YOUR ASSETS, RELYING 7487 04:15:05,001 --> 04:15:06,000 ON FAMILY OR OTHERS TO TAKE CARE 7488 04:15:06,001 --> 04:15:09,000 OF YOU BECAUSE YOU DON'T HAVE 7489 04:15:09,001 --> 04:15:11,000 THOSE 7490 04:15:11,001 --> 04:15:13,000 THIS IDEA THAT SENATOR KENNEDY 7491 04:15:13,001 --> 04:15:14,000 GENERATED YEARS 7492 04:15:14,001 --> 04:15:15,000 BEEN IMPROVED I THINK BECAUSE OF 7493 04:15:15,001 --> 04:15:16,000 THE AMENDMENTS AND IDEAS THAT 7494 04:15:16,001 --> 04:15:17,000 HAVE BEEN SUGGESTED BY A NUMBER 7495 04:15:17,001 --> 04:15:19,000 OF OUR COL 7496 04:15:19,001 --> 04:15:20,000 AS OTHERS, WE 7497 04:15:20,001 --> 04:15:21,000 STRENGTHENED I THINK THE CONCEPT 7498 04:15:21,001 --> 04:15:23,000 TO GIVE IT THE KIND OF 7499 04:15:23,001 --> 04:15:24,000 FINANCIALLY 7500 04:15:24,001 --> 04:15:26,000 INDEPENDENCE THAT MEMBERS WANT 7501 04:15:26,001 --> 04:15:29,000 TO HAVE, SHELTERING THESE 7502 04:15:29,001 --> 04:15:30,000 DOLLARS AGAINST BEING USED FOR 7503 04:15:30,001 --> 04:15:32,000 OTHER PURPOSES SUCH AS GOING OFF 7504 04:15:32,001 --> 04:15:34,000 TO SOME OF THEIR PROGRAMS THAT 7505 04:15:34,001 --> 04:15:37,000 PEOPLE MAY HAVE A GREAT DESIRE 7506 04:15:37,001 --> 04:15:40,000 TO RESOURCES. 7507 04:15:40,001 --> 04:15:41,000 WE PROHIBIT THAT FROM HAPPENING. 7508 04:15:41,001 --> 04:15:43,000 IF EMPLOYERS DON'T WANT TO HAVE 7509 04:15:43,001 --> 04:15:44,000 A PAYROLL DEDUCTION, THEY DON'T 7510 04:15:44,001 --> 04:15:46,000 HAVE TO. 7511 04:15:46,001 --> 04:15:47,000 NO ONE IS REQUIRED TO JOIN THE 7512 04:15:47,001 --> 04:15:49,000 PROGRAM. 7513 04:15:49,001 --> 04:15:50,000 WE BELIEVE, THOUGH, THAT WHEN 7514 04:15:50,001 --> 04:15:51,000 MEMBER 7515 04:15:51,001 --> 04:15:54,000 SOCIETY SEE THE BENEFITS OF 7516 04:15:54,001 --> 04:15:56,000 GRAVITATE TO IT AS A WONDERFUL 7517 04:15:56,001 --> 04:16:00,000 WAY TO ENSURE AGAINST THAT 7518 04:16:00,001 --> 04:16:02,000 OF -- PROBABILITY THAT ALL OF US 7519 04:16:02,001 --> 04:16:03,000 FACE, AND THAT IS BECOMING 7520 04:16:03,001 --> 04:16:04,000 DISABLED, UNABLE TO WORK AS MUCH 7521 04:16:04,001 --> 04:16:06,000 AS WE LIKE, NEEDING ADDITIONAL 7522 04:16:06,001 --> 04:16:07,000 ASSISTANCE AND HELP, AND OF 7523 04:16:07,001 --> 04:16:10,000 COURSE HAVING VERY FEW PLACES TO 7524 04:16:10,001 --> 04:16:11,000 TURN TO GET IT. 7525 04:16:11,001 --> 04:16:13,000 NOW, T 7526 04:16:13,001 --> 04:16:17,000 OTHERS WHO SUPPORT THIS, 275 7527 04:16:17,001 --> 04:16:18,000 ORGANIZATIONS, 7528 04:16:18,001 --> 04:16:19,000 GROUPS, DISABILITY ORGANIZATIONS 7529 04:16:19,001 --> 04:16:20,000 ACROSS THIS COUNTRY. 7530 04:16:20,001 --> 04:16:23,000 I'M NOT GOING TO READ ALL OF 7531 04:16:23,001 --> 04:16:26,000 THEM HERE BECAUSE 275 NAMES IS A 7532 04:16:26,001 --> 04:16:29,000 LOT, MR. PRESIDENT. 7533 04:16:29,001 --> 04:16:31,000 BUT I HAVE THE LIST OF ALL 275 7534 04:16:31,001 --> 04:16:34,000 ORGANIZATIONS THAT HAVE STRONGLY 7535 04:16:34,001 --> 04:16:37,000 SUPPORTED THIS PROPOSAL. 7536 04:16:37,001 --> 04:16:38,000 I CAN'T THINK OF ANY FINER WAY 7537 04:16:38,001 --> 04:16:39,000 TO CELEBRATE THE MEMORY OF OUR 7538 04:16:39,001 --> 04:16:41,000 FORMER COLLEAGUE, WHO CARED SO 7539 04:16:41,001 --> 04:16:44,000 MUCH ABOUT THIS BILL THAT WE'RE 7540 04:16:44,001 --> 04:16:47,000 NOW ENGAGED IN DEBATING. 7541 04:16:47,001 --> 04:16:48,000 AND WHO BROUGHT THIS IDEA YEARS 7542 04:16:48,001 --> 04:16:50,000 AGO TO THE TABLE AND TO HAVE 7543 04:16:50,001 --> 04:16:51,000 CHAMPIONED IT FOR SO MANY YEARS. 7544 04:16:51,001 --> 04:16:54,000 TODAY WE HAVE A CHANCE TO 7545 04:16:54,001 --> 04:16:56,000 INCLUDE THIS WONDERFUL CONCEPT, 7546 04:16:56,001 --> 04:16:59,000 THIS CREATIVE, INNOVATIVE IDEA 7547 04:16:59,001 --> 04:17:01,000 INDEPENDENCE FOR PEOPLE, GIVES 7548 04:17:01,001 --> 04:17:02,000 THEM A CHANCE TO LEAD GOOD 7549 04:17:02,001 --> 04:17:03,000 LIVES, PROVIDES THE KIND OF 7550 04:17:03,001 --> 04:17:05,000 SUPPORT FOR THEIR FAMILIES WHO 7551 04:17:05,001 --> 04:17:07,000 OTHERWISE HAVE TO BEAR A LOT OF THAT 7552 04:17:07,001 --> 04:17:08,000 AND NONE OF US WANT YOUR 7553 04:17:08,001 --> 04:17:09,000 CHILDREN OR YOUR GRANDCHILDREN 7554 04:17:09,001 --> 04:17:10,000 TO HAVE T 7555 04:17:10,001 --> 04:17:11,000 THEY'RE TRYING TO RAISE THEIR 7556 04:17:11,001 --> 04:17:15,000 OWN FAMILIES. 7557 04:17:15,001 --> 04:17:17,000 SO HERE'S A LITTLE IDEA THAT HAS 7558 04:17:17,001 --> 04:17:19,000 GENERATED SUPPORT TOTALLY BY 7559 04:17:19,001 --> 04:17:20,000 VOLUNTARY CONTRIBUTIONS. 7560 04:17:20,001 --> 04:17:21,000 NO GOVERNMENT MONEY INVOLVED AT 7561 04:17:21,001 --> 04:17:22,000 ALL. 7562 04:17:22,001 --> 04:17:24,000 YOU GIVE PEOPLE A CHANCE TO HAVE 7563 04:17:24,001 --> 04:17:27,000 TO LIVE OUT THE REMAINING TIMES 7564 04:17:27,001 --> 04:17:29,000 OF THEIR LIVES WITH DECENCY AND 7565 04:17:29,001 --> 04:17:31,000 DIGNITY, THE SENSE OF MAKING A 7566 04:17:31,001 --> 04:17:33,000 CONTRIBUTION, DIFFERENCE? 7567 04:17:33,001 --> 04:17:34,000 ALL OF THOSE FACTORS, 7568 04:17:34,001 --> 04:17:36,000 PUT A DOLLAR AMOUNT ON IT FOR. 7569 04:17:36,001 --> 04:17:37,000 I CAN'T TELL YOU 7570 04:17:37,001 --> 04:17:39,000 FINANCIAL BENEFIT IS OF SOMEONE 7571 04:17:39,001 --> 04:17:42,000 GETTING UP IN THE MORNING, 7572 04:17:42,001 --> 04:17:43,000 GETTING A LITTLE HELP OR 7573 04:17:43,001 --> 04:17:44,000 OFF TO A JOB AND KNOWING THAT 7574 04:17:44,001 --> 04:17:46,000 YOU'RE NEEDED, YOU HAVE WORTH 7575 04:17:46,001 --> 04:17:47,000 AND VALUE AS A HUMAN BEING. 7576 04:17:47,001 --> 04:17:48,000 WHAT BENEFIT, WHAT'S THE DOLLAR 7577 04:17:48,001 --> 04:17:49,000 AMOUNT ON THAT? 7578 04:17:49,001 --> 04:17:51,000 I CAN'T TELL YOU, MR. PRESIDENT, 7579 04:17:51,001 --> 04:17:52,000 EXCEPT I KNOW IT HAS 7580 04:17:52,001 --> 04:17:54,000 OUR COUNTRY. 7581 04:17:54,001 --> 04:17:56,000 OR THE ALTERNATIVE, GETTING RID 7582 04:17:56,001 --> 04:17:57,000 OF ALL YOUR ASSETS, IMPOVERISHING YOURSELF, 7583 04:17:57,001 --> 04:18:00,000 ON THAT FAMILY OR FRIENDS TO 7584 04:18:00,001 --> 04:18:01,000 TAKE CARE OF YOU IN ORDER TO TRY 7585 04:18:01,001 --> 04:18:02,000 AND SURVIVE, 7586 04:18:02,001 --> 04:18:04,000 DOING MORE. 7587 04:18:04,001 --> 04:18:09,000 SO, MR. PRESIDENT, I HOPE THAT 7588 04:18:09,001 --> 04:18:10,000 MY COLLEAGUES WILL SUPPORT 7589 04:18:10,001 --> 04:18:11,000 WHITEHOUSE AMENDMENT WHEN IT'S 7590 04:18:11,001 --> 04:18:13,000 OFFERED TO STRENGTH THEN PROGRAM 7591 04:18:13,001 --> 04:18:14,000 AND THAT THEY WILL RESOUNDINGLY 7592 04:18:14,001 --> 04:18:17,000 DEFEAT THE EFFORT TO CUT THIS 7593 04:18:17,001 --> 04:18:18,000 PROGRAM OUT OF THE BILL 7594 04:18:18,001 --> 04:18:19,000 ALTOGETHER. 7595 04:18:19,001 --> 04:18:20,000 I CAN'T THINK OF A WORSE THING 7596 04:18:20,001 --> 04:18:21,000 WE COULD DO WITH A PIECE OF 7597 04:18:21,001 --> 04:18:24,000 LEGISLATION THAT'S DESIGNED TO 7598 04:18:24,001 --> 04:18:25,000 BE CREATIVE, INNOVATIVE, REDUCE 7599 04:18:25,001 --> 04:18:26,000 COSTS AND MAKE A DIFFERENT FOR 7600 04:18:26,001 --> 04:18:27,000 MILLIONS OF OUR FELLOW CITIZENS. 7601 04:18:27,001 --> 04:18:29,000 AND A GROWING NUMBER, AS IS 7602 04:18:29,001 --> 04:18:30,000 POINTED OUT BY THE YEAR 7603 04:18:30,001 --> 04:18:31,000 14 MILLION AMERICANS IN OUR 7604 04:18:31,001 --> 04:18:32,000 COUNTRY, AND I SUSPECT MORE, 7605 04:18:32,001 --> 04:18:34,000 WILL BE INEED OF SERVICES LIKE THIS. 7606 04:18:34,001 --> 04:18:37,000 I SEE MY COLLEAGUE AND 7607 04:18:37,001 --> 04:18:38,000 FROM IOWA WHO'S BEEN AS STRONG A 7608 04:18:38,001 --> 04:18:40,000 CHAMPION AS THIS CONGRESS HAS 7609 04:18:40,001 --> 04:18:42,000 EVER HAD WHEN IT COMES TO THE 7610 04:18:42,001 --> 04:18:43,000 DISABLED IN OUR COUNTRY, HAVING 7611 04:18:43,001 --> 04:18:44,000 BEEN THE AUTHOR OF THE AMERICANS 7612 04:18:44,001 --> 04:18:47,000 WITH DISABILITIES ACT, ALONG 7613 04:18:47,001 --> 04:18:48,000 WITH OTHERS, BUT NONETHELESS THE 7614 04:18:48,001 --> 04:18:50,000 PRINCIPAL ARCHITECT OF THAT EFFORT. 7615 04:18:50,001 --> 04:18:53,000 AND HE CAN SPEAK MORE ELOQUENTLY 7616 04:18:53,001 --> 04:18:54,000 THA 7617 04:18:54,001 --> 04:18:55,000 KNOWN ABOUT W THIS PROGRAM IS 7618 04:18:55,001 --> 04:18:56,000 IMPORT 7619 04:18:56,001 --> 04:18:57,000 WHAT IT MEANS. 7620 04:18:57,001 --> 04:18:59,000 SO, MR. PRESIDENT, I'D ASK 7621 04:18:59,001 --> 04:19:00,000 CONSENT THAT THE 275 7622 04:19:00,001 --> 04:19:02,000 ORGANIZATIONS 7623 04:19:02,001 --> 04:19:03,000 ENDORSE AND SUPPORT SENATOR 7624 04:19:03,001 --> 04:19:04,000 KENNEDY'S CLASS ACT BE INCLUDED 7625 04:19:04,001 --> 04:19:05,000 IN THE RECORD AT THIS JUNCTURE. 7626 04:19:05,001 --> 04:19:06,000 THE PRESIDING OFFICER: WITHOUT OBJECTION. 7627 04:19:06,001 --> 04:19:07,000 MR. DODD: AND I YIELD THE FLOOR. 7628 04:19:07,001 --> 04:19:08,000 MR. HARKIN: MR. PRESIDENT? 7629 04:19:08,001 --> 04:19:09,000 THE PRESIDING OFFICER: THE SENATOR FR 7630 04:19:09,001 --> 04:19:10,000 MR. HARKIN MR. PRESIDENT, I 7631 04:19:10,001 --> 04:19:13,000 WANT TO THANK MY FRIEND AND OUR 7632 04:19:13,001 --> 04:19:15,000 LEADER ON THIS ISSUE, SENATOR 7633 04:19:15,001 --> 04:19:18,000 DODD, FOR HIS ELOQUENCE IN 7634 04:19:18,001 --> 04:19:21,000 SUPPORTING WHAT SO MANY OF OUR 7635 04:19:21,001 --> 04:19:22,000 ELDERLY IN THIS COUNTRY WANT 7636 04:19:22,001 --> 04:19:24,000 MORE DESPERATELY THAN JUST ABOUT 7637 04:19:24,001 --> 04:19:27,000 ANYTHING ELSE AND THAT'S THE 7638 04:19:27,001 --> 04:19:29,000 PEACE OF MIND OF KNOWING THAT IF 7639 04:19:29,001 --> 04:19:30,000 THEY SHOULD BECOME DISABLED, 7640 04:19:30,001 --> 04:19:32,000 THAT THEY WON'T BE FORCED TO GO 7641 04:19:32,001 --> 04:19:34,000 INTO A NURSING HOME, THAT 7642 04:19:34,001 --> 04:19:35,000 THEY'LL HAVE SOME SUPPORT THAT 7643 04:19:35,001 --> 04:19:37,000 THEY'LL BE ABLE TO LIVE IN THEIR 7644 04:19:37,001 --> 04:19:38,000 HOMES AND IN THEIR COMMUNITIES. 7645 04:19:38,001 --> 04:19:40,000 TALK TO ANYONE WITH A 7646 04:19:40,001 --> 04:19:41,000 DISABILITY, NOT JUST ELDERLY, 7647 04:19:41,001 --> 04:19:42,000 ANYONE WITH A DISABILITY. 7648 04:19:42,001 --> 04:19:45,000 AND THEY'LL TELL YOU HOW 7649 04:19:45,001 --> 04:19:49,000 IMPORTANT IT IS THAT THEY HAVE 7650 04:19:49,001 --> 04:19:51,000 THAT KIND OF ASSURANCE, THAT IF, 7651 04:19:51,001 --> 04:19:53,000 GOD 7652 04:19:53,001 --> 04:19:55,000 DISABLED, THAT THEIR ONLY HOPE 7653 04:19:55,001 --> 04:19:57,000 IS TO GO INTO A NURSING HOME FOR 7654 04:19:57,001 --> 04:19:58,000 THE REST OF THEIR NATURAL LIVES. 7655 04:19:58,001 --> 04:20:03,000 SENATOR KENNEDY HAS WORKED ON 7656 04:20:03,001 --> 04:20:05,000 THIS FOR YEARS, AND THE COUPLE 7657 04:20:05,001 --> 04:20:08,000 OF TIMES THAT I TALKED TO HIM 7658 04:20:08,001 --> 04:20:09,000 THIS SUMMER AND THIS SPRING, 7659 04:20:09,001 --> 04:20:12,000 THIS IS WHAT HE WANTED TO TALK 7660 04:20:12,001 --> 04:20:13,000 TO ME ABOUT, ABOUT MAKING SURE 7661 04:20:13,001 --> 04:20:14,000 THAT WE INCLUDED THIS IN THE 7662 04:20:14,001 --> 04:20:17,000 BILL. 7663 04:20:17,001 --> 04:20:19,000 THIS WAS HIS CAUSE 7664 04:20:19,001 --> 04:20:24,000 THAT WE HAD A PROGRAM 7665 04:20:24,001 --> 04:20:26,000 PEOPLE COULD CONTRIBUTE TO, THAT 7666 04:20:26,001 --> 04:20:28,000 WOULD AFFORD THEM SOME SUPPORT 7667 04:20:28,001 --> 04:20:34,000 IF, IN FACT, THEY BECAME 7668 04:20:34,001 --> 04:20:37,000 NOW, I DON'T UNDERSTAND THE MOVE 7669 04:20:37,001 --> 04:20:40,000 BY MY REPUBLICAN FRIENDS TO 7670 04:20:40,001 --> 04:20:45,000 THIS IS NOT A MANDATORY PROGRAM. 7671 04:20:45,001 --> 04:20:46,000 THIS IDOETHIS DOES NOT FORCE ANYONE TO 7672 04:20:46,001 --> 04:20:49,000 PAY A DIME. IT'S ALL VOLUNTARY. 7673 04:20:49,001 --> 04:20:50,000 WE SAY, IF YOU WANT TO PUT 7674 04:20:50,001 --> 04:20:56,000 MONEY ASIDE DURING YOUR WORKING 7675 04:20:56,001 --> 04:20:57,000 YEARS IN A FUND 7676 04:20:57,001 --> 04:20:58,000 AND THAT IF IN CASE YOU BECOME 7677 04:20:58,001 --> 04:21:05,000 DISABLED YOU CAN GET SOME 7678 04:21:05,001 --> 04:21:07,000 SUPPORT, TO STAY AT HOME MAYBE 7679 04:21:07,001 --> 04:21:09,000 WITH YOUR OWN 7680 04:21:09,001 --> 04:21:10,000 ENOUGH SUPPO 7681 04:21:10,001 --> 04:21:18,000 GET ANOTHER JOB AND WORK, EVEN 7682 04:21:18,001 --> 04:21:19,000 THOUGH YOU HAVE A DISABILITY. 7683 04:21:19,001 --> 04:21:20,000 THIS IS VOLUNTARY. 7684 04:21:20,001 --> 04:21:23,000 I ASK MY FRIENDS ON THE OTHER 7685 04:21:23,001 --> 04:21:24,000 SIDE OF THE AISLE: WHY ARE YOU 7686 04:21:24,001 --> 04:21:25,000 AGAINST A VOLUNTARY PROGRAM 7687 04:21:25,001 --> 04:21:28,000 WILL ENABLE PEOPLE TO HAVE THAT 7688 04:21:28,001 --> 04:21:31,000 KIND OF PEACE OF MIND? 7689 04:21:31,001 --> 04:21:33,000 WELL, YOU 7690 04:21:33,001 --> 04:21:34,000 SAID, WELL, YOU KNOW, MAYBE THE 7691 04:21:34,001 --> 04:21:36,000 TAXPAY 7692 04:21:36,001 --> 04:21:38,000 THIS AND EVERYTHING. 7693 04:21:38,001 --> 04:21:44,000 WELL, MR. PRESIDENT, 7694 04:21:44,001 --> 04:21:45,000 YOU THIS, THAT IN THE COMMITTEE, 7695 04:21:45,001 --> 04:21:49,000 SENATOR 7696 04:21:49,001 --> 04:21:52,000 FROM NEW HAMPSHIRE, REPUBLICAN 7697 04:21:52,001 --> 04:21:55,000 SENATOR GREGG, MY GOOD FRIEND -- 7698 04:21:55,001 --> 04:21:58,000 OFFERED AN AMENDMENT TO MAKE IT 7699 04:21:58,001 --> 04:22:02,000 SURE THAT THE CONTRIBUTIONS WERE 7700 04:22:02,001 --> 04:22:09,000 THE ONLY THING THA THAT WOULD STHEAN 7701 04:22:09,001 --> 04:22:13,000 PROGRASUSTAIN THIS PROGRAM, 7702 04:22:13,001 --> 04:22:14,000 WOULDN'T BECOME 7703 04:22:14,001 --> 04:22:16,000 HE SAID, "I OFFERED AN AMENDMENT 7704 04:22:16,001 --> 04:22:21,000 THAT WOULD REQUIRE THAT THE 7705 04:22:21,001 --> 04:22:22,000 PREMIUMS BE BASED ON A 7706 04:22:22,001 --> 04:22:23,000 ANNUAL ACTUARIAL ANALYSIS OF THE 7707 04:22:23,001 --> 04:22:27,000 PROGRAM'S COSTS. 7708 04:22:27,001 --> 04:22:28,000 MY AMENDMENT 7709 04:22:28,001 --> 04:22:30,000 WE DON'T PROMISE MORE THAN WE 7710 04:22:30,001 --> 04:22:31,000 CAN OFFER AND THAT IT WILL BE 7711 04:22:31,001 --> 04:22:33,000 FISCALLY SOLVENT AND WE WON'T BE 7712 04:22:33,001 --> 04:22:35,000 PASSING THE BUCK TO FUTURE GENERATIONS. 7713 04:22:35,001 --> 04:22:36,000 I'M PLEASED THE "HELP" COMMITTEE UNANIMOUSLY ACCEPTED THIS 7714 04:22:36,001 --> 04:22:37,000 AMENDMENT." 7715 04:22:37,001 --> 04:22:38,000 AND, MR. PRESIDENT, THE C.B.O. 7716 04:22:38,001 --> 04:22:42,000 HAS SCORED THIS. 7717 04:22:42,001 --> 04:22:43,000 THIS IS 7718 04:22:43,001 --> 04:22:46,000 75 YEARS. 7719 04:22:46,001 --> 04:22:49,000 OVER 75 YEARS. 7720 04:22:49,001 --> 04:22:50,000 I -- I DON'T UNDERSTAND WHY 7721 04:22:50,001 --> 04:22:51,000 ANYONE WOULD WANT TO STRIKE 7722 04:22:51,001 --> 04:22:53,000 NOW,HAT SENATOR WHITEHOUSE HAS 7723 04:22:53,001 --> 04:22:55,000 SAID -- AND, AGAIN, I THINK THIS 7724 04:22:55,001 --> 04:22:57,000 IS VERY APPROPRIATE FOR THIS -- 7725 04:22:57,001 --> 04:22:59,000 THAT ANY SAVINGS THAT WE 7726 04:22:59,001 --> 04:23:01,000 FROM THIS BE REINVESTED EITHER 7727 04:23:01,001 --> 04:23:03,000 IN THE CLASS ACT SO THAT 7728 04:23:03,001 --> 04:23:06,000 PEOPLE DO GET DISABLED, MAYBE THEY'LL GET A LITTLE BIT MORE 7729 04:23:06,001 --> 04:23:08,000 MONEY 7730 04:23:08,001 --> 04:23:09,000 SO WE HAVE SOME SAVINGS FROM THE 7731 04:23:09,001 --> 04:23:10,000 CLASS ACT. 7732 04:23:10,001 --> 04:23:12,000 WHAT SENATOR W 7733 04:23:12,001 --> 04:23:15,000 IS PUT THOSE SAVINGS BACK IN THE 7734 04:23:15,001 --> 04:23:16,000 CLASS ACT FOR SOCIAL SECURITY. 7735 04:23:16,001 --> 04:23:18,000 MAKES SENSE TO ME. 7736 04:23:18,001 --> 04:23:19,000 MAKES SENSE TO ME. 7737 04:23:19,001 --> 04:23:22,000 SO AGAIN, I THINK IT'S AN 7738 04:23:22,001 --> 04:23:25,000 IMPROVEMENT ON THE BILL SENATOR WHITEHOUSE HAS 7739 04:23:25,001 --> 04:23:28,000 SUGGESTED. 7740 04:23:28,001 --> 04:23:32,000 MR. PRESIDENT, I PLEAD, I PLEAD 7741 04:23:32,001 --> 04:23:39,000 WITH MY FELLOW SENATORS, DON'T 7742 04:23:39,001 --> 04:23:41,000 KILL THIS PROGR 7743 04:23:41,001 --> 04:23:51,000 WE STOOD HERE ON THIS FLOOR 19 7744 04:23:51,001 --> 04:23:52,000 YEARS AGO, JULY THE 20th, 1990 1990. 7745 04:23:52,001 --> 04:23:53,000 WE STOOD ON THIS FLOOR TO PASS 7746 04:23:53,001 --> 04:23:55,000 THE AMERICANS WITH DISABILITIES 7747 04:23:55,001 --> 04:23:56,000 ACT. 7748 04:23:56,001 --> 04:23:59,000 AND THERE WERE A FEW VOTES 7749 04:23:59,001 --> 04:24:01,000 AGAINST IT. 7750 04:24:01,001 --> 04:24:02,000 IN FACT, THERE WAS ONE OR TWO 7751 04:24:02,001 --> 04:24:04,000 PEOPLE STILL HERE THAT VOTED 7752 04:24:04,001 --> 04:24:05,000 AGAINST IT 7753 04:24:05,001 --> 04:24:07,000 I THINK -- I THINK IF YOU'D ASK 7754 04:24:07,001 --> 04:24:09,000 THEM NOW, I THINK THEY'D SAY 7755 04:24:09,001 --> 04:24:11,000 IT'S BEEN A PRETTY DARN GOOD BILL. 7756 04:24:11,001 --> 04:24:13,000 IT'S BROKEN DOWN A LOT OF 7757 04:24:13,001 --> 04:24:14,000 BARRIERS, OPENED A LOT OF DOORS 7758 04:24:14,001 --> 04:24:15,000 FOR PEOPLE WITH DISABILITIES IN 7759 04:24:15,001 --> 04:24:17,000 OUR COUNTRY, CHANGED OUR 7760 04:24:17,001 --> 04:24:19,000 ENVIRONMENT IN THIS COUNTRY. 7761 04:24:19,001 --> 04:24:21,000 NOT ONLY IN TERMS OF PHYSICAL 7762 04:24:21,001 --> 04:24:23,000 ACCESS BUT I THINK MORE 7763 04:24:23,001 --> 04:24:25,000 IMPORTANTLY IT'S CHANGED HOW WE 7764 04:24:25,001 --> 04:24:27,000 VIEW PEOPLE WITH DISABILITIES. 7765 04:24:27,001 --> 04:24:29,000 NO LONGER LOOKING AT PEOPLE WITH 7766 04:24:29,001 --> 04:24:30,000 THEIR DISABILITY. 7767 04:24:30,001 --> 04:24:33,000 WE NOW LOOK AT PEOPL 7768 04:24:33,001 --> 04:24:35,000 WHAT ARE YOUR ABILITIES, WHAT 7769 04:24:35,001 --> 04:24:36,000 ARE YOUR ABILITIES, WHAT CAN YOU 7770 04:24:36,001 --> 04:24:38,000 DO, NOT JUST LOOKING AT 7771 04:24:38,001 --> 04:24:41,000 SOMEONE'S D 7772 04:24:41,001 --> 04:24:43,000 SO WE'VE COME A LONG 7773 04:24:43,001 --> 04:24:45,000 THE ONE THING THAT WE'VE NEVER 7774 04:24:45,001 --> 04:24:49,000 BEEN ABLE TO REALLY DO IS TO SET 7775 04:24:49,001 --> 04:24:50,000 UP A FUNCTIONING SYSTEM SO 7776 04:24:50,001 --> 04:24:55,000 THAT -- THAT PEOPLE 7777 04:24:55,001 --> 04:24:59,000 SOME MONEY ASIDE 7778 04:24:59,001 --> 04:25:00,000 IN CASE THEY GOT DISABLED. WELL, THIS IS IT. 7779 04:25:00,001 --> 04:25:02,000 THIS IS OUR CHANCE. 7780 04:25:02,001 --> 04:25:05,000 THIS IS A BIG PART OF THIS 7781 04:25:05,001 --> 04:25:06,000 HEALTH CARE BILL, A BIG 7782 04:25:06,001 --> 04:25:08,000 WELL, MAYBE I SUPPOSE IF 7783 04:25:08,001 --> 04:25:10,000 TRYING TO KILL 7784 04:25:10,001 --> 04:25:11,000 YOU'RE TRYING TO KILL THE BILL, 7785 04:25:11,001 --> 04:25:12,000 I SUPPOSE THAT'S WHAT YOU'D WANT 7786 04:25:12,001 --> 04:25:14,000 TO DO, YOU'D WANT TO KILL THE 7787 04:25:14,001 --> 04:25:16,000 CLASS ACT. 7788 04:25:16,001 --> 04:25:19,000 BUT THIS IS VITALLY IMPOR 7789 04:25:19,001 --> 04:25:20,000 OUR COUNTRY 7790 04:25:20,001 --> 04:25:23,000 IT IS REALLY THE NEXT LOGICAL 7791 04:25:23,001 --> 04:25:28,000 STEP AFTER THE AMERICANS WITH 7792 04:25:28,001 --> 04:25:29,000 DISABILITIES ACT 7793 04:25:29,001 --> 04:25:32,000 IT'S GOING TO PROVIDE FOR SO 7794 04:25:32,001 --> 04:25:35,000 MANY PEOPLE IN THIS COUNTRY THAT 7795 04:25:35,001 --> 04:25:37,000 SECURITY AND THAT PEACE OF MIND 7796 04:25:37,001 --> 04:25:38,000 OF KNOWING THEY WON'T HAVE TO GO 7797 04:25:38,001 --> 04:25:40,000 TO A NURSING HOME OR AN 7798 04:25:40,001 --> 04:25:41,000 INSTITUTION IF THEY -- IF THEY 7799 04:25:41,001 --> 04:25:43,000 BECOME DISABLED. 7800 04:25:43,001 --> 04:25:47,000 AND IT CAN HAPPEN TO ANY ONE OF 7801 04:25:47,001 --> 04:25:48,000 US HERE ON THE SENATE FLOOR. 7802 04:25:48,001 --> 04:25:49,000 OUR FAMIES, OUR STAFF, OUR 7803 04:25:49,001 --> 04:25:52,000 LOVED ONES. 7804 04:25:52,001 --> 04:25:58,000 NO ONE KNOWS WHAT MIGHT HAPPEN 7805 04:25:58,001 --> 04:26:01,000 TO US 7806 04:26:01,001 --> 04:26:04,000 NO ONE KNOWS. 7807 04:26:04,001 --> 04:26:05,000 BUT SHOULDN'T WE AT LEAST 7808 04:26:05,001 --> 04:26:09,000 SOME PART OF THIS HEALTH CARE 7809 04:26:09,001 --> 04:26:14,000 BILL THAT PROVIDES THAT KIND OF 7810 04:26:14,001 --> 04:26:16,000 VOLUNTARY PROGRAM? 7811 04:26:16,001 --> 04:26:17,000 NO ONE'S FORCED INTO ANYTHING. 7812 04:26:17,001 --> 04:26:19,000 AND I GUESS THAT'S WHAT 7813 04:26:19,001 --> 04:26:20,000 PERPLEXES ME MORE THAN ANYTHING 7814 04:26:20,001 --> 04:26:23,000 SE IS WHY MY REPUBLICAN 7815 04:26:23,001 --> 04:26:25,000 FRIENDS WANT TO PREVENT 7816 04:26:25,001 --> 04:26:26,000 SOMETHING LIKE A VOLUNTEER 7817 04:26:26,001 --> 04:26:28,000 PROGRAM -- A VOLUNTARY PROGRAM 7818 04:26:28,001 --> 04:26:30,000 FROM GOING INTO EXISTENCE THAT 7819 04:26:30,001 --> 04:26:32,000 WOULD DO THIS. 7820 04:26:32,001 --> 04:26:34,000 THAT'S FISCALLY SOUND FOR 75 YEARS. 7821 04:26:34,001 --> 04:26:38,000 I JUST DON'T GET IT. 7822 04:26:38,001 --> 04:26:40,000 SO I HOPE -- I HOPE WE WILL 7823 04:26:40,001 --> 04:26:41,000 SUPPORT THE WHITEHOUSE 7824 04:26:41,001 --> 04:26:44,000 AMENDMENT, MAKE SURE THAT THIS 7825 04:26:44,001 --> 04:26:45,000 FUND IS TOTALLY SOLVENT. 7826 04:26:45,001 --> 04:26:46,000 I THINK HE'S ON THE RIGHT TRACK. 7827 04:26:46,001 --> 04:26:52,000 IF THERE ARE SAVINGS, PUT THE 7828 04:26:52,001 --> 04:26:53,000 MAYB THAT $75 A DAY COULD BE 7829 04:26:53,001 --> 04:27:02,000 MAYBE $80 A DAY OR SOMETHING 7830 04:27:02,001 --> 04:27:03,000 LIKE THAT TO HELP PEOPLE OUT. 7831 04:27:03,001 --> 04:27:10,000 AND I SEE, MR. PRESIDENT, WE NOW 7832 04:27:10,001 --> 04:27:14,000 HAVE A STATEMENT FROM THE 7833 04:27:14,001 --> 04:27:15,000 ABOUT THE CLASS PROGRAM AND 7834 04:27:15,001 --> 04:27:20,000 HERE'S WHAT THEY SAID. 7835 04:27:20,001 --> 04:27:21,000 THEY SAID THAT DECADES OF 7836 04:27:21,001 --> 04:27:22,000 TALKING TO OUR MEMBERS TELL US 7837 04:27:22,001 --> 04:27:25,000 THAT OLD AMERICANS WANT TO 7838 04:27:25,001 --> 04:27:26,000 LIVE IN THEIR HOMES AS THEY AGE. 7839 04:27:26,001 --> 04:27:28,000 THAT'S WHY AARP STRONGLY 7840 04:27:28,001 --> 04:27:30,000 SUPPORTS THE COMMUNITY LIVING 7841 04:27:30,001 --> 04:27:31,000 ASSISTANCE SERVICES AND SUPPORTS 7842 04:27:31,001 --> 04:27:32,000 PROGRAM, THE CLASS PROGRAM, 7843 04:27:32,001 --> 04:27:34,000 WHICH RECOGNIZES THAT OLDER 7844 04:27:34,001 --> 04:27:35,000 INDIVIDUALS AND PEOPLE WITH 7845 04:27:35,001 --> 04:27:37,000 DISABILITIES SHOULD HAVE THE 7846 04:27:37,001 --> 04:27:38,000 RIGHT TO LIVE INDEPENDENTLY IN 7847 04:27:38,001 --> 04:27:40,000 THEIR OWN HOMES AND COMMUNITIES 7848 04:27:40,001 --> 04:27:42,000 AND TO R 7849 04:27:42,001 --> 04:27:45,000 NEED WITHOUT HAVING TO SPEND 7850 04:27:45,001 --> 04:27:46,000 DOWN TO POVERTY." 7851 04:27:46,001 --> 04:27:47,000 SO, MR. PRESIDENT, I WOULD ASK 7852 04:27:47,001 --> 04:27:49,000 UNANIMOUS CONSENT TO HAVE THAT 7853 04:27:49,001 --> 04:27:50,000 LETTER FROM THE AARP PRINTED AT 7854 04:27:50,001 --> 04:27:51,000 THIS POINT IN THE RECORD. 7855 04:27:51,001 --> 04:27:53,000 THE PRES 7856 04:27:53,001 --> 04:27:54,000 OBJECTION. 7857 04:27:54,001 --> 04:27:55,000 MR. HARKIN: NOW, MR. PRESIDENT, 7858 04:27:55,001 --> 04:27:57,000 I'M GOING TO PUT THIS IN 7859 04:27:57,001 --> 04:28:01,000 PERSONAL TERMS. 7860 04:28:01,001 --> 04:28:02,000 PERSONAL 7861 04:28:02,001 --> 04:28:05,000 I'VE TOLD THIS STORY BEFORE AND 7862 04:28:05,001 --> 04:28:07,000 I'M GOING TO TELL IT AGAIN. 7863 04:28:07,001 --> 04:28:09,000 BECAUSE I THINK IT INDICATES WHY 7864 04:28:09,001 --> 04:28:12,000 WE NEED A PROGRAM LIKE THIS. 7865 04:28:12,001 --> 04:28:14,000 I HAVE A NEPHEW, KELLY, MY 7866 04:28:14,001 --> 04:28:15,000 SISTER'S BOY. 7867 04:28:15,001 --> 04:28:18,000 HE GOT INJURED AT A VERY YOUN AGE. 7868 04:28:18,001 --> 04:28:21,000 HE WAS ONLY 19 YEARS OLD. 7869 04:28:21,001 --> 04:28:22,000 MADE HIM A SEVERE PARAPLEGIC, 7870 04:28:22,001 --> 04:28:23,000 ALMOST QUADRIPLEGIC. 7871 04:28:23,001 --> 04:28:28,000 MY SISTER AND HER HUSBAND, THEY 7872 04:28:28,001 --> 04:28:30,000 DIDN'T HAVE ANY MONEY AT ALL AND 7873 04:28:30,001 --> 04:28:34,000 YET KELLY WAS ABLE TO GO TO 7874 04:28:34,001 --> 04:28:37,000 COLLEGE, GO TO SCHOOL, HE WAS 7875 04:28:37,001 --> 04:28:39,000 ABLE TO GET A JOB, ABLE TO LIVE 7876 04:28:39,001 --> 04:28:42,000 IN A HOUSE BY HIMSELF, HAD HIS 7877 04:28:42,001 --> 04:28:44,000 OWN LITTLE HOME, HAD HIS OWN VAN 7878 04:28:44,001 --> 04:28:45,000 THAT HE DROVE THAT HAD A LIFT ON 7879 04:28:45,001 --> 04:28:46,000 IT AND HE COULD GET HIS 7880 04:28:46,001 --> 04:28:49,000 WHEELCHAIR IN THERE AND DRIVE IT 7881 04:28:49,001 --> 04:28:50,000 TO WORK. 7882 04:28:50,001 --> 04:28:53,000 ACTUALLY SRTED A SMALL 7883 04:28:53,001 --> 04:28:54,000 BUSINESS, EMPLOYED SOME PEOPLE 7884 04:28:54,001 --> 04:28:58,000 AND HE'S LIVED A FULL LIFE. 7885 04:28:58,001 --> 04:29:00,000 HE'S NOW A MAN OF ABOUT 50. 7886 04:29:00,001 --> 04:29:02,000 HE'S HAD A GREAT LIFE. 7887 04:29:02,001 --> 04:29:05,000 EVEN WITH THAT DISABILITY, 7888 04:29:05,001 --> 04:29:06,000 BEEN ABLE TO GET AROUND AND DO 7889 04:29:06,001 --> 04:29:07,000 THINGS, A TAXPAYER. 7890 04:29:07,001 --> 04:29:09,000 HE'S PAID TAXES. 7891 04:29:09,001 --> 04:29:10,000 HE HAD EMPLOYED PEOPLE. 7892 04:29:10,001 --> 04:29:11,000 -- HE'S EMPLOYED PEOPLE. 7893 04:29:11,001 --> 04:29:13,000 EVERY NIGHT WHEN HE GOES HOME, 7894 04:29:13,001 --> 04:29:15,000 HE HAS TO HAVE A NURSE COME IN 7895 04:29:15,001 --> 04:29:17,000 THE AND GET HIM READY FOR BED 7896 04:29:17,001 --> 04:29:18,000 AND DO HIS EXERCISES AND THINGS 7897 04:29:18,001 --> 04:29:20,000 LIKE THAT. 7898 04:29:20,001 --> 04:29:21,000 THEN IN THE MORNING HE HAS TO 7899 04:29:21,001 --> 04:29:23,000 HAVE ANOTHER NURSE COME IN AND 7900 04:29:23,001 --> 04:29:26,000 GET HIM OUT OF BED AND TAKE CARE 7901 04:29:26,001 --> 04:29:27,000 OF HIS NEEDS, 7902 04:29:27,001 --> 04:29:28,000 GO. 7903 04:29:28,001 --> 04:29:29,000 ACTUALLY, KELLY GETS HIS OWN 7904 04:29:29,001 --> 04:29:31,000 MEALS AND STUFF, THEN HE GOES 7905 04:29:31,001 --> 04:29:33,000 OFF TO WORK, COMES BACK. 7906 04:29:33,001 --> 04:29:34,000 THIS HAPPENS EVERY DAY. 7907 04:29:34,001 --> 04:29:40,000 NOW, HOW IS HE ABLE TO AFFORD TO 7908 04:29:40,001 --> 04:29:44,000 DO THAT? 7909 04:29:44,001 --> 04:29:45,000 HE DOESN'T ANY MONEY, ANY 7910 04:29:45,001 --> 04:29:47,000 INSURANCE. 7911 04:29:47,001 --> 04:29:49,000 HOW IS HE ABLE TO AFFORD TO DO THAT? 7912 04:29:49,001 --> 04:29:50,000 HE GOT INJURED IN THE MILITARY. 7913 04:29:50,001 --> 04:29:54,000 HE GOT INJURED IN THE MILITARY. 7914 04:29:54,001 --> 04:29:55,000 SO FOR ALL OF THESE YEARS THE 7915 04:29:55,001 --> 04:29:57,000 VETERANS ADMINISTRATION'S BEEN 7916 04:29:57,001 --> 04:29:58,000 PAYING FOR THIS. 7917 04:29:58,001 --> 04:30:00,000 IT'SEEN WONDERFUL. 7918 04:30:00,001 --> 04:30:02,000 KEPT HIM OUT OF AN INSTITUTION. 7919 04:30:02,001 --> 04:30:03,000 KEPT HIM OUT OF A NURSING HOME. 7920 04:30:03,001 --> 04:30:06,000 ALLOWED HIM TO LIVE BY HIMSELF, 7921 04:30:06,001 --> 04:30:08,000 GO TO SCHOOL, WORK, BE WITH HIS 7922 04:30:08,001 --> 04:30:11,000 FAMILY, BE WITH HIS FRIENDS. 7923 04:30:11,001 --> 04:30:13,000 REICH OFTEN THOUGHT THIS IS 7924 04:30:13,001 --> 04:30:14,000 -- I'VE OFTEN THOUGHT, THIS IS 7925 04:30:14,001 --> 04:30:15,000 WONDERFUL. 7926 04:30:15,001 --> 04:30:18,000 BUT WHY SHOULD THAT JUST BE FOR 7927 04:30:18,001 --> 04:30:20,000 PEOPLE WHO ARE INJURED IN THE MILITARY? 7928 04:30:20,001 --> 04:30:23,000 WHAT ABOUT SO MANY OTHER PEOPLE 7929 04:30:23,001 --> 04:30:25,000 WHO GET INJURED LIKE MY NEPHEW 7930 04:30:25,001 --> 04:30:26,000 KELLY WHO ARE NOT IN THE MILITARY. 7931 04:30:26,001 --> 04:30:28,000 MAYBE EVEN INJURED BEFORE THEY 7932 04:30:28,001 --> 04:30:30,000 COULD GO TO THE MILITARY. 7933 04:30:30,001 --> 04:30:32,000 HE WAS ONLY 19 WHEN IT HAPPENED 7934 04:30:32,001 --> 04:30:33,000 TO HIM. 7935 04:30:33,001 --> 04:30:35,000 SO FOR ALL OF THESE YEARS I 7936 04:30:35,001 --> 04:30:38,000 THOUGHT WE SHOULD HAVE SOME 7937 04:30:38,001 --> 04:30:40,000 SYSTEM IN THIS COUNTRY THAT 7938 04:30:40,001 --> 04:30:42,000 WOULD ALLOW PEOPLE LIKE MY 7939 04:30:42,001 --> 04:30:44,000 NEPHEW WHO ARE NOT IN THE 7940 04:30:44,001 --> 04:30:48,000 MILITARY, BUT WHO, THROUGH AN 7941 04:30:48,001 --> 04:30:51,000 FORTUNATE ACCIDENT, BECAME DISABLED. 7942 04:30:51,001 --> 04:30:53,000 THAT THEY COULD HAVE THAT SAME 7943 04:30:53,001 --> 04:30:56,000 KIND OF LIFE WHERE THEY COULD 7944 04:30:56,001 --> 04:30:58,000 LIVE IN THEIR OWN COMMUNITIES, 7945 04:30:58,001 --> 04:30:59,000 WITH THEIR OWN FAMILIES, HAVE 7946 04:30:59,001 --> 04:31:02,000 THEIR OWN FRIENDS. 7947 04:31:02,001 --> 04:31:06,000 THAT'S WHY THIS IS SO IMPORTANT. 7948 04:31:06,001 --> 04:31:08,000 THIS IS PERHAPS ONE OF THE MOST 7949 04:31:08,001 --> 04:31:10,000 IMPORTANT THINGS THAT W HAVE 7950 04:31:10,001 --> 04:31:13,000 DONE SINCE THE PASSAGE OF THE 7951 04:31:13,001 --> 04:31:16,000 AMERICANS WITH DISABILITIES ACT. 7952 04:31:16,001 --> 04:31:24,000 TO MAKE SURE THAT PEOPLE 7953 04:31:24,001 --> 04:31:26,000 DISABILITY CONVICTION HAVDISDISABILIES HAVE A FULL, 7954 04:31:26,001 --> 04:31:27,000 ENJOYABLE, PRODUCTIVE, QUALITY 7955 04:31:27,001 --> 04:31:30,000 LIFE. 7956 04:31:30,001 --> 04:31:32,000 I HOPE THAT SENATORS WILL 7957 04:31:32,001 --> 04:31:36,000 DECISIVELY DEFEAT THE AMENDMENT 7958 04:31:36,001 --> 04:31:38,000 THAT WANTS TO STRIKE THIS. 7959 04:31:38,001 --> 04:31:44,000 SAY YES. 7960 04:31:44,001 --> 04:31:45,000 SAY YES TO SO MANY PEOPLE WITH 7961 04:31:45,001 --> 04:31:47,000 SABILITIES AND YOUNG PEOPLE 7962 04:31:47,001 --> 04:31:50,000 TODAY AND WORKING TODAY, SAY 7963 04:31:50,001 --> 04:31:51,000 YES, THAT WE'LL HAVE A SYSTEM 7964 04:31:51,001 --> 04:31:53,000 WHERE BY YOU'LL HAVE A PEACE OF 7965 04:31:53,001 --> 04:31:54,000 MIND OF KNOWING IF YOU WANT TO 7966 04:31:54,001 --> 04:31:55,000 CONTRIBUTE THE MONEY, YOU'LL BE 7967 04:31:55,001 --> 04:31:56,000 PROTECTED. 7968 04:31:56,001 --> 04:31:57,000 SAY NO TO THE AMENDMENT THAT 7969 04:31:57,001 --> 04:31:58,000 WOULD STRIKE THAT. 7970 04:31:58,001 --> 04:32:01,000 SAY YES TO THE WHITE HOUSE 7971 04:32:01,001 --> 04:32:04,000 AMENDMENT THAT ACTUALLY SUPPORT 7972 04:32:04,001 --> 04:32:06,000 THE CLASS ACT. 7973 04:32:06,001 --> 04:32:07,000 MAKE SURE THAT ANY SAVINGS FROM 7974 04:32:07,001 --> 04:32:08,000 IT IS REINVESTED IN THAT 7975 04:32:08,001 --> 04:32:10,000 PROGRAM. 7976 04:32:10,001 --> 04:32:11,000 I THANK THE PRESIDENT AND YIELD 7977 04:32:11,001 --> 04:32:13,000 THE FLOOR. 7978 04:32:13,001 --> 04:32:15,000 MR. DODD: MR. PRESIDENT, BEFORE 7979 04:32:15,001 --> 04:32:16,000 WE GO TO THE 7980 04:32:16,001 --> 04:32:17,000 THE PRESIDING OFFICER: THE 7981 04:32:17,001 --> 04:32:18,000 SENATOR FROM CONNECTICUT. 7982 04:32:18,001 --> 04:32:20,000 MR. DODD: IF I COULD REQUEST 7983 04:32:20,001 --> 04:32:21,000 THAT THE NEXT HALF-HOUR IS 7984 04:32:21,001 --> 04:32:25,000 EQUALLY DIVIDED. 7985 04:32:25,001 --> 04:32:26,000 IS THAT OKAY WITH MY -- 7986 04:32:26,001 --> 04:32:28,000 THE PRESIDING OFFICER: THE 7987 04:32:28,001 --> 04:32:30,000 REPUBLICAN DEPUTY LEADER. MR. KYL: MR. PRESIDENT, I HAD 7988 04:32:30,001 --> 04:32:33,000 HOPED TO TAKE THE NEXT HALF-HOUR. 7989 04:32:33,001 --> 04:32:35,000 BUT IF WE COULD DO 40 MINUTES EQUALLY DIVIDED. 7990 04:32:35,001 --> 04:32:37,000 I COULD TAKE 20 AND I THINK I 7991 04:32:37,001 --> 04:32:39,000 COULD 7992 04:32:39,001 --> 04:32:40,000 MR. DODD: 40 MINUTES EQUALLY 7993 04:32:40,001 --> 04:32:41,000 DIVIDED? 7994 04:32:41,001 --> 04:32:43,000 MR. KYL: AND WOULD I BE ABLE TO 7995 04:32:43,001 --> 04:32:45,000 TAKE THE FIRST 20 MINUTES? 7996 04:32:45,001 --> 04:32:47,000 MR. DODD: THAT WOULD BE UNDER 7997 04:32:47,001 --> 04:32:48,000 THE SAME ORDER AS WE HAD BEFORE, 7998 04:32:48,001 --> 04:32:49,000 I ASK THE CHAIR? 7999 04:32:49,001 --> 04:32:50,000 THE PRESIDING OFFICER: IS THERE 8000 04:32:50,001 --> 04:32:51,000 OBJECTION? 8001 04:32:51,001 --> 04:33:03,000 WITHOUT OBJECTION. 8002 04:33:03,001 --> 04:33:04,000 MR. KYL: THANK YOU. 8003 04:33:04,001 --> 04:33:05,000 MR. PRESIDENT? THE PRESIDING OFFICER: THE 8004 04:33:05,001 --> 04:33:06,000 SENATOR FROM ARIZONA. 8005 04:33:06,001 --> 04:33:07,000 MR. KYL: THANK YOU. 8006 04:33:07,001 --> 04:33:10,000 MR. PRESIDENT, WE ARE DISCUSSING 8007 04:33:10,001 --> 04:33:12,000 THE HATCH AMENDMENT TO PRESERVE MEDICA 8008 04:33:12,001 --> 04:33:14,000 AND I WANTED TO GIVE A LITTLE 8009 04:33:14,001 --> 04:33:15,000 BIT BACKGROUND ABOUT THE 8010 04:33:15,001 --> 04:33:16,000 MEDICARE ADVANTAGE PROGRAM. 8011 04:33:16,001 --> 04:33:18,000 IT WAS ESTABLISHED WITH THE GOAL 8012 04:33:18,001 --> 04:33:19,000 OF ENSURING THAT BENEFICIARIES 8013 04:33:19,001 --> 04:33:22,000 ALL ACROSS THE COURY WOULD 8014 04:33:22,001 --> 04:33:24,000 ACTUALLY HAVE MEDICARE CHOICES. 8015 04:33:24,001 --> 04:33:25,000 UNDER THE PROGRAM PRIVATE HEALTH 8016 04:33:25,001 --> 04:33:29,000 PLANS RECEIVE GOVERNMENT 8017 04:33:29,001 --> 04:33:32,000 PAYMENTS IN ORDER TO 8018 04:33:32,001 --> 04:33:35,000 MEDICARE BENEFICIARIES, IN 8019 04:33:35,001 --> 04:33:36,000 ADDITION TO OFFERING PART-A TO 8020 04:33:36,001 --> 04:33:37,000 HOSPITALS AND PART-B TO 8021 04:33:37,001 --> 04:33:42,000 PHYSICIANS SERVICES. 8022 04:33:42,001 --> 04:33:43,000 AND THERE IS PART-D. 8023 04:33:43,001 --> 04:33:45,000 THE CENTRAL GOAL IS TO ENSURE 8024 04:33:45,001 --> 04:33:47,000 THAT BENEFICIARIES ACROSS THE 8025 04:33:47,001 --> 04:33:48,000 NATION, NOT JUST THOSE IN 8026 04:33:48,001 --> 04:33:51,000 POPULOUS AREAS, WOULD HAVE 8027 04:33:51,001 --> 04:33:53,000 ACCESS TO HEALTH PLAN OPTIONS. 8028 04:33:53,001 --> 04:33:55,000 AND UNDER 8029 04:33:55,001 --> 04:33:57,000 ADVANTAGE PLANS MUST PROVIDE ALL 8030 04:33:57,001 --> 04:33:58,000 PHYSICIAN AND HOSPITAL MEDICARE 8031 04:33:58,001 --> 04:33:59,000 BENEFITS. 8032 04:33:59,001 --> 04:34:01,000 AND HERE'S THE KEY. 8033 04:34:01,001 --> 04:34:03,000 AND I HOPE MY COLLEAGUES WILL 8034 04:34:03,001 --> 04:34:05,000 THINK ABOUT THIS FOR A MOTEL 8035 04:34:05,001 --> 04:34:06,000 BECAUSE THIS HAS -- FOR A MOMENT 8036 04:34:06,001 --> 04:34:07,000 BECAUSE THIS HAS BEEN A LITTLE 8037 04:34:07,001 --> 04:34:10,000 BIT PERHAPS DISTORTED IN THE 8038 04:34:10,001 --> 04:34:12,000 CONVERSATION WE'VE HAD. 8039 04:34:12,001 --> 04:34:14,000 IF A PLAN'S COST TO PROVIDE ALL 8040 04:34:14,001 --> 04:34:16,000 OF THE MEDICARE BENEFIT 8041 04:34:16,001 --> 04:34:18,000 LESS THAN THE GOVERNMENT 8042 04:34:18,001 --> 04:34:21,000 PAYMENT, THEN BY LAW THE PLAN 8043 04:34:21,001 --> 04:34:22,000 MUST APPLY THE DIFFERENCEO 8044 04:34:22,001 --> 04:34:26,000 PROVIDE ADDITIONAL BENEFITS TO 8045 04:34:26,001 --> 04:34:27,000 THE BENEFICIARY OR TO REDUCE PREMIUMS. 8046 04:34:27,001 --> 04:34:29,000 AND IT SEEMS TO ME THAT'S WHAT 8047 04:34:29,001 --> 04:34:30,000 THIS WHOLE REFORM WAS ABOUT IN 8048 04:34:30,001 --> 04:34:32,000 THE FIRST 8049 04:34:32,001 --> 04:34:34,000 TO TRY TO ENSURE QUALITY CARE 8050 04:34:34,001 --> 04:34:35,000 AND REDUCE THE COST OF INSURANCE 8051 04:34:35,001 --> 04:34:38,000 TO BENEFICIARIES. 8052 04:34:38,001 --> 04:34:39,000 WELL, WHAT ARE THESE EXTRA 8053 04:34:39,001 --> 04:34:40,000 BENEFITS? 8054 04:34:40,001 --> 04:34:42,000 WE'VE HEARD THEM DISCUSSED. 8055 04:34:42,001 --> 04:34:44,000 THEY 8056 04:34:44,001 --> 04:34:45,000 LOWER COST SHA 8057 04:34:45,001 --> 04:34:49,000 INCLUDING OUT-OF-POCKET LIMITS 8058 04:34:49,001 --> 04:34:50,000 ON THE BENEFICIARY'S SHARE OF COSTS. 8059 04:34:50,001 --> 04:34:53,000 AS WELL AS SPECIFIC HEALTH 8060 04:34:53,001 --> 04:34:57,000 BENEFITS LIKE VISION, DENTAL, 8061 04:34:57,001 --> 04:34:59,000 CANCER SCREENINGS AND SO ON. 8062 04:34:59,001 --> 04:35:00,000 PLANS CAN OFFER MANAGEMENT 8063 04:35:00,001 --> 04:35:01,000 SERVICES, WHICH CAN BE 8064 04:35:01,001 --> 04:35:03,000 PARTICULARLY IMPORTANT TO 8065 04:35:03,001 --> 04:35:04,000 BENEFICIARIES WITH CHRONIC 8066 04:35:04,001 --> 04:35:05,000 ILLNESSES, AND THAT'S A 8067 04:35:05,001 --> 04:35:09,000 PROTECTION, BY THE WAKES THAT 8068 04:35:09,001 --> 04:35:12,000 DOES NOT EXIST IN REGULAR 8069 04:35:12,001 --> 04:35:14,000 FEE-FOR-SERVICE PROGRAMS. 8070 04:35:14,001 --> 04:35:15,000 SINCE 2003, A NUMBER OF MEDICARE 8071 04:35:15,001 --> 04:35:18,000 BENEFICIARIES ENROLLED IN 8072 04:35:18,001 --> 04:35:22,000 PRIVATE PLANS HAS NEARLY DOUBLED 8073 04:35:22,001 --> 04:35:24,000 OM $5.3 MILLION T 8074 04:35:24,001 --> 04:35:26,000 TO $10.2 MILLION IN THE 8075 04:35:26,001 --> 04:35:27,000 2009 ACCORDING TO KAISER FAMILY 8076 04:35:27,001 --> 04:35:28,000 FOUNDATION 8077 04:35:28,001 --> 04:35:30,000 SO THESE ARE VERY POPULAR PLANS 8078 04:35:30,001 --> 04:35:33,000 AND GROWING IN POP ALERTCY. 8079 04:35:33,001 --> 04:35:37,000 LET'S GO BACK IN TIME JUST -- POPULARITY. 8080 04:35:37,001 --> 04:35:38,000 LET'S GO BACK IN TIME IN HISTORY 8081 04:35:38,001 --> 04:35:40,000 BACK TO 1972. 8082 04:35:40,001 --> 04:35:41,000 BECAUSE IN PAST YEARS, MY 8083 04:35:41,001 --> 04:35:43,000 COLLEAGUES ON THE OTHER SIDE OF 8084 04:35:43,001 --> 04:35:44,000 THE AISLE WERE ALL FOR MEDICARE 8085 04:35:44,001 --> 04:35:45,000 ADVANTAGE. 8086 04:35:45,001 --> 04:35:47,000 OVER THE YEARS CONGRESS HAS 8087 04:35:47,001 --> 04:35:48,000 TRIED TO CONTROL SPENDING BY 8088 04:35:48,001 --> 04:35:49,000 REDUCING PAYMENTS TO PRIVATE 8089 04:35:49,001 --> 04:35:51,000 MEDICARE PLANS. 8090 04:35:51,001 --> 04:35:53,000 ONE PROBLEM WAS THAT SEVERE 8091 04:35:53,001 --> 04:35:55,000 PAYMENT REDUCTIONS RESULTED IN 8092 04:35:55,001 --> 04:35:58,000 THE ELIMINATION OF PLAN OPTIONS. 8093 04:35:58,001 --> 04:36:00,000 FOR EXAMPLE, IN 1997 THE 8094 04:36:00,001 --> 04:36:03,000 BALANCED BUDGET ACT REDUCED 8095 04:36:03,001 --> 04:36:05,000 PAYMEN 8096 04:36:05,001 --> 04:36:06,000 OVER 10 YEARS -- $4.5 BILLION 8097 04:36:06,001 --> 04:36:08,000 OVER 10 YEARS. 8098 04:36:08,001 --> 04:36:09,000 WHAT HAPPENED? 8099 04:36:09,001 --> 04:36:11,000 THREE-QUARTER OF THE 8100 04:36:11,001 --> 04:36:13,000 BENEFICIARIES FROM 1999 8101 04:36:13,001 --> 04:36:15,000 HAD TO CHANGE PLANS. 8102 04:36:15,001 --> 04:36:17,000 THIS 8103 04:36:17,001 --> 04:36:19,000 MORE RURAL AREAS OF THE COUNTRY, 8104 04:36:19,001 --> 04:36:20,000 BUT ALSO AREAS LIKE LONG ISLAND, 8105 04:36:20,001 --> 04:36:22,000 NEW YORK. 8106 04:36:22,001 --> 04:36:24,000 WELL, CONGRESS HEARD FROM THESE 8107 04:36:24,001 --> 04:36:26,000 SENIORS LOUD AND CLEAR AND THEY 8108 04:36:26,001 --> 04:36:29,000 WERE ANGRY ABOUT LOSING THEIR COVERAGE. 8109 04:36:29,001 --> 04:36:31,000 MANY REMBER THAT THE MEDICARE 8110 04:36:31,001 --> 04:36:32,000 MODERNIZATION ACT WAS A LANDMARK 8111 04:36:32,001 --> 04:36:34,000 ACHIEVEMENT, BUT IT WAS 8112 04:36:34,001 --> 04:36:35,000 NECESSARY FOR ANOTHER REASON AS 8113 04:36:35,001 --> 04:36:36,000 WELL, AND THAT WAS TO RESPOND TO 8114 04:36:36,001 --> 04:36:38,000 THE CAL 8115 04:36:38,001 --> 04:36:41,000 WANTED THEIR PRIVATE OPTIONS BACK. 8116 04:36:41,001 --> 04:36:42,000 SO IN 2003, THE MEDICARE 8117 04:36:42,001 --> 04:36:46,000 MODERNIZATION ACT EXPANDED PLAN 8118 04:36:46,001 --> 04:36:48,000 OPTIONS TO INCLUDE REGIONAL 8119 04:36:48,001 --> 04:36:50,000 P.O.'S AND RESTORED PLAN AND 8120 04:36:50,001 --> 04:36:51,000 PAISSMENTS IT WAS A DELIBERATE, 8121 04:36:51,001 --> 04:36:53,000 BIPARTISAN DECISION -- PAYMENTS. 8122 04:36:53,001 --> 04:36:55,000 IT WAS A DELIBERATE BIPARTISAN 8123 04:36:55,001 --> 04:36:57,000 DECISION TO INCREASE THE PLAN'S 8124 04:36:57,001 --> 04:37:00,000 PAYMENTS TO INCLUDE RURAL AREAS 8125 04:37:00,001 --> 04:37:01,000 AND SOME URBAN 8126 04:37:01,001 --> 04:37:03,000 MENTIONED LONG ISLAND. 8127 04:37:03,001 --> 04:37:04,000 LET ME REMIND MY COLLEAGUES, 8128 04:37:04,001 --> 04:37:06,000 FORMER SENATOR CLINTON FROM NEW 8129 04:37:06,001 --> 04:37:08,000 YORK, FOR EXAMPLE, SAID THAT 8130 04:37:08,001 --> 04:37:10,000 THESE MEDICARE PLUS CHOICE 8131 04:37:10,001 --> 04:37:11,000 PLANS, WE NOW CALL THEM MEDICARE 8132 04:37:11,001 --> 04:37:13,000 ADVANTAGE PLANS, AND I'M -- 8133 04:37:13,001 --> 04:37:15,000 QUOTE -- "ING ARE FEELING THE 8134 04:37:15,001 --> 04:37:17,000 SQUEEZE IN A SYSTEM CAUGHT 8135 04:37:17,001 --> 04:37:19,000 BETWEEN RAPIDLY EXPLODING COSTS 8136 04:37:19,001 --> 04:37:21,000 AND RAPIDLY IMPLODING FINANCES. 8137 04:37:21,001 --> 04:37:22,000 WHILE WE DEBATE 8138 04:37:22,001 --> 04:37:24,000 NEED TO RECOGNIZE THERE ARE 8139 04:37:24,001 --> 04:37:25,000 PEOPLE IN OUR STATES WHO DEPEND 8140 04:37:25,001 --> 04:37:28,000 ON THESE PLANS TODAY. 8141 04:37:28,001 --> 04:37:30,000 AND THE CURRENT SENIOR SENATOR 8142 04:37:30,001 --> 04:37:31,000 FROM MASSACHUSETTS SAID AT THE 8143 04:37:31,001 --> 04:37:32,000 TIME, AND I QUOTE, I URGE MY 8144 04:37:32,001 --> 04:37:34,000 COLLEAGUES TO SUPPORT THE 8145 04:37:34,001 --> 04:37:35,000 ADDITIONAL FUNDING THAT IS 8146 04:37:35,001 --> 04:37:36,000 URGENTLY NEEDED TO STRENGTHEN 8147 04:37:36,001 --> 04:37:37,000 THE MEDICARE PLUS CHOICE PROGRAM 8148 04:37:37,001 --> 04:37:40,000 FOR SENIORS. 8149 04:37:40,001 --> 04:37:41,000 THIS SHOULD BE AMONG OUR HIGHEST 8150 04:37:41,001 --> 04:37:42,000 PRIORITIES IN THIS YEAR'S 8151 04:37:42,001 --> 04:37:43,000 MEDICARE DEBATE. 8152 04:37:43,001 --> 04:37:44,000 MR. PRESIDENT, IT WAS. 8153 04:37:44,001 --> 04:37:45,000 AND WE DID. 8154 04:37:45,001 --> 04:37:46,000 SO THESE -- THIS IS NOT 8155 04:37:46,001 --> 04:37:49,000 SOMETHING BAD THAT WE PROVIDED 8156 04:37:49,001 --> 04:37:51,000 WE PROVIDED IT SO THE PLANS 8157 04:37:51,001 --> 04:37:52,000 COULD PROVIDE THE BENEFITS TO 8158 04:37:52,001 --> 04:37:55,000 SENIORS, PARTICULARLY IN AREAS 8159 04:37:55,001 --> 04:37:57,000 WHERE OTHERWISE THEY WOULDN'T 8160 04:37:57,001 --> 04:37:59,000 HAVE THOSE CHOICES. 8161 04:37:59,001 --> 04:38:00,000 SO WHY HAS THIS ALL OF A SUDDEN 8162 04:38:00,001 --> 04:38:02,000 BECOME UNPOPULAR WITH OUR 8163 04:38:02,001 --> 04:38:03,000 FRIENDS ON THE OTHER SIDE OF THE 8164 04:38:03,001 --> 04:38:05,000 AISLE? 8165 04:38:05,001 --> 04:38:06,000 OBVIOUSLY FIRST AND FOREMOST 8166 04:38:06,001 --> 04:38:07,000 THEY NEED TRILLIONS OF DOLLARS 8167 04:38:07,001 --> 04:38:09,000 TO FUND THEIR BILL. 8168 04:38:09,001 --> 04:38:11,000 SO THEY LOOK AROUND WHERE THEY 8169 04:38:11,001 --> 04:38:14,000 CAN GET SOME MONEY. 8170 04:38:14,001 --> 04:38:15,000 THEY CAN GET $120 BILLION FROM 8171 04:38:15,001 --> 04:38:17,000 THIS AND THAT'S ONE WAY TO PAY 8172 04:38:17,001 --> 04:38:18,000 FOR THE NEW ENTITLEMENTS UND 8173 04:38:18,001 --> 04:38:20,000 THEIR BILL. 8174 04:38:20,001 --> 04:38:21,000 BUT THEN T 8175 04:38:21,001 --> 04:38:23,000 JUSTIFICATION TO TAKE THAT MONEY. 8176 04:38:23,001 --> 04:38:24,000 SO THE IDEA IS, WELL, IT'S NOT 8177 04:38:24,001 --> 04:38:26,000 FAIR THAT THE GOVERNMENT WOULD 8178 04:38:26,001 --> 04:38:28,000 PAY MONEY INTO THIS PROGRAM FOR 8179 04:38:28,001 --> 04:38:30,000 EXTRA BENEFITS FOR SENIORS WHEN 8180 04:38:30,001 --> 04:38:31,000 THAT MONEY COULD BE SPENT ON REGULAR FEE-FOR-SERVICE 8181 04:38:31,001 --> 04:38:34,000 MEDICARE. 8182 04:38:34,001 --> 04:38:35,000 OF COURSE, 8183 04:38:35,001 --> 04:38:37,000 PRESUPPOSES THAT GOVER 8184 04:38:37,001 --> 04:38:38,000 HEALTH CARE IS ALWAYS SUPERIOR 8185 04:38:38,001 --> 04:38:40,000 TO THE PLANS OFFERED IN THE 8186 04:38:40,001 --> 04:38:42,000 PRIVATE MARKET, WHICH THESE 8187 04:38:42,001 --> 04:38:43,000 SENIORS HAVE MADE CLEAR BY 8188 04:38:43,001 --> 04:38:45,000 DOUBLING THE ENROLLMENT IN THE 8189 04:38:45,001 --> 04:38:47,000 PRIVATE PLANS IS NOT THE CASE. 8190 04:38:47,001 --> 04:38:50,000 AS I SAID, THEY'VE MADE THEIR 8191 04:38:50,001 --> 04:38:52,000 PR 8192 04:38:52,001 --> 04:38:55,000 AND THEY ASKED US FOR CHOICES 8193 04:38:55,001 --> 04:38:58,000 LIKE MEMBERS OF CONGRESS 8194 04:38:58,001 --> 04:38:59,000 PRIVATE PLANS AND THESE 8195 04:38:59,001 --> 04:39:01,000 AND WE DELIVERED AS PROMISED. 8196 04:39:01,001 --> 04:39:02,000 WE GAVE THEM THE CHOICES, 8197 04:39:02,001 --> 04:39:04,000 REPUBLICANS AND DEMOCRATS ALIKE. 8198 04:39:04,001 --> 04:39:07,000 NOW THEY NEED THE MONEY, SO THEY 8199 04:39:07,001 --> 04:39:08,000 DECIDE THIS IS A WAY TO PAY FOR 8200 04:39:08,001 --> 04:39:09,000 THEIR NEW ENTITLEMENT. 8201 04:39:09,001 --> 04:39:11,000 OUR FRIENDS ON THE OTHER SIDE OF 8202 04:39:11,001 --> 04:39:12,000 THE AISLE HAVE BEEN TALKING 8203 04:39:12,001 --> 04:39:14,000 ABOU OVERPAYMENTS. 8204 04:39:14,001 --> 04:39:15,000 THERE IS NO SUCH THING AS AN 8205 04:39:15,001 --> 04:39:18,000 OVERPAYMENT IN THIS PROGRAM 8206 04:39:18,001 --> 04:39:20,000 UNDER THE LAW. 8207 04:39:20,001 --> 04:39:22,000 ANY MONEY DOESN'T GO TO THE PLANS. 8208 04:39:22,001 --> 04:39:23,000 IT'S NOT AS IF THE INSURANCE 8209 04:39:23,001 --> 04:39:24,000 COMPANIES GET THE MONEY FROM THE 8210 04:39:24,001 --> 04:39:26,000 GOVERNMENT. 8211 04:39:26,001 --> 04:39:28,000 THE INSURANCE COMPANIES, IF THEY 8212 04:39:28,001 --> 04:39:29,000 -- IF THEIR BID IS UNDER WHAT 8213 04:39:29,001 --> 04:39:31,000 THE TRADITIONAL MEDICARE IS, 8214 04:39:31,001 --> 04:39:32,000 THEY HAVE TO RETURN 25% OF IT TO 8215 04:39:32,001 --> 04:39:35,000 THE UNITED STATES GOVERNMENT. 8216 04:39:35,001 --> 04:39:37,000 AND THE OTHER 8217 04:39:37,001 --> 04:39:40,000 GO TO THEIR BENEFICIARIES. 8218 04:39:40,001 --> 04:39:42,000 EITHER 8219 04:39:42,001 --> 04:39:44,000 PREMIUMS OR ADDITIONAL BENEFITS. 8220 04:39:44,001 --> 04:39:46,000 SO THESE AREN'T OVERPAYMENTS TO 8221 04:39:46,001 --> 04:39:47,000 THE PLANS, AS HAS BEEN 8222 04:39:47,001 --> 04:39:50,000 REPRESENTED. 8223 04:39:50,001 --> 04:39:53,000 AS I SAID, 75% OF THE ADDITIONAL 8224 04:39:53,001 --> 04:39:55,000 PAYMENTS MUST BE MADE TO USE TO 8225 04:39:55,001 --> 04:39:57,000 PROVIDE SENIORS WITH EXTRA 8226 04:39:57,001 --> 04:39:59,000 BENEFITS WHI COULD INCLUDE 8227 04:39:59,001 --> 04:40:00,000 LOWERING PREMIUMS, INCLUDING 8228 04:40:00,001 --> 04:40:01,000 CHRONIC CARE MANAGEMENT AND SO 8229 04:40:01,001 --> 04:40:03,000 ON. 8230 04:40:03,001 --> 04:40:06,000 THE OTHER 25% IS RETURNED TO THE GOVERNMENT. 8231 04:40:06,001 --> 04:40:07,000 SO THERE IS NO OVERPAYMENT. 8232 04:40:07,001 --> 04:40:09,000 SOME ON THE OTHER SIDE ARGUE 8233 04:40:09,001 --> 04:40:10,000 THEY'RE PROTECTING GUARANTEED 8234 04:40:10,001 --> 04:40:14,000 BENEFITS 8235 04:40:14,001 --> 04:40:18,000 THIS IS HE IS 8236 04:40:18,001 --> 04:40:19,000 -- 8237 04:40:19,001 --> 04:40:21,000 WHAT WE ARE POINTING OUT AND 8238 04:40:21,001 --> 04:40:22,000 WHAT THIS AMENDMENT WOULD 8239 04:40:22,001 --> 04:40:24,000 PREVENT FROM HAPPENING IS THAT 8240 04:40:24,001 --> 04:40:26,000 THE BENEFITS UNDER THE MEDICARE 8241 04:40:26,001 --> 04:40:28,000 ADVANTAGE WOULD NOT BE CUT. 8242 04:40:28,001 --> 04:40:29,000 AND THERE'S NO QUESTION. 8243 04:40:29,001 --> 04:40:30,000 NOBODY CAN DENY THAT THOSE 8244 04:40:30,001 --> 04:40:32,000 BENEFITS WOULD BE CUT. 8245 04:40:32,001 --> 04:40:35,000 IN FACT, ACCORDING TO THE C.B.O. 8246 04:40:35,001 --> 04:40:37,000 BY THE YEAR 2019, THEY WOULD 8247 04:40:37,001 --> 04:40:42,000 HAVE BEEN CUT BY 64%. 8248 04:40:42,001 --> 04:40:44,000 A HUGE ALMOST $90 -- OVER $90 8249 04:40:44,001 --> 04:40:47,000 ACTUARIAL 8250 04:40:47,001 --> 04:40:48,000 SO MY POINT HERE IS THAT 8251 04:40:48,001 --> 04:40:50,000 SENIORS, OF COURSE, WOULD LIKE 8252 04:40:50,001 --> 04:40:51,000 TO KEEP WHAT THEY HAVE. 8253 04:40:51,001 --> 04:40:53,000 AND I GUESS WHAT ABOUT THIS 8254 04:40:53,001 --> 04:40:55,000 PROME IF YOU LIKE WHAT YOU 8255 04:40:55,001 --> 04:40:57,000 HAVE, YOU GET TO KEEP IT. 8256 04:40:57,001 --> 04:41:00,000 SORRY, NOT IF YOU'RE ON MEDICARE ADVANTAGE. 8257 04:41:00,001 --> 04:41:01,000 AS I SAID, ACCORDING TO THE 8258 04:41:01,001 --> 04:41:04,000 CONGRESSIONAL BUDGET OFFICE THE 8259 04:41:04,001 --> 04:41:06,000 LEGISLATION WOULD CUT BENEFITS 8260 04:41:06,001 --> 04:41:11,000 FROM $135 A MONTH ACTUARIAL 8261 04:41:11,001 --> 04:41:12,000 VALUE TO $49 A MONTH ACTUARIAL VALUE. 8262 04:41:12,001 --> 04:41:14,000 THAT'S A REAL CUT. 8263 04:41:14,001 --> 04:41:16,000 IT MAY NOT SOUND LIKE A LOT TO 8264 04:41:16,001 --> 04:41:18,000 SOME PEOPLE, BUT TO OUR SENIORS, 8265 04:41:18,001 --> 04:41:20,000 IT'S A HUGE HIT. 8266 04:41:20,001 --> 04:41:24,000 THERE'S AN INTERESTING MEMO, MR. 8267 04:41:24,001 --> 04:41:26,000 PRESIDENT, BY JAMES CAPPARETTA 8268 04:41:26,001 --> 04:41:28,000 AND ROBERT BOOK, WHO WRITE FOR 8269 04:41:28,001 --> 04:41:30,000 THE HERITAGE FOUNDATION ON THE MEDICARE CUTS. 8270 04:41:30,001 --> 04:41:32,000 HERE'S WHAT THEY SAY, REFORMS 8271 04:41:32,001 --> 04:41:34,000 SHOULD MEAN MORE PATIENT CHOICE 8272 04:41:34,001 --> 04:41:35,000 AND HEALTH PLAN ACCOUNTABILITY. 8273 04:41:35,001 --> 04:41:37,000 BUT THE CURRENT PROPOSALS WOULD 8274 04:41:37,001 --> 04:41:39,000 LEAD IN THE OPPOSITE DIRECTION, 8275 04:41:39,001 --> 04:41:42,000 TOWARD A SYSTEM OF LESS CHOICE, 8276 04:41:42,001 --> 04:41:44,000 LESS ACCOUNTABILITY, AND 8277 04:41:44,001 --> 04:41:45,000 EVENTUALLY LOWER QUALITY HEALTH CARE. 8278 04:41:45,001 --> 04:41:47,000 THAT'S WHAT THE HATCH AMENDMENT 8279 04:41:47,001 --> 04:41:48,000 IS ATTEMPTING TO PREVENT, MR. 8280 04:41:48,001 --> 04:41:51,000 PRESIDENT. 8281 04:41:51,001 --> 04:41:55,000 TO PRESERVE THESE BENEFITS FOR SENIORS. 8282 04:41:55,001 --> 04:41:57,000 NOW, I HAVE GOTTEN TONS OF CALLS 8283 04:41:57,001 --> 04:41:59,000 -- ABOUT 500 CALLS JUST IN THE 8284 04:41:59,001 --> 04:42:00,000 LAST SEVERAL DAYS OPPOSING CUTS 8285 04:42:00,001 --> 04:42:02,000 TO MEDICARE ADVANTAGE. 8286 04:42:02,001 --> 04:42:04,000 AND I HAVEN'T, BY THE WAY, 8287 04:42:04,001 --> 04:42:05,000 RECEIVED A SINGLE CALL FROM A 8288 04:42:05,001 --> 04:42:06,000 SENIOR CITIZENS ASKING US TO 8289 04:42:06,001 --> 04:42:08,000 MAKE THESE CUTS. 8290 04:42:08,001 --> 04:42:09,000 LET ME JUST -- I'VE BEEN READING 8291 04:42:09,001 --> 04:42:10,000 FROM THESE LETTERS. 8292 04:42:10,001 --> 04:42:11,000 I READ ABOUT A DOZEN OF THESE 8293 04:42:11,001 --> 04:42:14,000 LETTERS. 8294 04:42:14,001 --> 04:42:16,000 AND LET ME JUST READ FROM A FEW 8295 04:42:16,001 --> 04:42:17,000 OF CONSTITUENTS WHO TELL YOU THE 8296 04:42:17,001 --> 04:42:18,000 REAL EFFECT THAT THESE CUTS 8297 04:42:18,001 --> 04:42:21,000 WOULD HAVE ON THEM. 8298 04:42:21,001 --> 04:42:24,000 AND BEAR IN MIND IN MY STATE WE 8299 04:42:24,001 --> 04:42:26,000 HAVE ABOUT 329,000 SENIORS WHO 8300 04:42:26,001 --> 04:42:27,000 ARE ENROLLED IN MEDICARE 8301 04:42:27,001 --> 04:42:28,000 ADVANTAGE PLANS. 8302 04:42:28,001 --> 04:42:30,000 ONE CONSTITUENT FROM PHOENIX 8303 04:42:30,001 --> 04:42:32,000 SAYS, F THE PAST MONTH I'VE 8304 04:42:32,001 --> 04:42:34,000 HEARD ABOUT CUTS. 8305 04:42:34,001 --> 04:42:37,000 FINALLY AFTER YEARS OF BEING 8306 04:42:37,001 --> 04:42:39,000 SELF-EMPLOYED AND ONLY AFFORDING 8307 04:42:39,001 --> 04:42:40,000 HIGH-DEDUCTIBLE INSURANCE, I NOW 8308 04:42:40,001 --> 04:42:41,000 HAVE MEDICARE AND IN THE 8309 04:42:41,001 --> 04:42:43,000 MEDICARE ADVANTAGE PLAN. 8310 04:42:43,001 --> 04:42:45,000 PLEASE TELL ME YOU'RE NOT CUTTING MEDICARE ADVANTAGE. 8311 04:42:45,001 --> 04:42:47,000 HAVE A HEART. 8312 04:42:47,001 --> 04:42:49,000 LEAVE MAIR AND MEDICARE 8313 04:42:49,001 --> 04:42:50,000 ADVANTAGE A-- LEAVE MEDICARE AND 8314 04:42:50,001 --> 04:42:53,000 MEDICARE ADVANTAGE A LOAN. 8315 04:42:53,001 --> 04:42:55,000 A CONSTITUENT FROM PEORIA, 8316 04:42:55,001 --> 04:42:56,000 ARIZONA, SAYS, I HAVE TWO 8317 04:42:56,001 --> 04:42:57,000 FAMILIES RECEIVING HEALTH CARE 8318 04:42:57,001 --> 04:42:59,000 UNDER PROGRAM. 8319 04:42:59,001 --> 04:43:00,000 THE CARE HAS BEEN CONSISTENTLY 8320 04:43:00,001 --> 04:43:02,000 OUTSTANDING DUE TO THE EFFORTS 8321 04:43:02,001 --> 04:43:03,000 OF OUR CASE MANAGER IN 8322 04:43:03,001 --> 04:43:04,000 COORDINATING PATIENT CARE 8323 04:43:04,001 --> 04:43:06,000 BETWEEN PRIVATES AND PATIENTS. 8324 04:43:06,001 --> 04:43:07,000 WE HAVE A VOICE IN DETERMINING 8325 04:43:07,001 --> 04:43:09,000 TYPEND SCOPE OF OUR CARE. 8326 04:43:09,001 --> 04:43:10,000 PLEASE DO NOT CUT MEDICARE 8327 04:43:10,001 --> 04:43:14,000 ADVANTAGE. 8328 04:43:14,001 --> 04:43:17,000 HERE'S A NOTE FROM A CONSTITUENT. 8329 04:43:17,001 --> 04:43:18,000 I HAVE HEARD REPORTS THAT THE 8330 04:43:18,001 --> 04:43:20,000 GOVERNMENT NEW -- THE NEW 8331 04:43:20,001 --> 04:43:21,000 GOVERNMENT PLAN WOULD DO AWAY 8332 04:43:21,001 --> 04:43:23,000 WITH MEDICARE ADVANTAGE. 8333 04:43:23,001 --> 04:43:24,000 IF SO, IT WOULD DOUBLE MY HEALTH 8334 04:43:24,001 --> 04:43:25,000 CARE CTS WITH MY CURRENT 8335 04:43:25,001 --> 04:43:27,000 HEALTH CARE PROVIDER. 8336 04:43:27,001 --> 04:43:29,000 I DO NOT WANT ANY LEGISLATION 8337 04:43:29,001 --> 04:43:31,000 PASSED THAT WOULD TAKE AWAY THE 8338 04:43:31,001 --> 04:43:32,000 MEDICARE OPTION FOR SENIORS. 8339 04:43:32,001 --> 04:43:34,000 END OF QUOTE. 8340 04:43:34,001 --> 04:43:35,000 ANOTHER CONSTITUENT FROM PEORIA. 8341 04:43:35,001 --> 04:43:36,000 PRESIDENT OBAMA HAS SAID THAT WE 8342 04:43:36,001 --> 04:43:38,000 CAN KEEP THE INSURANCE WE HAVE 8343 04:43:38,001 --> 04:43:41,000 IF WE LIKE IT. 8344 04:43:41,001 --> 04:43:43,000 BUT HAS SAID HE WANTS TO CUT OR ELIMINATE MEDICARE ADVANTAGE. 8345 04:43:43,001 --> 04:43:44,000 WHAT HAPPENS TO THE MILLIONS OF 8346 04:43:44,001 --> 04:43:45,000 PEOPLE WHO HAVE MEDICARE 8347 04:43:45,001 --> 04:43:46,000 ADVANTAGE? 8348 04:43:46,001 --> 04:43:49,000 THESE ARE ALL SENRS, MANY OF 8349 04:43:49,001 --> 04:43:51,000 WHOM CANNOT AFFORD TO PAY MORE. 8350 04:43:51,001 --> 04:43:53,000 WHY SHOULD SO MANY SENIORS HAVE 8351 04:43:53,001 --> 04:43:56,000 TO SACRIFICE TO -- I 8352 04:43:56,001 --> 04:43:57,000 HELP PAY FOR UNIVERSAL COVERAGE? 8353 04:43:57,001 --> 04:44:00,000 WHY DO WE NOT HEAR MORE ABOUT 8354 04:44:00,001 --> 04:44:02,000 DEBATE 8355 04:44:02,001 --> 04:44:03,000 WELL, TO MY 8356 04:44:03,001 --> 04:44:04,000 PEORIA, THAT'S WHAT THIS DEBATE 8357 04:44:04,001 --> 04:44:06,000 IS ALL ABOUT. 8358 04:44:06,001 --> 04:44:09,000 WE ARE TRYING TO PREVENT THESE CUTS. 8359 04:44:09,001 --> 04:44:10,000 HERE'S A CONST 8360 04:44:10,001 --> 04:44:11,000 PRESCOTT VALLEY. 8361 04:44:11,001 --> 04:44:12,000 I H 8362 04:44:12,001 --> 04:44:15,000 MY HUSBAND WANTS TO RETIRE FROM 8363 04:44:15,001 --> 04:44:17,000 HIS JOB WHERE HE HAS EXCELLENT 8364 04:44:17,001 --> 04:44:18,000 HEALTH COVERAGE FOR SERIO 8365 04:44:18,001 --> 04:44:20,000 HEALTH CONCERNS. 8366 04:44:20,001 --> 04:44:22,000 SO LONG 8367 04:44:22,001 --> 04:44:23,000 COVERAGE, HE DOES WELL. 8368 04:44:23,001 --> 04:44:25,000 SHOULD MEDICARE ADVANTAGE BE 8369 04:44:25,001 --> 04:44:27,000 CUT, HIS HEALTH WOULD 8370 04:44:27,001 --> 04:44:29,000 NECESSARILY SUFFER AFTER HIS RETIREMENT. 8371 04:44:29,001 --> 04:44:30,000 WE CANNOT AFFORD SUPPLEMENTAL 8372 04:44:30,001 --> 04:44:31,000 COVERAGE. 8373 04:44:31,001 --> 04:44:34,000 I DON'T WANT TO LOSE MY HUSBAND. 8374 04:44:34,001 --> 04:44:36,000 I HAVE SPENT MANY A SLEEPLESS 8375 04:44:36,001 --> 04:44:39,000 NIGHT WONDERING HOW TO KEEP HI 8376 04:44:39,001 --> 04:44:41,000 HUSBAND HEALTHY WHEN HE RETIRES. 8377 04:44:41,001 --> 04:44:42,000 I HAVE SEVERAL FRIENDS 8378 04:44:42,001 --> 04:44:45,000 UNDERGOING CHEMOTHERAPY AND 8379 04:44:45,001 --> 04:44:46,000 WONDER IF THEIR HEALTH IS IN 8380 04:44:46,001 --> 04:44:48,000 JEOPARDY ONCE MEDICARE ADVANTAGE IS CUT. 8381 04:44:48,001 --> 04:44:50,000 ARE WE NOT WORTH SAVING. 8382 04:44:50,001 --> 04:44:52,000 CLEARLY THERE ARE 8383 04:44:52,001 --> 04:44:54,000 TO SPEND MONEY ON THEIR OWN PRIORITIES. 8384 04:44:54,001 --> 04:44:56,000 THANK YOU FOR ADVOCATING ON OUR 8385 04:44:56,001 --> 04:44:59,000 BEHALF. 8386 04:44:59,001 --> 04:45:01,000 REAL PEOPLE. 8387 04:45:01,001 --> 04:45:03,000 THEY DON'T WANT US MEDICARE ADVANTAGE. 8388 04:45:03,001 --> 04:45:04,000 A FINAL POINT WANT TO MAKE IS, 8389 04:45:04,001 --> 04:45:05,000 ONE OF OUR COLLEAGUES WAS 8390 04:45:05,001 --> 04:45:07,000 TALKING ABOUT THERE ARE BAD 8391 04:45:07,001 --> 04:45:08,000 MEDICARE ADVANTAGE PLANS AND 8392 04:45:08,001 --> 04:45:10,000 GOOD MEDICARE ADVANTAGE PLANS. 8393 04:45:10,001 --> 04:45:11,000 HOW DO WE KNOW WHICH ONES ARE 8394 04:45:11,001 --> 04:45:13,000 GOOD AND BAD? 8395 04:45:13,001 --> 04:45:15,000 IT TURNS OUT THE SENIOR SENATOR 8396 04:45:15,001 --> 04:45:17,000 FROM FLORIDA DEVISED A FORMULA 8397 04:45:17,001 --> 04:45:21,000 WHICH PROTECTS A LOT OF FOLKS IN 8398 04:45:21,001 --> 04:45:23,000 COUNTY, MIAMI-DADE COUNTY AND 8399 04:45:23,001 --> 04:45:25,000 PALM BEACH BUT DON'T PROTECT 8400 04:45:25,001 --> 04:45:26,000 VERY MANY OTHER FOLKS, SO MAYBE 8401 04:45:26,001 --> 04:45:27,000 THIS IS THE DEFINITION OF GOOD 8402 04:45:27,001 --> 04:45:30,000 VERSUS BAD. 8403 04:45:30,001 --> 04:45:32,000 THERE ARE FEW THAT ARE PROTECTED 8404 04:45:32,001 --> 04:45:33,000 IN COLORADO, MARYLAND, 8405 04:45:33,001 --> 04:45:35,000 AND TEXAS. 8406 04:45:35,001 --> 04:45:36,000 FOR EXAMPLE, IN MY HOME STATE OF 8407 04:45:36,001 --> 04:45:38,000 ARIZONA, WITH A LOT OF RETIREES, 8408 04:45:38,001 --> 04:45:39,000 VERY FEW ARE EXEMPTED FROM THE CUTS. 8409 04:45:39,001 --> 04:45:43,000 THIS IS NOT GOING TO GO OVER WELL. 8410 04:45:43,001 --> 04:45:44,000 TO EXEMPT ONLY A FEW IN CERTAIN 8411 04:45:44,001 --> 04:45:45,000 KEY AREAS AND NONE OF THE 8412 04:45:45,001 --> 04:45:48,000 OTHERS. 8413 04:45:48,001 --> 04:45:50,000 AGAIN, WHAT HAPPENED TO THE 8414 04:45:50,001 --> 04:45:51,000 KEEP WHAT THEY HAVE? 8415 04:45:51,001 --> 04:45:53,000 MR. PRESIDENT, MY BOTTOM LINE 8416 04:45:53,001 --> 04:45:55,000 HERE IS IN SUPPORTING THE HATCH 8417 04:45:55,001 --> 04:45:56,000 AMENDMENT IS THAT WE SHOULD NOT 8418 04:45:56,001 --> 04:45:58,000 PUNISH SENIORS WHO HAVE SIGNED 8419 04:45:58,001 --> 04:45:59,000 UP TO HAVE THE CHOICE OF 8420 04:45:59,001 --> 04:46:00,000 MEDICARE ADVANTAGE. 8421 04:46:00,001 --> 04:46:01,000 THERE ARE BETTER WAYS TO REFORM 8422 04:46:01,001 --> 04:46:05,000 HEALTH CARE. 8423 04:46:05,001 --> 04:46:06,000 WE'VE TALKED ABOUT THOSE WAYS. 8424 04:46:06,001 --> 04:46:08,000 OUR SENIOR CITIZENS HAVE PAID 8425 04:46:08,001 --> 04:46:10,000 INTO THE PROGRAM, THEY HAVE 8426 04:46:10,001 --> 04:46:11,000 ASKED US FOR THIS PROGRAM. 8427 04:46:11,001 --> 04:46:13,000 DEMOCRATS AND BOTTOM LINES HAVE 8428 04:46:13,001 --> 04:46:15,000 SUPPORTED IT IN THE PAST, AND 8429 04:46:15,001 --> 04:46:16,000 NOW SIMPLY BECAUSE SOMEHOW OR 8430 04:46:16,001 --> 04:46:18,000 OTHER WE HAVE TO SCRAPE UP MONEY 8431 04:46:18,001 --> 04:46:19,000 FOR THE NEW 8432 04:46:19,001 --> 04:46:20,000 LEGISLATION, WE'RE GOING TO 8433 04:46:20,001 --> 04:46:22,000 ATTACK THE VERY PROGRAM THAT ALL 8434 04:46:22,001 --> 04:46:23,000 OF US INHE PAST HAVE 8435 04:46:23,001 --> 04:46:25,000 SUPPORTED. 8436 04:46:25,001 --> 04:46:29,000 IT'S UNFAIR, IT'S NOT RIGHT, WE 8437 04:46:29,001 --> 04:46:30,000 NEED TO DEFEAT THOSE CUTS IN MEDI 8438 04:46:30,001 --> 04:46:32,000 THAT'S WHY THE HATCH AMENDMENT 8439 04:46:32,001 --> 04:46:35,000 TO PRESERVE MEDICARE ADVANTAGE 8440 04:46:35,001 --> 04:46:43,000 SHOULD BE SUPPORTED BY MY 8441 04:46:43,001 --> 04:46:44,000 CO 8442 04:46:44,001 --> 04:46:48,000 MR. GRASSLEY: MR. PRESIDENT, DO 8443 04:46:48,001 --> 04:46:49,000 WE HAV 8444 04:46:49,001 --> 04:46:52,000 THE ESIDING OFFICER: SIX AND A 8445 04:46:52,001 --> 04:46:54,000 HALF MINUTES REMAIN. 8446 04:46:54,001 --> 04:46:57,000 MR. GRASSLEY: MR. PRESIDENT? THE PRESIDING OFFICER: THE 8447 04:46:57,001 --> 04:46:58,000 SENATOR FROM IOWA. 8448 04:46:58,001 --> 04:47:02,000 MR. GRASSLEY: BEFORE THE SENATOR 8449 04:47:02,001 --> 04:47:06,000 FROM ARIZONA LEAVES -- BEFORE 8450 04:47:06,001 --> 04:47:08,000 THE -- BEFORE THE SENATOR FROM 8451 04:47:08,001 --> 04:47:14,000 ARIZONA LEAVES, THE POINT YOU 8452 04:47:14,001 --> 04:47:15,000 MADE AND THE EFFORTS BY THE 8453 04:47:15,001 --> 04:47:16,000 MEMBERS OF THE OTHER PARTY TO 8454 04:47:16,001 --> 04:47:18,000 STRIKE MEDICARE ADVANTAGE, I 8455 04:47:18,001 --> 04:47:20,000 HAVE A LETTER HERE THAT WAS SENT 8456 04:47:20,001 --> 04:47:24,000 TO MEMBERS OF THE MEDICARE 8457 04:47:24,001 --> 04:47:25,000 CONFERENCE SEPTEMBER 30, 2003, 8458 04:47:25,001 --> 04:47:27,000 WITH MORE DEMOCRATIC SIGNERS 8459 04:47:27,001 --> 04:47:29,000 THAT ARE STILL IN THE SENATE 8460 04:47:29,001 --> 04:47:31,000 THAN REPUBLICAN SIG 8461 04:47:31,001 --> 04:47:32,000 IN THE SENATE THAT SET OUT ALL 8462 04:47:32,001 --> 04:47:35,000 OF T 8463 04:47:35,001 --> 04:47:37,000 ADVANTAGE WAS 8464 04:47:37,001 --> 04:47:39,000 IMPORTANT AND WHY IT NEEDED TO 8465 04:47:39,001 --> 04:47:42,000 BE -- WHY IT NEEDED TO HAVE MORE 8466 04:47:42,001 --> 04:47:44,000 MONEY PUT IT IN THE YEAR 2003. 8467 04:47:44,001 --> 04:47:45,000 FOR INSTANCE, I WOULD READ FROM 8468 04:47:45,001 --> 04:47:47,000 THIS LETTER." 8469 04:47:47,001 --> 04:47:49,000 FOREARLY FIVE MILLION MEDICARE 8470 04:47:49,001 --> 04:47:52,000 BENEFICIARIES ACROSS AMERICA, 8471 04:47:52,001 --> 04:47:54,000 MEDICARE CHOICE "-- AND THAT'S 8472 04:47:54,001 --> 04:47:57,000 WHAT IT WAS CALLED BEFORE IT WAS 8473 04:47:57,001 --> 04:47:59,000 CALLED MEDICARE ADVANTAGE --" IS 8474 04:47:59,001 --> 04:48:01,000 AN ESSENTIAL PROGRAM THAT 8475 04:48:01,001 --> 04:48:02,000 PROVIDES COMPENSATION AFFORDABLE 8476 04:48:02,001 --> 04:48:03,000 HEALTH COVERAGE. 8477 04:48:03,001 --> 04:48:04,000 THESE SENIORS AND DISABLED 8478 04:48:04,001 --> 04:48:05,000 AMERICANS HAVE VOLUNTARILY 8479 04:48:05,001 --> 04:48:06,000 CHOSEN TO RECEIVE THEIR HEALTH 8480 04:48:06,001 --> 04:48:08,000 BENEFITS THROUGH MEDICARE 8481 04:48:08,001 --> 04:48:11,000 H.M.O.'S AND OTHER PRIVATE 8482 04:48:11,001 --> 04:48:12,000 SECTOR PLANS BECAUSE THEY HAVE 8483 04:48:12,001 --> 04:48:13,000 EXCELLENT VALUE. 8484 04:48:13,001 --> 04:48:16,000 TO PRESERVE THIS IMPORTANT 8485 04:48:16,001 --> 04:48:18,000 OPTION FOR SENIORS ACROSS THE 8486 04:48:18,001 --> 04:48:21,000 COUNTR 8487 04:48:21,001 --> 04:48:22,000 WAS INT 8488 04:48:22,001 --> 04:48:24,000 590 AT THAT TIME CALLED THE 8489 04:48:24,001 --> 04:48:27,000 MEDICARE CHOICE EQUITY AND 8490 04:48:27,001 --> 04:48:30,000 ACCESS ACT, COSPONSORED BY 8491 04:48:30,001 --> 04:48:32,000 SENATORS SCHUMER AND SANTORUM. 8492 04:48:32,001 --> 04:48:34,000 S. 590 SOUGHT TO INCREASE 8493 04:48:34,001 --> 04:48:35,000 REIMBURSEMENT RATES AND ADD NEW 8494 04:48:35,001 --> 04:48:37,000 REIMBURSEMENT OPTIONS." 8495 04:48:37,001 --> 04:48:38,000 ET CETERA, ET CETERA. 8496 04:48:38,001 --> 04:48:41,000 WE HAVE PLENTY OF HISTORY IN THE 8497 04:48:41,001 --> 04:48:43,000 UNITED STATES SENATE THAT'S A 8498 04:48:43,001 --> 04:48:46,000 BIPARTISAN HISTORY THAT WE OUGHT 8499 04:48:46,001 --> 04:48:48,000 TO MAINTAIN MEDICARE ADVANTAGE 8500 04:48:48,001 --> 04:48:50,000 RATHER THAN DO AN INJUSTICE TO 8501 04:48:50,001 --> 04:48:52,000 IT AS THIS PRESENT PIECE OF 8502 04:48:52,001 --> 04:48:53,000 LEGISLATION BEFORE THE SENATE IS 8503 04:48:53,001 --> 04:48:55,000 TRYING TO DO, AND I'D LIKE TO 8504 04:48:55,001 --> 04:48:57,000 PLACE THIS IN THE RECORD, MR. PRESIDENT. 8505 04:48:57,001 --> 04:48:59,000 THE PRESIDING OFFICER: WITHOUT 8506 04:48:59,001 --> 04:49:01,000 OBJECTION. 8507 04:49:01,001 --> 04:49:02,000 MR. GRASSLEY: I WOULD -- DOES 8508 04:49:02,001 --> 04:49:07,000 THE SENATO FROM WYOMING WANT 8509 04:49:07,001 --> 04:49:09,000 THE REMAINDER OF OUR 20 THE PRESIDING OFFICER: THE 8510 04:49:09,001 --> 04:49:10,000 SENATOR FROM WYOMING. 8511 04:49:10,001 --> 04:49:11,000 MR. BARRASSO: THANK YOU, 8512 04:49:11,001 --> 04:49:12,000 MR. PRESIDENT. 8513 04:49:12,001 --> 04:49:13,000 I WOULD LIKE TO DO THAT, TO 8514 04:49:13,001 --> 04:49:14,000 FIRST CORRECT SOMETHING THAT I 8515 04:49:14,001 --> 04:49:17,000 HE 8516 04:49:17,001 --> 04:49:20,000 FLOOR TODAY WHEN THE SENR 8517 04:49:20,001 --> 04:49:23,000 SENATOR FROM CONNECTICUT HAD 8518 04:49:23,001 --> 04:49:25,000 SOME CONCERNS ABOUT -- HE 8519 04:49:25,001 --> 04:49:28,000 HIGHLIGHTED, HE SAID HOW PRIVATE 8520 04:49:28,001 --> 04:49:30,000 HEALTH PLANS DENY CLAIMS, AND 8521 04:49:30,001 --> 04:49:34,000 WHAT HIS STATEMENT WAS IS THAT 8522 04:49:34,001 --> 04:49:35,000 HE SAID THAT MEDICARE DOES NOT 8523 04:49:35,001 --> 04:49:36,000 DENY CLAIMS. 8524 04:49:36,001 --> 04:49:37,000 IN THE UNITED STATES OF AMERICA, 8525 04:49:37,001 --> 04:49:40,000 THE NUMBER ONE DEANER OF CLAIMS 8526 04:49:40,001 --> 04:49:43,000 FOR HEALTH CARE IS MEDICARE. 8527 04:49:43,001 --> 04:49:46,000 THE -- THE STUDY THAT'S OUT FROM 8528 04:49:46,001 --> 04:49:51,000 A FULL YEAR, MARCH, 2007, TO 8529 04:49:51,001 --> 04:49:54,000 MARCH, 2008, MEDICARE REJECTED 8530 04:49:54,001 --> 04:49:55,000 475,000 CLAIMS OF ITS 8531 04:49:55,001 --> 04:49:58,000 6.9 MILLION CLAIMS FILED. 8532 04:49:58,001 --> 04:50:00,000 THAT'S A RATE OF 6.85%. 8533 04:50:00,001 --> 04:50:01,000 WHEN YOU COMPARE THAT TO PRIVATE 8534 04:50:01,001 --> 04:50:03,000 INSURANCE COMPANIES, THE 8535 04:50:03,001 --> 04:50:09,000 INDUSTRY AVERAGE FOR THE CLAIMS 8536 04:50:09,001 --> 04:50:12,000 THAT ARE REJECTED IS ABOUT 4%, 4.05%. 8537 04:50:12,001 --> 04:50:15,000 SO MEDICARE REJECTS BY NUMBER 8538 04:50:15,001 --> 04:50:17,000 TEN TIMES MORE THAN THE LARGEST 8539 04:50:17,001 --> 04:50:20,000 PRIVATE INSURANCE COMPANY, AND A 8540 04:50:20,001 --> 04:50:21,000 LOT OF THESE CLAIMS -- AND I 8541 04:50:21,001 --> 04:50:23,000 FOLLOWED THIS CLOSELY BECAUSE I 8542 04:50:23,001 --> 04:50:25,000 HAVE BEEN THE MEDICAL DIRECTOR 8543 04:50:25,001 --> 04:50:26,000 OF SOMETHING CALLED THE WYOMING 8544 04:50:26,001 --> 04:50:28,000 HEALTH FAIRS WHERE PEOPLE CAN 8545 04:50:28,001 --> 04:50:29,000 GET THEIR BLOOD TESTED, IT'S 8546 04:50:29,001 --> 04:50:30,000 VERY LOW COST AND IT GIVES 8547 04:50:30,001 --> 04:50:32,000 PEOPLE AN OPPORTUNITY TO CHECK 8548 04:50:32,001 --> 04:50:33,000 HOW THEY'RE DOING, TO STAY 8549 04:50:33,001 --> 04:50:36,000 HEALTHY. 8550 04:50:36,001 --> 04:50:38,000 IT'S A PREVENTION DESIGNED 8551 04:50:38,001 --> 04:50:43,000 PROGRAM, BUT YET MEDICARE 8552 04:50:43,001 --> 04:50:46,000 REFUSES TO PAY FOR PREVENTION, REFUSES. 8553 04:50:46,001 --> 04:50:47,000 IT REFUSES TO PAY FOR THESE 8554 04:50:47,001 --> 04:50:49,000 BLOOD TESTS BECAUSE THEY ARE 8555 04:50:49,001 --> 04:50:50,000 PREVENTATIVE AS OPPOSED TO 8556 04:50:50,001 --> 04:50:51,000 DIAGNOSE A SPECIFIC PROBLEM AND 8557 04:50:51,001 --> 04:50:53,000 A SPECIFIC PATIENT WITH A 8558 04:50:53,001 --> 04:50:55,000 SPECIFIC SYMPTOM. 8559 04:50:55,001 --> 04:50:56,000 SO WHAT DO PEOPLE IN AMERICA DO? 8560 04:50:56,001 --> 04:50:59,000 WHAT DO OUR SENIORS DO? 8561 04:50:59,001 --> 04:51:00,000 THEY TURN TO A PROGRAM CALLED 8562 04:51:00,001 --> 04:51:01,000 MEDICARE ADVANTAGE BECAUSE IT'S 8563 04:51:01,001 --> 04:51:02,000 AN ADVANTAGE FOR THEM TO CHOOSE 8564 04:51:02,001 --> 04:51:04,000 THIS PROGRAM. 8565 04:51:04,001 --> 04:51:07,000 IT'S ONE OF THE CHOICES THEY 8566 04:51:07,001 --> 04:51:08,000 HAVE UNDER MEDICARE, AND AT THIS 8567 04:51:08,001 --> 04:51:12,000 POINT 11 MILLION AMERICANS HAVE 8568 04:51:12,001 --> 04:51:13,000 CHOSEN TO PARTICIPATE IN 8569 04:51:13,001 --> 04:51:14,000 MEDICARE ADVANTAGE TO RECEIVE 8570 04:51:14,001 --> 04:51:15,000 THEIR HEALTH CARE THROUGH 8571 04:51:15,001 --> 04:51:17,000 MEDICARE ADVANTAGE. 8572 04:51:17,001 --> 04:51:18,000 WE'RE TALKING ABOUT SENIORS WHO 8573 04:51:18,001 --> 04:51:19,000 DEPEND ON MEDICARE FOR THEIR 8574 04:51:19,001 --> 04:51:21,000 HEALTH CARE. 8575 04:51:21,001 --> 04:51:22,000 THE NUMBER OF PEOPLE SIGNING UP 8576 04:51:22,001 --> 04:51:23,000 FOR MEDICARE ADVANTAGE HAS 8577 04:51:23,001 --> 04:51:25,000 CONTINUED TO INCREASE OVER THE 8578 04:51:25,001 --> 04:51:27,000 YEARS TO NOW 11 MILLION PEOPLE, 8579 04:51:27,001 --> 04:51:28,000 ONE OUT OF EVERY FOUR SENIORS 8580 04:51:28,001 --> 04:51:30,000 MEDICARE IS IN THIS MEDICARE 8581 04:51:30,001 --> 04:51:33,000 ADVANTAGE PROGRAM, AND TY KNOW 8582 04:51:33,001 --> 04:51:34,000 WHO THEY ARE AND THEY LIKE THE 8583 04:51:34,001 --> 04:51:35,000 PROGRAM, AND THE REASON THAT 8584 04:51:35,001 --> 04:51:37,000 THEY LIKE T PROGRAM IS BECAUSE 8585 04:51:37,001 --> 04:51:39,000 THEY GET ADDITIONAL SERVICES, 8586 04:51:39,001 --> 04:51:41,000 SERVICES BEYOND WHAT SOMEONE ON 8587 04:51:41,001 --> 04:51:42,000 THE TRADITIONAL MEDICARE PROGRAM 8588 04:51:42,001 --> 04:51:46,000 RECEIVES. 8589 04:51:46,001 --> 04:51:49,000 DENTAL CARE, HEARING CARE, EYE 8590 04:51:49,001 --> 04:51:50,000 CARE, PREVENTATIVEARE, 8591 04:51:50,001 --> 04:51:52,000 COORDINATED CARE. 8592 04:51:52,001 --> 04:51:53,000 YOU KNOW, WE HEAR A LOT ABOUT 8593 04:51:53,001 --> 04:51:54,000 THE FAILINGS OF THE HEALTH CARE 8594 04:51:54,001 --> 04:51:56,000 SYSTEM AND THERE ARE MANY IN 8595 04:51:56,001 --> 04:51:58,000 THIS COUNTRY TODAY AND ONE OF 8596 04:51:58,001 --> 04:52:00,000 THE PROBLEMS IS THAT CARE IS NOT COORDINATED. 8597 04:52:00,001 --> 04:52:03,000 PEOPLE GO FROM SPECIALIST TO SPECIALIST. 8598 04:52:03,001 --> 04:52:04,000 WE NEED COORDINATED CARE. 8599 04:52:04,001 --> 04:52:06,000 MEDICARE ADVANTAGE DOES A MUCH 8600 04:52:06,001 --> 04:52:08,000 BETTER JOB AT COORDINATING CARE 8601 04:52:08,001 --> 04:52:09,000 THAN REGULAR MEDICARE, THAN THE 8602 04:52:09,001 --> 04:52:12,000 TRADITIONAL MEDICARE. 8603 04:52:12,001 --> 04:52:15,000 SO IT IS BAFFLING TO ME, MR. PRESIDENT, THAT THE PLAN IN 8604 04:52:15,001 --> 04:52:16,000 FRONT OF US TOD IN THE UNITED 8605 04:52:16,001 --> 04:52:18,000 STATES SENATE TRY -- IS TRYING 8606 04:52:18,001 --> 04:52:22,000 TO ELIMINATE MEDICARE ADVANTAGE 8607 04:52:22,001 --> 04:52:25,000 TO THE TUNE OF OVER OVER $100 BILLION. 8608 04:52:25,001 --> 04:52:29,000 WHEN ONE TAKES A LOOK AT THE 8609 04:52:29,001 --> 04:52:33,000 CUTS THAT ARE APPROVED IN THIS 8610 04:52:33,001 --> 04:52:35,000 PLAN, 8611 04:52:35,001 --> 04:52:37,000 CUTS, IS 35 BILLION FOR 8612 04:52:37,001 --> 04:52:38,000 HOSPITALS, $42 BILLION FOR HOME 8613 04:52:38,001 --> 04:52:40,000 HEALTH AGENCIES, $15 BILLION 8614 04:52:40,001 --> 04:52:42,000 FROM NURSING HOMES, $8 BILLION 8615 04:52:42,001 --> 04:52:45,000 FROM HOSPICE PROVIDE, BUT 8616 04:52:45,001 --> 04:52:46,000 BUT $120 BILLION FROM MEDICARE 8617 04:52:46,001 --> 04:52:47,000 ADVANTAGE. 8618 04:52:47,001 --> 04:52:49,000 THE PROGRAM, MR. PRESIDENT, THAT 8619 04:52:49,001 --> 04:52:51,000 MORE SENIORS AS THEY LEARN ABOUT 8620 04:52:51,001 --> 04:52:53,000 IT WANT TO SIGN UP FOR, BECAUSE 8621 04:52:53,001 --> 04:52:54,000 IT IS AN ADVANTAGE TO THEM TO 8622 04:52:54,001 --> 04:52:57,000 DEAL WITH IT, TO HAVE THEIR 8623 04:52:57,001 --> 04:52:59,000 HEALTH CARE THROUGH A PROGRAM 8624 04:52:59,001 --> 04:53:01,000 WHICH FOCUS ON PREVENTATIVE 8625 04:53:01,001 --> 04:53:04,000 CARE, COORDINATED CARE, HELPS 8626 04:53:04,001 --> 04:53:06,000 THEM STAY HEALTHY, HELPS THEM 8627 04:53:06,001 --> 04:53:08,000 LIVE LONGER, AND YET THIS SENATE 8628 04:53:08,001 --> 04:53:10,000 AND THIS SENATE BILL THAT 8629 04:53:10,001 --> 04:53:12,000 SENATOR REID HAS BROUGHT TO THIS 8630 04:53:12,001 --> 04:53:14,000 FLOOR IS TRYING TO COMPLETELY 8631 04:53:14,001 --> 04:53:17,000 GUT THAT PROGRAM AND DENY OUR 8632 04:53:17,001 --> 04:53:18,000 SENIORS WHO RELY UPON IT FROM 8633 04:53:18,001 --> 04:53:21,000 RECEIVING THE CARE THAT THEY 8634 04:53:21,001 --> 04:53:23,000 HAVE EARNED. 8635 04:53:23,001 --> 04:53:25,000 MR. PRESIDENT, I YIELD THE 8636 04:53:25,001 --> 04:53:26,000 FLOOR. 8637 04:53:26,001 --> 04:53:27,000 A SENATOR: MR. PRESIDENT? 8638 04:53:27,001 --> 04:53:28,000 THE PRESIDING OFFICER: THE 8639 04:53:28,001 --> 04:53:32,000 SENATOR FROM 8640 04:53:32,001 --> 04:53:33,000 THE SENATOR FROM WISCONSIN. 8641 04:53:33,001 --> 04:53:34,000 MR. FEINGOLD: MR. PRESIDENT, I 8642 04:53:34,001 --> 04:53:36,000 RISE IN STRONG SUPPORT OF THE 8643 04:53:36,001 --> 04:53:37,000 COMMUNITY LIVING AND ASSISTANCE 8644 04:53:37,001 --> 04:53:39,000 SERVICES SUPPORT ACT OR CLASS 8645 04:53:39,001 --> 04:53:40,000 ACT WHICH WAS INTRODUCED BY THE 8646 04:53:40,001 --> 04:53:42,000 LATE SENATOR TED KENNEDY. 8647 04:53:42,001 --> 04:53:43,000 THE CLASS ACT WOULD CREATE AN 8648 04:53:43,001 --> 04:53:44,000 OPTIONAL INSURANCE PROGRAM TO 8649 04:53:44,001 --> 04:53:46,000 HELP PAY FOR HOME CARE AND OER 8650 04:53:46,001 --> 04:53:47,000 ASSIST 8651 04:53:47,001 --> 04:53:48,000 DISABLED, AND THOSE CHOOSING TO 8652 04:53:48,001 --> 04:53:50,000 PARTICIPATE WOULD PAY MONTHLY 8653 04:53:50,001 --> 04:53:51,000 PREMIUMS INTO AN INSURANCE 8654 04:53:51,001 --> 04:53:55,000 TRUST, AND AFTER FIVE YEARS 8655 04:53:55,001 --> 04:53:57,000 COULD ACCESS A CACHE IF THEY 8656 04:53:57,001 --> 04:53:58,000 BECOME DISABLED AND NEED 8657 04:53:58,001 --> 04:53:59,000 ASSISTANCE. 8658 04:53:59,001 --> 04:54:00,000 OVER TEN MILLION AMERICANS ARE 8659 04:54:00,001 --> 04:54:01,000 CURRENTLY IN NEED OF LONG-TERM 8660 04:54:01,001 --> 04:54:03,000 CARE, AND THAT NUMBER IS 8661 04:54:03,001 --> 04:54:05,000 EXPECTED TO RISE TO 15 MILLION 8662 04:54:05,001 --> 04:54:06,000 IN THE NEXT TEN YEARS. 8663 04:54:06,001 --> 04:54:08,000 THESE I 8664 04:54:08,001 --> 04:54:09,000 REMAIN INDEPENDENT WITH LIMITED 8665 04:54:09,001 --> 04:54:12,000 ASSISTANCE AND MAY TURN TO 8666 04:54:12,001 --> 04:54:13,000 MEDICAID AS AN INSURER OF LAST RESORT. 8667 04:54:13,001 --> 04:54:15,000 IN ORDER TO QUALIFY, HOWEVER, 8668 04:54:15,001 --> 04:54:17,000 PEOPLE NEED TO GO THROUGH A 8669 04:54:17,001 --> 04:54:18,000 SUBSTANTIAL SPENDDOWN OF THEIR 8670 04:54:18,001 --> 04:54:21,000 ASSETS AND COMMIT TO 8671 04:54:21,001 --> 04:54:23,000 UNEMPLOYMENT TO REMAIN ELIGIBLE. 8672 04:54:23,001 --> 04:54:24,000 MR. PRESIDENT, THIS IS TOTALLY 8673 04:54:24,001 --> 04:54:26,000 INEFFICIENT. 8674 04:54:26,001 --> 04:54:27,000 INSTEAD OF ENSURING THAT AN 8675 04:54:27,001 --> 04:54:28,000 INDIVIDUAL CAN REMAIN 8676 04:54:28,001 --> 04:54:30,000 INDEPENDENT AND A FUNCTIONAL 8677 04:54:30,001 --> 04:54:32,000 MEMBER OF SOCIETY, THE CURRENT 8678 04:54:32,001 --> 04:54:33,000 POLICY REQUIRES THAT TO RECEIVE 8679 04:54:33,001 --> 04:54:35,000 ASSISTANCE, 8680 04:54:35,001 --> 04:54:36,000 HAS TO BECOME A WARD OF THE STATE. 8681 04:54:36,001 --> 04:54:38,000 MEDICAID PAYS FOR HALF OF 8682 04:54:38,001 --> 04:54:39,000 LONG-TERM CARE COSTS AND 8683 04:54:39,001 --> 04:54:41,000 INCREASED EXPENDITURES ARE 8684 04:54:41,001 --> 04:54:42,000 EXPECTED TO ADD ANOTHER 8685 04:54:42,001 --> 04:54:45,000 ANOTHER $44 BILLION EA YEAR TO 8686 04:54:45,001 --> 04:54:48,000 MEDICAID OVER THE NEXT DECADE. 8687 04:54:48,001 --> 04:54:50,000 NOT ONLY IS THIS UNSUSTAINABLE, 8688 04:54:50,001 --> 04:54:54,000 IT'S ACTUALLY NONSENSICAL. 8689 04:54:54,001 --> 04:54:55,000 MR. PRESIDENT, THIS IS ABOUT AS 8690 04:54:55,001 --> 04:54:56,000 MUCH -- THIS IS ABOUT AS MUCH 8691 04:54:56,001 --> 04:54:58,000 ABOUT PROTECTING PEOPLE'S 8692 04:54:58,001 --> 04:55:00,000 DIGNITY AS IT IS ABOUT FISCAL RESPONSIBILITY. 8693 04:55:00,001 --> 04:55:01,000 TOO MANY AMERICANS FALL ON HARD 8694 04:55:01,001 --> 04:55:03,000 TIMES, BECOMING DISABLED FROM AN 8695 04:55:03,001 --> 04:55:05,000 ACCIDENT OR ILLNESS WITH NO 8696 04:55:05,001 --> 04:55:08,000 SAFETY NET TO HELP THEM STAY INDEPENDENT. 8697 04:55:08,001 --> 04:55:09,000 ENSURING THAT THESE PEOPLE HAVE 8698 04:55:09,001 --> 04:55:10,000 AN ALTERNATIVE TO MEDICAID SO 8699 04:55:10,001 --> 04:55:13,000 THAT THEY CAN REMAIN ACTIVE AND 8700 04:55:13,001 --> 04:55:16,000 INDEPENDENT WILL REDUCE THE 8701 04:55:16,001 --> 04:55:20,000 FEDERAL DEFICIT BY $73.4 BILLION 8702 04:55:20,001 --> 04:55:22,000 OVER TEN YEARS AND SAVE MEDICAID 8703 04:55:22,001 --> 04:55:23,000 MEDICAID $1.6 BILLION IN THE 8704 04:55:23,001 --> 04:55:25,000 FIRST FOUR YEARS THAT THE 8705 04:55:25,001 --> 04:55:26,000 BENEFITS ARE AVAILABLE. 8706 04:55:26,001 --> 04:55:29,000 MEDICAID SAVINGS WILL CONTINUE 8707 04:55:29,001 --> 04:55:30,000 TO GROW OVER TIME AS MORE 8708 04:55:30,001 --> 04:55:32,000 BENEFICIARIES UTILIZE THE CLASS 8709 04:55:32,001 --> 04:55:33,000 ACT BENEFITS INSTEAD OF 8710 04:55:33,001 --> 04:55:35,000 MEDICAID. 8711 04:55:35,001 --> 04:55:37,000 THANKS TO AMENDMENTS ACCEPTED IN 8712 04:55:37,001 --> 04:55:39,000 THE SENATE HEALTH EDUCATION AND 8713 04:55:39,001 --> 04:55:41,000 LABOR PENSIONS COMMITTEE, THE 8714 04:55:41,001 --> 04:55:42,000 BILL LANGUAGE IS STRONGER THAN EVER. 8715 04:55:42,001 --> 04:55:43,000 SENATOR GREGG, MY COLLEAGUE IN 8716 04:55:43,001 --> 04:55:44,000 THE BUDGET COMMITT, AMENDED 8717 04:55:44,001 --> 04:55:45,000 THE BILL TO REQUIRE THE 8718 04:55:45,001 --> 04:55:47,000 SECRETARY OF HEALTH AND HUMAN 8719 04:55:47,001 --> 04:55:51,000 SERVICES TO SET PREMIUMS THAT 8720 04:55:51,001 --> 04:55:53,000 ARE ACTUARIALLY SOUND FOR A 8721 04:55:53,001 --> 04:55:54,000 75-YEAR-OLD WINDOW AND MAINTAINS 8722 04:55:54,001 --> 04:55:55,000 A SUSTAINABLE 8723 04:55:55,001 --> 04:55:56,000 BENEFIT STRUCTURE. 8724 04:55:56,001 --> 04:55:59,000 WHILE SOME HAVE SUGGESTED THAT 8725 04:55:59,001 --> 04:56:00,000 THE CLASS ACT IS FISCALLY NOT 8726 04:56:00,001 --> 04:56:01,000 SOUND, THE GREGG AMENDMENT 8727 04:56:01,001 --> 04:56:02,000 SHOULD PUT THOSE CONCERN TO 8728 04:56:02,001 --> 04:56:03,000 REST. 8729 04:56:03,001 --> 04:56:04,000 MR. PRESIDENT, LONG-TERM CARE 8730 04:56:04,001 --> 04:56:06,000 REFORM HAS BEEN A CORNERSTONE O 8731 04:56:06,001 --> 04:56:08,000 MY WORK IN PUBLIC OFFICE SINCE 8732 04:56:08,001 --> 04:56:09,000 MY FIRST DAYS IN THE WISCONSIN 8733 04:56:09,001 --> 04:56:11,000 STATE SENATE. 8734 04:56:11,001 --> 04:56:12,000 I'VE SEEN HOW IMPORTANT IT IS TO 8735 04:56:12,001 --> 04:56:13,000 GIVE PEOPLE OPTIONS SO THEY CAN 8736 04:56:13,001 --> 04:56:15,000 MATCH THE LEVEL OF CARE AND 8737 04:56:15,001 --> 04:56:17,000 ASSISTANCE TO THEIR PERSONAL NEEDS. 8738 04:56:17,001 --> 04:56:18,000 PUSHING ANYONE AND EVERYONE INTO 8739 04:56:18,001 --> 04:56:20,000 MEDICAID OR INTO A NURSING HOME 8740 04:56:20,001 --> 04:56:23,000 IS A WASTE OF POTENTIAL, A WASTE 8741 04:56:23,001 --> 04:56:24,000 OF OPPORTUNITY AND A WASTE OF MONEY. 8742 04:56:24,001 --> 04:56:25,000 MEDICAID AND OUR NATION'S 8743 04:56:25,001 --> 04:56:27,000 NURSING HOMES HAVE A CRITICAL 8744 04:56:27,001 --> 04:56:29,000 HOLE TO PLAY FOR SOME AMERICANS, 8745 04:56:29,001 --> 04:56:31,000 BUT FOR MANY AMERICANS, IT'S 8746 04:56:31,001 --> 04:56:32,000 SIMPLY NOT THE RIGHT FIT. 8747 04:56:32,001 --> 04:56:34,000 THE CLASS ACT WILL ENSURE THAT 8748 04:56:34,001 --> 04:56:36,000 TAXPAYER DOLLARS ARE SPENT 8749 04:56:36,001 --> 04:56:38,000 ENROLLING ONLY THOSE WHO TRULY 8750 04:56:38,001 --> 04:56:39,000 NEED MEDICAID INTO THE PROGRAM 8751 04:56:39,001 --> 04:56:41,000 AND THEN HELP OTHERS SAVE FOR A 8752 04:56:41,001 --> 04:56:42,000 TIME WHEN THEY MIGHT NEED SOME 8753 04:56:42,001 --> 04:56:43,000 ASSISTANCE TO REMAIN 8754 04:56:43,001 --> 04:56:45,000 INDEPENDENT. 8755 04:56:45,001 --> 04:56:47,000 THE CLASS ACT IS A CRITICAL PART 8756 04:56:47,001 --> 04:56:49,000 OF THIS HEALTH CARE REFORM BILL, 8757 04:56:49,001 --> 04:56:50,000 AND I URGE MY COLLEAGUES TO 8758 04:56:50,001 --> 04:56:52,000 OPPOSE ANY EFFORT TO WEAKEN OR 8759 04:56:52,001 --> 04:56:54,000 STRIKE THE PROGRAM FROM THE 8760 04:56:54,001 --> 04:57:01,000 MR. PRESIDENT, I YIELD THE 8761 04:57:01,001 --> 04:57:03,000 FLOOR. 8762 04:57:03,001 --> 04:57:06,000 MR. DODD: MR. PRESIDENT, MY 8763 04:57:06,001 --> 04:57:07,000 WANTS TO BE HEARD. 8764 04:57:07,001 --> 04:57:08,000 MR. WHITEHOUSE: MR. PRESIDENT? 8765 04:57:08,001 --> 04:57:11,000 MR. PRESIDENT, I WILL JUST SPEAK 8766 04:57:11,001 --> 04:57:12,000 FOR A MOMENT BECAUSE I KNOW THE 8767 04:57:12,001 --> 04:57:13,000 DISTINGUISHED SENATOR FROM 8768 04:57:13,001 --> 04:57:14,000 PENNSYLVANIA WISHES TO SPEAK, 8769 04:57:14,001 --> 04:57:16,000 AND WHEN HE COMES TO THE FLOOR, 8770 04:57:16,001 --> 04:57:18,000 I WILL QUICKLY YIELD TO HIM, BUT 8771 04:57:18,001 --> 04:57:22,000 WHILE THERE IS A MOMENT IN 8772 04:57:22,001 --> 04:57:23,000 BETWEEN, I DID WANT TO SPEAK TO 8773 04:57:23,001 --> 04:57:25,000 SOME OF THE ARGUMENTS THAT WE 8774 04:57:25,001 --> 04:57:28,000 HAVE HEARD. 8775 04:57:28,001 --> 04:57:30,000 THERE IS 8776 04:57:30,001 --> 04:57:33,000 THE SUBSTANCE OF AN ARGUMENT. 8777 04:57:33,001 --> 04:57:36,000 THERE IS ALSO THE QUESTION OF 8778 04:57:36,001 --> 04:57:37,000 THE CREDIBILITY OF AN ARGUMENT, 8779 04:57:37,001 --> 04:57:42,000 AND I THINK AS PEOPLE WHO ARE 8780 04:57:42,001 --> 04:57:43,000 WATCHING THIS DEBATE DISCUSS THE 8781 04:57:43,001 --> 04:57:45,000 CREDIBILITY OF THE CONCERN 8782 04:57:45,001 --> 04:57:47,000 EXPRESSED BY OUR FRIENDS ON THE 8783 04:57:47,001 --> 04:57:51,000 OTHER SIDE OF THE AISLE ABOUT 8784 04:57:51,001 --> 04:57:54,000 THE DEFICIT IMPACT OF THE CLASS 8785 04:57:54,001 --> 04:57:56,000 ACT, IT'S WORTH CONSIDERING A 8786 04:57:56,001 --> 04:57:58,000 FEW FACTS JUST TO EVALUATE THAT. 8787 04:57:58,001 --> 04:58:04,000 THE FIRST THING IS THAT THE 8788 04:58:04,001 --> 04:58:07,000 CLASS ACT IS REQUIRED TO BE 8789 04:58:07,001 --> 04:58:08,000 ACTUARIALLY SELF-SUSTAINING. 8790 04:58:08,001 --> 04:58:10,000 PEOPLE PAY INTO IT AND FROM 8791 04:58:10,001 --> 04:58:14,000 THOSE FUNDS UNDER THE INSURANCE 8792 04:58:14,001 --> 04:58:16,000 PRINCIPLE, FUNDS COME BACK OUT. 8793 04:58:16,001 --> 04:58:19,000 IT IS REQUIRED TO BE 8794 04:58:19,001 --> 04:58:20,000 SELF-SUSTAING THAT WAY. 8795 04:58:20,001 --> 04:58:21,000 SECOND, IT IS VOLUNTARY. 8796 04:58:21,001 --> 04:58:23,000 NOBODY HAS TO CONTRIBUTE. 8797 04:58:23,001 --> 04:58:26,000 IF YOU WANT TO CONTRIBUTE, THEN 8798 04:58:26,001 --> 04:58:27,000 YOU BECOME EGIBLE FOR THE 8799 04:58:27,001 --> 04:58:30,000 BENEFIT ONCE YOU VEST IT, BUT 8800 04:58:30,001 --> 04:58:31,000 NOBODY IS FORCED INTO THIS. 8801 04:58:31,001 --> 04:58:32,000 IT IS ENTIRELY VOLUNTARY. 8802 04:58:32,001 --> 04:58:35,000 THE CONGRESSIONAL BUDGET OFFICE 8803 04:58:35,001 --> 04:58:37,000 ON WHICH WE RELY IN BIPARTISAN 8804 04:58:37,001 --> 04:58:41,000 OR NONPARTISAN FASHION HAS 8805 04:58:41,001 --> 04:58:42,000 THAT THIS ISOLVENT FOR 75 8806 04:58:42,001 --> 04:58:43,000 YEARS. 8807 04:58:43,001 --> 04:58:45,000 AND FINALLY, BECAUSE WE THINK AT 8808 04:58:45,001 --> 04:58:47,000 LEAST ON THIS SIDE THAT THIS 8809 04:58:47,001 --> 04:58:50,000 MATTERS, IT WILL HELP THE 8810 04:58:50,001 --> 04:58:53,000 DISABLED AND T ELDERLY AT THAT 8811 04:58:53,001 --> 04:58:55,000 CRITICAL POINT OF DECISION WHEN 8812 04:58:55,001 --> 04:58:57,000 YOUR ABILITY TO STAY HOME, YOUR 8813 04:58:57,001 --> 04:58:59,000 ABILITY TO STAY 8814 04:58:59,001 --> 04:59:00,000 YOUR ABILITY TO STAY AT WORK 8815 04:59:00,001 --> 04:59:03,000 DEPENDS ON JUST A LITTLE BIT OF 8816 04:59:03,001 --> 04:59:04,000 HELP TO ACCOMMODATE YOUR AGE OR 8817 04:59:04,001 --> 04:59:06,000 DISABILITY, AND IT'S AT THAT 8818 04:59:06,001 --> 04:59:07,000 POINT THAT THIS WILL REALLY MAKE 8819 04:59:07,001 --> 04:59:09,000 THE DIFFERENCE AND WHAT A 8820 04:59:09,001 --> 04:59:11,000 DIFFERENCE IT WILL MAKE IN HUMAN LIVES. 8821 04:59:11,001 --> 04:59:15,000 I KNOW THE DISTINGUISHED SENATOR 8822 04:59:15,001 --> 04:59:18,000 FROM CONNECTICUT WISHES TO USE 8823 04:59:18,001 --> 04:59:20,000 AN EXAMPLE, AND I WILL YIELD TO 8824 04:59:20,001 --> 04:59:21,000 HIM ON HIS SIGNAL. 8825 04:59:21,001 --> 04:59:23,000 BUT WE'VE SEEN THIS BEFORE. 8826 04:59:23,001 --> 04:59:25,000 WE SAW THIS NOT LONG AGO ON THE 8827 04:59:25,001 --> 04:59:27,000 PUBLIC OPTION. 8828 04:59:27,001 --> 04:59:29,000 THE PUBLIC OPTION WOULD COMPETE 8829 04:59:29,001 --> 04:59:30,000 WITH INSURERS HEAD TO HEAD ON 8830 04:59:30,001 --> 04:59:32,000 FAIR, LEVEL PLAYING FIELD. 8831 04:59:32,001 --> 04:59:34,000 IT WAS REQUIRED -- IT WAS 8832 04:59:34,001 --> 04:59:36,000 COMPLETELY VOLUNTARY. 8833 04:59:36,001 --> 04:59:38,000 NOBODY'S REQUIRED TO SIGN UP FOR IT. 8834 04:59:38,001 --> 04:59:42,000 COMPLETELY VOLUNTARY. 8835 04:59:42,001 --> 04:59:44,000 AND IT HAD TO BE ACTUARIALLY SELF-SUSTAINING. 8836 04:59:44,001 --> 04:59:46,000 IT HAD TO MEET THE SOLVENCY LAWS 8837 04:59:46,001 --> 04:59:47,000 OF THE STATE IN WHICH IT 8838 04:59:47,001 --> 04:59:50,000 OPERATED. 8839 04:59:50,001 --> 04:59:51,000 IN BOTH 8840 04:59:51,001 --> 04:59:53,000 CASES OUR COLLEAGUES ON THE 8841 04:59:53,001 --> 04:59:55,000 OTHER SIDES HAVE RUN TO THE 8842 04:59:55,001 --> 04:59:56,000 FLOOR TO TALK ABOUT DEFICITS AND 8843 04:59:56,001 --> 04:59:57,000 HOW THIS WOULD CONTRIBUTE TO THE 8844 04:59:57,001 --> 05:00:01,000 DEFICIT. 8845 05:00:01,001 --> 05:00:03,000 THESE ARE BOTH ACTUARIALLY SELF-SUSTAINING PROGRAMS 8846 05:00:03,001 --> 05:00:05,000 REQUIRED TO STAY SOLVENT. 8847 05:00:05,001 --> 05:00:07,000 AND YET, HERE THEY COME TO RAISE 8848 05:00:07,001 --> 05:00:09,000 THE SPECTER OF DEFICITS. 8849 05:00:09,001 --> 05:00:13,000 BUT THIS IS THE SAME PARTY THAT 8850 05:00:13,001 --> 05:00:15,000 PAYS FOR 14% SUBSIDIES TO 8851 05:00:15,001 --> 05:00:16,000 PRIVATE INSURERS TO COMPETE WITH 8852 05:00:16,001 --> 05:00:20,000 MEDICAID. 8853 05:00:20,001 --> 05:00:22,000 WELL, AS MY SON WOULD SAY, 8854 05:00:22,001 --> 05:00:25,000 "DUH," IF YOU'RE GETTING 14% 8855 05:00:25,001 --> 05:00:26,000 EXTRA, IT'S PRETTY EASY TO COMPETE. 8856 05:00:26,001 --> 05:00:29,000 WHEN THEY ASKED FOR THAT DEAL, 8857 05:00:29,001 --> 05:00:32,000 THEY PROMISED THEY'D DRIVE COSTS DOWN. 8858 05:00:32,001 --> 05:00:34,000 IN FACT, THEY'VE DRIVEN COSTS 8859 05:00:34,001 --> 05:00:38,000 UP, THEY'VE PUT THEM IN THEIR POCKETS. 8860 05:00:38,001 --> 05:00:39,000 AND IT ISN'T FAIR TO THE 8861 05:00:39,001 --> 05:00:41,000 PROGRAM. 8862 05:00:41,001 --> 05:00:42,000 IT IS GREEDY ON THEIR PART. 8863 05:00:42,001 --> 05:00:44,000 DO WE HEAR CONCERNS ABOUT THE 8864 05:00:44,001 --> 05:00:45,000 DEFICIT PROBLEM ON THE 14% 8865 05:00:45,001 --> 05:00:46,000 SUBSIDY FOR THE MEDICARE 8866 05:00:46,001 --> 05:00:47,000 ADVANTAGE PROGRAMS? NO. 8867 05:00:47,001 --> 05:00:48,000 DEAD SILENT. 8868 05:00:48,001 --> 05:00:51,000 GUESS WHAT? 8869 05:00:51,001 --> 05:00:55,000 BECAUSE IT HELPS THE INSURANCE INDUSTRY. 8870 05:00:55,001 --> 05:00:57,000 WHEN THE PART-D PROGRAM CAME IN, 8871 05:00:57,001 --> 05:00:58,000 OUR FRIENDS ON THE OTHER SIDE 8872 05:00:58,001 --> 05:01:00,000 FORCED THROUGH A PROVISION, A 8873 05:01:00,001 --> 05:01:02,000 UNIQUE PROVISION THAT GAVE THE 8874 05:01:02,001 --> 05:01:03,000 PHARMACEUTICAL INDUSTRY THE SPECIAL PRIVILEGE THAT THE 8875 05:01:03,001 --> 05:01:06,000 UNITED STATES GOVERNMENT 8876 05:01:06,001 --> 05:01:10,000 CODN'T NEGOTIATE WITH IT OVER PRICE. 8877 05:01:10,001 --> 05:01:11,000 COULDN'T NEGOTIATE WITH IT. 8878 05:01:11,001 --> 05:01:14,000 LORD KNOWS HOW MUCH THAT HAS 8879 05:01:14,001 --> 05:01:16,000 ADDED TO OUR DEFICIT. 8880 05:01:16,001 --> 05:01:18,000 BUT HAVE THEY EVER COME COMPLAIN? 8881 05:01:18,001 --> 05:01:20,000 NO, BECAUSE THE BENEFICIARY IS 8882 05:01:20,001 --> 05:01:22,000 THE PHARMACEUTICAL INDUSTRY. 8883 05:01:22,001 --> 05:01:25,000 BUT WHEN THINGS HELP REGULAR 8884 05:01:25,001 --> 05:01:27,000 PEOPLE, WHEN THINGS HELP 8885 05:01:27,001 --> 05:01:29,000 COMPETITION IN THE INSURANCE 8886 05:01:29,001 --> 05:01:32,000 MARKET, EVEN WHERE THEY'RE 8887 05:01:32,001 --> 05:01:34,000 REQUIRED TO BE ACTUARIALLY 8888 05:01:34,001 --> 05:01:36,000 SELF-SUSTAING AND SOLVENT, 8889 05:01:36,001 --> 05:01:38,000 THEN SUDDENLY THEY TURN UP. 8890 05:01:38,001 --> 05:01:40,000 THEY CAN DETECT THE THREAT IN 8891 05:01:40,001 --> 05:01:41,000 DEFICIT IN PARTS PER BILLION 8892 05:01:41,001 --> 05:01:45,000 WHEN IT HELPS SOM 8893 05:01:45,001 --> 05:01:47,000 BUT A PATENT ACTUAL, LIVING, 8894 05:01:47,001 --> 05:01:48,000 BREATHING DEFICIT-ENHANCING 8895 05:01:48,001 --> 05:01:50,000 SUBSIDY THAT IS ON THE BOOKS 8896 05:01:50,001 --> 05:01:54,000 RIGHT NOW, THEY DON'T CARE ABOUT 8897 05:01:54,001 --> 05:01:56,000 IF IT HELPS THE PHARMACEUTICAL 8898 05:01:56,001 --> 05:01:57,000 INDUSTRY OR THE INSURANCE 8899 05:01:57,001 --> 05:01:58,000 INDUSTRY. 8900 05:01:58,001 --> 05:01:59,000 I THINK SIN 8901 05:01:59,001 --> 05:02:01,000 DISCUSSION THAT IS A POINT WORTH 8902 05:02:01,001 --> 05:02:03,000 BEARING IN MIND BECAUSE IT IS 8903 05:02:03,001 --> 05:02:04,000 NOT THE SUBSTANCE OF AN 8904 05:02:04,001 --> 05:02:06,000 ARGUMENT, IT IS THE CREDIBILITY 8905 05:02:06,001 --> 05:02:07,000 OF AN ARGUMENT THAT COUS. 8906 05:02:07,001 --> 05:02:08,000 I SAID I WOULD YIELD TO THE 8907 05:02:08,001 --> 05:02:11,000 SENATOR FROM PENNSYLVANIA WHEN 8908 05:02:11,001 --> 05:02:12,000 HE ARRIVES, AND HE HAS 8909 05:02:12,001 --> 05:02:14,000 WITHOUT FURTHER ADD DUE, I YIELD 8910 05:02:14,001 --> 05:02:16,000 THE FLO. 8911 05:02:16,001 --> 05:02:17,000 -- WITHOUT FURTHER ADIEU, I 8912 05:02:17,001 --> 05:02:19,000 YIELD THE FLOOR. THE PRESIDING OFFICER: THE 8913 05:02:19,001 --> 05:02:22,000 SENATOR FROM PENNSYLVANIA. 8914 05:02:22,001 --> 05:02:25,000 MR. CASEY: I WANT TO THANK MY 8915 05:02:25,001 --> 05:02:29,000 COLLEAGUE FROM RHODE ISLAND WHO 8916 05:02:29,001 --> 05:02:31,000 HAS BEEN THE MOST FORTHRIGHT, IN 8917 05:02:31,001 --> 05:02:33,000 PARTICULAR TO WHAT BRINGS US TO 8918 05:02:33,001 --> 05:02:35,000 THE FLOOR AT THIS MOMENT. 8919 05:02:35,001 --> 05:02:36,000 PRINCIPALLY, HIS WORK AND THE 8920 05:02:36,001 --> 05:02:39,000 WORK OVER MANY YEARS THAT 8921 05:02:39,001 --> 05:02:41,000 SENATOR KENNEDY DID FOR THE 8922 05:02:41,001 --> 05:02:43,000 SO-CALLED CLASS ACT, THE 8923 05:02:43,001 --> 05:02:44,000 COMMUNITY LIVING ASSISTANCE 8924 05:02:44,001 --> 05:02:45,000 SERVICES AND SUPPORTS ACT. 8925 05:02:45,001 --> 05:02:47,000 WHAT IS THIS ALL ABOUT? 8926 05:02:47,001 --> 05:02:49,000 I WANTED TO TALK FOR A COUPLE OF 8927 05:02:49,001 --> 05:02:52,000 MINUTES ABOUT HOW IT WORKS. 8928 05:02:52,001 --> 05:02:58,000 I THINK SOMETIMES WHEN WE GET 8929 05:02:58,001 --> 05:02:59,000 LOST IN THE DISCUSSION ABOUT THE 8930 05:02:59,001 --> 05:03:00,000 FINER POINTS OF A POLICY OR 8931 05:03:00,001 --> 05:03:01,000 PROGRAM, WE TEND TO FORGET WHAT 8932 05:03:01,001 --> 05:03:03,000 IT MEANS. 8933 05:03:03,001 --> 05:03:04,000 HERE'S WHAT IT MEANS. 8934 05:03:04,001 --> 05:03:05,000 HERE'S WHAT IT MEANS FOR AN 8935 05:03:05,001 --> 05:03:07,000 AMERICAN WHO IS WORKING AND 8936 05:03:07,001 --> 05:03:09,000 WANTS TO CONTINUE WORKING TO 8937 05:03:09,001 --> 05:03:10,000 SUPPORT HIS OR HER FAMILY OR TO 8938 05:03:10,001 --> 05:03:12,000 SUPPORT HIMSELF, CONTRIBUTE TO 8939 05:03:12,001 --> 05:03:14,000 OUR ECONOMY, DEMONSTRATE THAT 8940 05:03:14,001 --> 05:03:16,000 PEOPLE WHO HAPPEN TO LIVE WITH A 8941 05:03:16,001 --> 05:03:19,000 DISABILITY OF ONE KIND OR 8942 05:03:19,001 --> 05:03:21,000 ANOTHER CAN BE SO SIGNIFICANT IN 8943 05:03:21,001 --> 05:03:23,000 OUR ECONOMY, CAN CONTRIBUTE SO 8944 05:03:23,001 --> 05:03:25,000 MUCH WITH THEIR ABILITY AND 8945 05:03:25,001 --> 05:03:27,000 THEIR BRAINPOWER AND THEIR 8946 05:03:27,001 --> 05:03:30,000 ABILITY TO CONTRIBUTE IN A VERY POSITIVE WAY 8947 05:03:30,001 --> 05:03:33,000 SO WE'RE TALKING ABOUT HERE THE 8948 05:03:33,001 --> 05:03:34,000 DIGNITY OF WORK, WHETHER OR NOT 8949 05:03:34,001 --> 05:03:37,000 THE UNITED STATES SENATE IS 8950 05:03:37,001 --> 05:03:39,000 GOING TO STAND UP AND SAY WITH 8951 05:03:39,001 --> 05:03:41,000 THIS ACT, WITH THIS PROGRAM FOR 8952 05:03:41,001 --> 05:03:42,000 SOMEONE WHO HAPPENSO HAVE A 8953 05:03:42,001 --> 05:03:45,000 DISABILITY AND WANTS TO WORK AND 8954 05:03:45,001 --> 05:03:48,000 WANTS TO 8955 05:03:48,001 --> 05:03:50,000 PREMIUMS SO THEY HAVE SOME, SOME 8956 05:03:50,001 --> 05:03:51,000 SECURITY, SOME PEACE OF MIND 8957 05:03:51,001 --> 05:03:53,000 DOWN THE ROAD IF THEY SHOULD 8958 05:03:53,001 --> 05:03:55,000 NEED THIS HELP, WE'RE TALKING 8959 05:03:55,001 --> 05:03:57,000 ABOUT THE DIGNITY OF THAT WORK. 8960 05:03:57,001 --> 05:03:59,000 AND THIS IS A TEST OF THE UNITED 8961 05:03:59,001 --> 05:04:01,000 STATES SENATE, WHETHER WE'RE 8962 05:04:01,001 --> 05:04:04,000 GOING TO STAND UP FOR PEOPLE WHO 8963 05:04:04,001 --> 05:04:05,000 HAVE A DISABILITY AND THEIR 8964 05:04:05,001 --> 05:04:07,000 OPPORTUNITY TO WORK OR NOT. 8965 05:04:07,001 --> 05:04:09,000 IT'S A VERY SIMPLE QUESTION. 8966 05:04:09,001 --> 05:04:10,000 YOU EITHER STAND WITH THEM OR 8967 05:04:10,001 --> 05:04:13,000 YOU DON'T. 8968 05:04:13,001 --> 05:04:16,000 IT'S ALSO ABOUT ONE IMPORTANT 8969 05:04:16,001 --> 05:04:17,000 WORD, I THINK: INDEPENDENCE, 8970 05:04:17,001 --> 05:04:20,000 WHETHER OR NOT WE'RE GOING TO 8971 05:04:20,001 --> 05:04:22,000 SAY TO SOMEONE WHO WANTS TO WORK 8972 05:04:22,001 --> 05:04:24,000 AND HAS 8973 05:04:24,001 --> 05:04:26,000 GOING TO HAVE THE INDEPENDENCE, 8974 05:04:26,001 --> 05:04:29,000 THE FREEDOM TO BE ABLE TO WORK 8975 05:04:29,001 --> 05:04:31,000 AND LIVE THE LIFE THAT THEY CHOOSE? 8976 05:04:31,001 --> 05:04:32,000 BUT HERE'S HOW IT WORKS. 8977 05:04:32,001 --> 05:04:36,000 THIS ISN'T COMPLICATED. 8978 05:04:36,001 --> 05:04:39,000 THIS ISN'T SOME MYSTERIOUS PROGRAM. 8979 05:04:39,001 --> 05:04:41,000 HERE'S HOW IT WORKS: 8980 05:04:41,001 --> 05:04:42,000 INDIVIDUALS -- HERE'S HOW THEY 8981 05:04:42,001 --> 05:04:43,000 QUALIFY TO GET THESE BENEFITS. 8982 05:04:43,001 --> 05:04:45,000 THEY QUALIFY TO RECEIVE BENEFITS 8983 05:04:45,001 --> 05:04:47,000 WHEN THEY DO ABOUT THREE THINGS. 8984 05:04:47,001 --> 05:04:49,000 FIRST OF ALL, WHEN THEY NEED 8985 05:04:49,001 --> 05:04:51,000 HELP WITH CERTAIN ACTIVITIES OF DAILY LIVING. 8986 05:04:51,001 --> 05:04:53,000 WE ALL KNOW WHAT THOSE ARE. 8987 05:04:53,001 --> 05:04:55,000 THERE ARE SO MANY PEOPLE OUT 8988 05:04:55,001 --> 05:04:57,000 THERE WHO CAN WORK AND CAN 8989 05:04:57,001 --> 05:04:59,000 CONTRIBUTE IF WE JUST GIVE THEM 8990 05:04:59,001 --> 05:05:00,000 A LITTLE HELP, JUST A LITTLE BIT 8991 05:05:00,001 --> 05:05:01,000 OF HELP THAT WE'RE TALKING ABOUT 8992 05:05:01,001 --> 05:05:03,000 HERE TODAY. 8993 05:05:03,001 --> 05:05:05,000 TO DO THE BASIC THINGS IN LIFE, 8994 05:05:05,001 --> 05:05:06,000 TO BE ABLE TO WAKE UP IN THE 8995 05:05:06,001 --> 05:05:07,000 MORNING AND MAYBE HAVE SOMEONE, 8996 05:05:07,001 --> 05:05:09,000 IF YOU HAVE A DISABILITY, 8997 05:05:09,001 --> 05:05:11,000 SOMEONE HELP YOU GET READY FOR 8998 05:05:11,001 --> 05:05:13,000 WORK WHR-RBGS THAT'S GOING TO 8999 05:05:13,001 --> 05:05:15,000 THE SHOWER OR SHAVING OR 9000 05:05:15,001 --> 05:05:18,000 WHATEVER YOU HAVE TPO DO TO 9001 05:05:18,001 --> 05:05:20,000 TKPW ET READY FOR WORK IN THE -- 9002 05:05:20,001 --> 05:05:22,000 WHATEVER YOU HAVE TO DO TO GET 9003 05:05:22,001 --> 05:05:23,000 READY FOR WORK IN THE MORNING. 9004 05:05:23,001 --> 05:05:25,000 THAT'S THE FIRST THING YOU HAVE 9005 05:05:25,001 --> 05:05:27,000 TO HAVE, IS THAT NEED THAT WE 9006 05:05:27,001 --> 05:05:30,000 CAN ALL UNDERSTAND. 9007 05:05:30,001 --> 05:05:32,000 SECONDLY, THIS PERSON WOULD HAVE 9008 05:05:32,001 --> 05:05:34,000 TO PAY PREMIUMS FOR AT LEAST 9009 05:05:34,001 --> 05:05:36,000 FIVE YEARS BEFORE THEY COULD 9010 05:05:36,001 --> 05:05:38,000 BENEFIT FROM THE PROGRAM. 9011 05:05:38,001 --> 05:05:40,000 NOW, I SAID PREMIUMS. 9012 05:05:40,001 --> 05:05:41,000 I DIDN'T SAY A GOVERNMENT 9013 05:05:41,001 --> 05:05:42,000 SUBSIDY. 9014 05:05:42,001 --> 05:05:44,000 WE'RE TALKING ABOUT PREMIUMS HERE. 9015 05:05:44,001 --> 05:05:47,000 AND THIS IS A PROGRAM THAT 9016 05:05:47,001 --> 05:05:50,000 CERTAINLY HAS ITS ORIGIN IN 9017 05:05:50,001 --> 05:05:52,000 GOVERNMENT, BUT THIS ISN'T, THIS 9018 05:05:52,001 --> 05:05:54,000 ISN'T SIMILAR OR EXACTLY SIMILAR 9019 05:05:54,001 --> 05:05:55,000 TO THE CHILDREN'S HEALTH 9020 05:05:55,001 --> 05:05:57,000 INSURANCE PROGRAM, FOR EXAMPLE, 9021 05:05:57,001 --> 05:06:00,000 OR MEDICAID, WHERE IT IS A 9022 05:06:00,001 --> 05:06:02,000 GOVERNMENT PROGRAM THAT HELPS A 9023 05:06:02,001 --> 05:06:03,000 PARTICULAR PERSON, A PERSON WHO 9024 05:06:03,001 --> 05:06:07,000 HAPPENS TO HAVE A DISABITY OR 9025 05:06:07,001 --> 05:06:09,000 IS A CHILD N. THIS CASE 9026 05:06:09,001 --> 05:06:10,000 HAVE TO PAY THOSE PREMIUMS FOR 9027 05:06:10,001 --> 05:06:12,000 FIVE YEARS. 9028 05:06:12,001 --> 05:06:16,000 FIVE YEARS. 9029 05:06:16,001 --> 05:06:19,000 THIRDLY, IN ADDITION TO THE NEED 9030 05:06:19,001 --> 05:06:20,000 AND PAYING PREMIUMS, THE THIRD 9031 05:06:20,001 --> 05:06:22,000 REQUIREMENT IS THEY HAVE HAD TO 9032 05:06:22,001 --> 05:06:23,000 WORK AT LEAST 9033 05:06:23,001 --> 05:06:24,000 FIVE YEARS. 9034 05:06:24,001 --> 05:06:28,000 SO WE'RE TALKING ABOUT PEOPLE 9035 05:06:28,001 --> 05:06:30,000 WHO ARE EMPLOYED, WORKING 9036 05:06:30,001 --> 05:06:32,000 PEOPLE, WHO HAPPEN TO HAVE A DISABILITY. 9037 05:06:32,001 --> 05:06:34,000 AND THIS IS A CREATIVE PROGRAM 9038 05:06:34,001 --> 05:06:36,000 TO HELP THEM DO THAT. 9039 05:06:36,001 --> 05:06:38,000 WHY DO WE GET THE OPPOSITION WE 9040 05:06:38,001 --> 05:06:40,000 DO FROM ACROSS THE AISLE? 9041 05:06:40,001 --> 05:06:41,000 WELL, I THINK IT'S PRETTY 9042 05:06:41,001 --> 05:06:42,000 SIMPLE. 9043 05:06:42,001 --> 05:06:44,000 YOU'VE GOT A LOT OF FOLKS ACROSS 9044 05:06:44,001 --> 05:06:45,000 THE AISLE HERE WHO WANT TO KILL 9045 05:06:45,001 --> 05:06:48,000 THIS BILL. 9046 05:06:48,001 --> 05:06:51,000 SO THEY'RE GOING TO TRY TO 9047 05:06:51,001 --> 05:06:55,000 STRIKE THE CLASS ACT, WHICH IS 9048 05:06:55,001 --> 05:06:57,000 REALLY OUTRAGEOUS AND INSULTING. 9049 05:06:57,001 --> 05:06:58,000 THEY'RE GOING TO TRY TO STRIKE 9050 05:06:58,001 --> 05:06:59,000 WHATEVER THEY CAN IF THEY CAN TO 9051 05:06:59,001 --> 05:07:01,000 KILL THE BIL 9052 05:07:01,001 --> 05:07:02,000 SO THIS IS A BILL-KILLING 9053 05:07:02,001 --> 05:07:04,000 EXERCISE. 9054 05:07:04,001 --> 05:07:05,000 THIS ISN'T, YOU KNOW, A DEBATE 9055 05:07:05,001 --> 05:07:09,000 ABOUT THE FINER POINTS OF THE CLASS ACT. 9056 05:07:09,001 --> 05:07:10,000 THIS IS 9057 05:07:10,001 --> 05:07:12,000 IT'S VERY SIMPLE. 9058 05:07:12,001 --> 05:07:13,000 AND I THINK IT WILL TELL A LOT 9059 05:07:13,001 --> 05:07:15,000 ABOUT WHERE PEOPLE STAND. 9060 05:07:15,001 --> 05:07:16,000 LET ME GO INTO A COUPLE MORE 9061 05:07:16,001 --> 05:07:18,000 DETAILS. 9062 05:07:18,001 --> 05:07:20,000 I KNOW WE'RE ALMOST OUT OF TIME. 9063 05:07:20,001 --> 05:07:21,000 HERE'S WHAT HAPPENS TO THAT 9064 05:07:21,001 --> 05:07:22,000 BENEFICIARY. 9065 05:07:22,001 --> 05:07:25,000 PERSON WORKING, A PERSON WHO HAS 9066 05:07:25,001 --> 05:07:26,000 A NEED, AND A PERSON WHO HAS 9067 05:07:26,001 --> 05:07:28,000 PAID PREMIUMS. 9068 05:07:28,001 --> 05:07:31,000 THAT BENEFICIARY RECEIVES A 9069 05:07:31,001 --> 05:07:34,000 LIFETIME CASH BENEFIT BASED UPON 9070 05:07:34,001 --> 05:07:39,000 THE DEGREE OF IMPAIRMENT. 9071 05:07:39,001 --> 05:07:41,000 NOT JUST ANY OLD FORMULA HERE. 9072 05:07:41,001 --> 05:07:43,000 WE WANT TO MAKE SURE THAT THE 9073 05:07:43,001 --> 05:07:44,000 BENEFIT CORRESPONDS TO SOMEONE'S 9074 05:07:44,001 --> 05:07:46,000 IMPAIRMENT. 9075 05:07:46,001 --> 05:07:47,000 THEIR INABILITY TO DO THEIR JOB 9076 05:07:47,001 --> 05:07:49,000 OR LIVE THEIR LIFE THE WAY THEY 9077 05:07:49,001 --> 05:07:51,000 WOULD HOPE TO DO. 9078 05:07:51,001 --> 05:07:54,000 AND THE EXPECTED, EXPECTED TO 9079 05:07:54,001 --> 05:07:56,000 AVERAGE ABOUT $75 A DAY OR MORE 9080 05:07:56,001 --> 05:07:57,000 IN THE CASE OF AN INDIVIDUAL. 9081 05:07:57,001 --> 05:08:00,000 SO THAT'S WHAT WE'RE TALKING ABOUT HERE. 9082 05:08:00,001 --> 05:08:03,000 NOW WE'RE NOT TALKING ABOUT, IN 9083 05:08:03,001 --> 05:08:05,000 THIS CASE, A GOVERNMENT 9084 05:08:05,001 --> 05:08:08,000 ENTITLEMENT PROGRAM. 9085 05:08:08,001 --> 05:08:10,000 NOW, FEW PEOPLE ARE AS 9086 05:08:10,001 --> 05:08:11,000 PASSIONATELY SUPPORTIVE OF THE 9087 05:08:11,001 --> 05:08:14,000 CHILDREN'S HEALTH INSURANCE 9088 05:08:14,001 --> 05:08:16,000 PROGRAM OR MEDICAID AS I AM; OKAY? 9089 05:08:16,001 --> 05:08:18,000 I BELIEVE THAT THERE ARE 9090 05:08:18,001 --> 05:08:19,000 PROGRAMS THAT ARE FUNDED BY THE 9091 05:08:19,001 --> 05:08:21,000 GOVERNMENT, RUN BY THE 9092 05:08:21,001 --> 05:08:22,000 GOVERNMENT THAT WORK VERY WELL. 9093 05:08:22,001 --> 05:08:25,000 BUT IN THIS CASE WE'RE NOT 9094 05:08:25,001 --> 05:08:26,000 TALKING ABOUT THAT KIND OF A 9095 05:08:26,001 --> 05:08:27,000 QUESTION, OR THAT KIND OF A 9096 05:08:27,001 --> 05:08:28,000 PROGRAM. 9097 05:08:28,001 --> 05:08:31,000 WE'RE TALKING ABOUT A PROGRAM 9098 05:08:31,001 --> 05:08:33,000 THAT DOESN'T CONFER RIGHTS OR AN 9099 05:08:33,001 --> 05:08:35,000 OBLIGATION ON GOVERNMENT FUNDING. 9100 05:08:35,001 --> 05:08:38,000 NOR DOES IT AFFECT THE RECEIPT 9101 05:08:38,001 --> 05:08:41,000 OR ELIGIBILITY FOR OTHER BENEFITS. 9102 05:08:41,001 --> 05:08:43,000 THE PROGRAM STANDS ON ITS OWN 9103 05:08:43,001 --> 05:08:45,000 FINANCIAL FEET BECAUSE PEOPLE 9104 05:08:45,001 --> 05:08:47,000 ARE PAYING PREMIUMS OUT OF THEIR 9105 05:08:47,001 --> 05:08:49,000 OWN POCKET FOR FIVE YEARS TO BE 9106 05:08:49,001 --> 05:08:53,000 ABLE TO SAVE FOR THAT DAY WHEN 9107 05:08:53,001 --> 05:08:55,000 THEY HAVE A NEED BECAUSE THEY 9108 05:08:55,001 --> 05:08:59,000 HAVE SOME KIND OF DISABILITY. 9109 05:08:59,001 --> 05:09:00,000 AND IT'S SOLVENT; OKAY? SOLVENT. 9110 05:09:00,001 --> 05:09:03,000 OKAY? 9111 05:09:03,001 --> 05:09:05,000 AND IT'S A PROGRAM THAT 9112 05:09:05,001 --> 05:09:09,000 SIGN UP FOR VOLUNTARILY. 9113 05:09:09,001 --> 05:09:11,000 SO IT'S A VOLUNTARY PROGRAM. 9114 05:09:11,001 --> 05:09:16,000 SO, WHEN YOU LIN UP ALL OF THE 9115 05:09:16,001 --> 05:09:18,000 REASONS TO SUPPORT THIS PROGRAM 9116 05:09:18,001 --> 05:09:22,000 THAT SENATOR DODD, AS THE 9117 05:09:22,001 --> 05:09:24,000 CHAIRMAN OF OUR COMMITTEE, THE 9118 05:09:24,001 --> 05:09:26,000 HEALTH, EDUCATION, LABOR, 9119 05:09:26,001 --> 05:09:27,000 PENSIONS COMMITTEE, THIS SUMMER 9120 05:09:27,001 --> 05:09:29,000 WE'RE DEBATING THIS, HE CARRIED 9121 05:09:29,001 --> 05:09:30,000 THE BALL FOR SENATOR KENNEDY IN 9122 05:09:30,001 --> 05:09:32,000 THE CHAIRMANSHIP THIS SUMMER IN 9123 05:09:32,001 --> 05:09:33,000 OUR HEARINGS, BUT ALSO FOR THIS 9124 05:09:33,001 --> 05:09:35,000 PROGRAM. 9125 05:09:35,001 --> 05:09:37,000 SO I'M GRATEFUL FOR HIS LEADERSHIP. 9126 05:09:37,001 --> 05:09:39,000 ALSO GRATEFUL FOR SENATOR 9127 05:09:39,001 --> 05:09:41,000 HARKIN'S LEADERSHIP TO SUPPORT 9128 05:09:41,001 --> 05:09:44,000 THIS VOLUNTARY PROGRAM. 9129 05:09:44,001 --> 05:09:46,000 AND ALSO GRATEFUL THAT SENATOR 9130 05:09:46,001 --> 05:09:49,000 WHITEHOUSE HAS LENT HIS VOICE 9131 05:09:49,001 --> 05:09:51,000 AND HIS EXPERTISE AND HIS FOCUS 9132 05:09:51,001 --> 05:09:53,000 ON GETTING THIS PROGRAM AS PART 9133 05:09:53,001 --> 05:09:56,000 OF OUR HEALTH CARE REFORM BILL. 9134 05:09:56,001 --> 05:10:02,000 BUT IT MAKES A LOT OF SENSE. 9135 05:10:02,001 --> 05:10:03,000 IT'S SOLVENT, AND IT WILL HELP 9136 05:10:03,001 --> 05:10:05,000 JUST WANT TO WORK, 9137 05:10:05,001 --> 05:10:06,000 TO GO TO WORK EVERY DAY AND LIVE 9138 05:10:06,001 --> 05:10:09,000 A FULL LIFE. 9139 05:10:09,001 --> 05:10:11,000 AND WITH THAT, MR. PRESIDENT, I 9140 05:10:11,001 --> 05:10:13,000 WILL YIELD THE 9141 05:10:13,001 --> 05:10:15,000 MR. DODD: MR. PRESIDENT, I 9142 05:10:15,001 --> 05:10:16,000 YIELD WHATEVER TIME WE MAY HAVE, 9143 05:10:16,001 --> 05:10:17,000 HAVE LEFT HERE T 9144 05:10:17,001 --> 05:10:20,000 OF MASSACHUSETTS, WHO HAS DONE 9145 05:10:20,001 --> 05:10:21,000 AN INCREDIBLE JOB IN VERY 9146 05:10:21,001 --> 05:10:23,000 DIFFICULT CIRCUMSTANCES, 9147 05:10:23,001 --> 05:10:24,000 REPLACING OUR BELOVED FORMER 9148 05:10:24,001 --> 05:10:25,000 COLLEAGUE, TED KENNEDY FROM 9149 05:10:25,001 --> 05:10:27,000 MASSACHUSETTS. 9150 05:10:27,001 --> 05:10:28,000 AND HE'S BEEN A VALUABLE 9151 05:10:28,001 --> 05:10:30,000 CONTRIBUTION OVER THE DAYS HE'S BEEN HERE. 9152 05:10:30,001 --> 05:10:31,000 I KNOW HE'D LIKE TO SAY A FEW 9153 05:10:31,001 --> 05:10:32,000 WORDS ABOUT THIS AS WELL. 9154 05:10:32,001 --> 05:10:33,000 THE PRESIDING OFFICER: THE 9155 05:10:33,001 --> 05:10:34,000 SENATOR FROM MASSAUSETTS, 9156 05:10:34,001 --> 05:10:36,000 THERE'S THREE MINUTES LEFT. 9157 05:10:36,001 --> 05:10:38,000 MR. KIRK: THANK YOU, MR. PRESIDENT. 9158 05:10:38,001 --> 05:10:42,000 AND THANK YOU, SENATOR DODD, AND 9159 05:10:42,001 --> 05:10:44,000 ALSO SENATOR BAUCUS FOR YOUR 9160 05:10:44,001 --> 05:10:46,000 TIRELESS LEADERSHIP ON THIS 9161 05:10:46,001 --> 05:10:51,000 ENTIRE HEALTH CARE BILL. 9162 05:10:51,001 --> 05:10:52,000 JUST A WORD ABOUT THE CLASS 9163 05:10:52,001 --> 05:10:55,000 YOU'VE HEARD SENATOR DODD AND 9164 05:10:55,001 --> 05:10:58,000 OTHERS SAY THAT THIS WAS THE 9165 05:10:58,001 --> 05:11:02,000 CORE ELEMENT OF THIS HEALTH 9166 05:11:02,001 --> 05:11:04,000 REFORM BILL CHAMPIONED BY 9167 05:11:04,001 --> 05:11:05,000 SENATOR EDWARD KENNEDY. 9168 05:11:05,001 --> 05:11:09,000 I WOULD SAY IF HE WERE HERE 9169 05:11:09,001 --> 05:11:12,000 TODAY, HE WOULD SAY THIS IS NOT 9170 05:11:12,001 --> 05:11:13,000 ABOUT POLITICS. 9171 05:11:13,001 --> 05:11:17,000 THIS IS ABOUT THE CONTENT OF THE 9172 05:11:17,001 --> 05:11:19,000 CHARACTER OF OUR NATION. 9173 05:11:19,001 --> 05:11:22,000 AND HE BELIEVED, AS I DO -- AND 9174 05:11:22,001 --> 05:11:24,000 I KNOW SENATOR DODD DOES -- THIS 9175 05:11:24,001 --> 05:11:27,000 NATION IS JUDGED, OR SHOULD BE 9176 05:11:27,001 --> 05:11:30,000 JUDGED ON HOW WE TREAT THE 9177 05:11:30,001 --> 05:11:31,000 INFIRMED AND THE WEAKEST AMONG 9178 05:11:31,001 --> 05:11:35,000 US. 9179 05:11:35,001 --> 05:11:36,000 AND THIS CLASS ACT, AS WAS JUST 9180 05:11:36,001 --> 05:11:41,000 ELOQUENTLY POINTED OUT BY 9181 05:11:41,001 --> 05:11:44,000 SENATORASEY OF PENNSYLVANIA, 9182 05:11:44,001 --> 05:11:48,000 NO TAXPAYER FUNDS, FISCALLY 9183 05:11:48,001 --> 05:11:53,000 SOLVENT, AND DOES THE THINGS 9184 05:11:53,001 --> 05:11:55,000 THAT EVERYONE WOULD SAY WE MUST 9185 05:11:55,001 --> 05:11:57,000 DO, PROVIDING INDEPENDENCE, 9186 05:11:57,001 --> 05:12:02,000 SELF-RESPECT AND DIGNITY TO THE 9187 05:12:02,001 --> 05:12:03,000 INFIRMED IN OUR SOCIETY. 9188 05:12:03,001 --> 05:12:06,000 SECONDLY, KEEPING THE CAREGIVERS 9189 05:12:06,001 --> 05:12:09,000 AND THE LOVED ONES FROM CARRYING 9190 05:12:09,001 --> 05:12:11,000 THAT BURDEN ALL BY THEMSELVES, 9191 05:12:11,001 --> 05:12:13,000 AND NOT HAVING TO SACRIFICE 9192 05:12:13,001 --> 05:12:16,000 THEIR JOBS AND THEIR TIME AND 9193 05:12:16,001 --> 05:12:19,000 THEIR HEARTACHE TO BE ABLE TO 9194 05:12:19,001 --> 05:12:21,000 SHARE THEIR CHILDREN WITH THEIR, 9195 05:12:21,001 --> 05:12:22,000 WITH PERHAPS ONE OF THEIR 9196 05:12:22,001 --> 05:12:24,000 PANTS AND DIVIDING THAT FAMILY 9197 05:12:24,001 --> 05:12:26,000 IN THAT WAY. 9198 05:12:26,001 --> 05:12:29,000 THIS IS AT THE HEART OF WHAT OUR 9199 05:12:29,001 --> 05:12:32,000 COUNTRY SHOULD BE ABOUT. 9200 05:12:32,001 --> 05:12:34,000 IT'S NOT WHO WINS, THE 9201 05:12:34,001 --> 05:12:36,000 REPUBLICANS OR THE DEMOCRATS. 9202 05:12:36,001 --> 05:12:37,000 IT'S NOT A GOVERNMENT PROGRAM. 9203 05:12:37,001 --> 05:12:38,000 IT'SELF-FUNDED. 9204 05:12:38,001 --> 05:12:41,000 IT'S VOLUNTARY. 9205 05:12:41,001 --> 05:12:45,000 THERE'S NO TAXPAYER MONEY INVOLVED. 9206 05:12:45,001 --> 05:12:47,000 AND SO WHAT OTHER REASON COULD 9207 05:12:47,001 --> 05:12:50,000 THERE BE BUT POLITICS WOULD KEEP 9208 05:12:50,001 --> 05:12:53,000 PEOPLE FROM COMING TOGETHER ON THIS. 9209 05:12:53,001 --> 05:12:54,000 I URGE MY COLLEAGUES ALL ON THIS 9210 05:12:54,001 --> 05:12:57,000 SIDE AND MY REPUBLICAN 9211 05:12:57,001 --> 05:12:59,000 COLLEAGUES ON THE OTHER SIDE TO 9212 05:12:59,001 --> 05:13:00,000 THINK ABOUT THOSE FAMILIES WHO 9213 05:13:00,001 --> 05:13:02,000 ARE FACING THIS PLIGHT. 9214 05:13:02,001 --> 05:13:05,000 THEY ARE REPUBLICANS. 9215 05:13:05,001 --> 05:13:06,000 THEY ARE INDEPENDENTS, AND 9216 05:13:06,001 --> 05:13:08,000 THEY'RE DEMOCRATS FILIES AS WELL. 9217 05:13:08,001 --> 05:13:10,000 THIS IS AN AMERICAN PROGRAM FOR 9218 05:13:10,001 --> 05:13:12,000 SOME VETERANS AND OTHERS WHO 9219 05:13:12,001 --> 05:13:13,000 HAVE SACRIFICED. 9220 05:13:13,001 --> 05:13:15,000 AND I THINK THE ONLY THING WE 9221 05:13:15,001 --> 05:13:18,000 CAN DO, THE ONLY RIGHT THING WE 9222 05:13:18,001 --> 05:13:19,000 CAN DO IF THIS IS GOING TO BE A 9223 05:13:19,001 --> 05:13:21,000 REFLECTION OF THE CHARACTER OF 9224 05:13:21,001 --> 05:13:22,000 THIS NATION, IS TO SUPPORT THE 9225 05:13:22,001 --> 05:13:25,000 CLASS ACT. 9226 05:13:25,001 --> 05:13:27,000 AND I THANK SENATOR DODD ONCE AGAIN. 9227 05:13:27,001 --> 05:13:29,000 I'M PROUD TO BE STANDING AT THE 9228 05:13:29,001 --> 05:13:32,000 DESK OF SENATOR EDWARD KENNEDY, 9229 05:13:32,001 --> 05:13:34,000 WHO BELIEVED DEEPLY IN THIS, 9230 05:13:34,001 --> 05:13:36,000 STARTED WAY A LONG TIME AGO AND 9231 05:13:36,001 --> 05:13:37,000 WANTED TO SEE AFTERNOON. 9232 05:13:37,001 --> 05:13:38,000 I YIELD THE FLOOR, MR. PRESIDENT. 9233 05:13:38,001 --> 05:13:39,000 THE PRESIDING OFFICER: THE 9234 05:13:39,001 --> 05:13:43,000 TIME CONTROLLED BY THE MAJORITY 9235 05:13:43,001 --> 05:13:45,000 HAS 9236 05:13:45,001 --> 05:13:49,000 MR. DODD: MR. PRESIDENT, WHAT 9237 05:13:49,001 --> 05:13:50,000 IS THE -- OKAY. 9238 05:13:50,001 --> 05:13:51,000 I NOTE THE ABSENCE OF A 9239 05:13:51,001 --> 05:13:52,000 EQUALLY 9240 05:13:52,001 --> 05:13:57,000 THE PRESIDING OFFICER: THE 9241 05:13:57,001 --> 05:14:35,000 CLERK WILL CALL THE ROLL. 9242 05:14:35,001 --> 05:16:19,000 QUORUM CALL: 9243 05:16:19,001 --> 05:16:20,000 QUORUM CALL: 9244 05:16:20,001 --> 05:16:21,000 MR. DODD: MR. PRESIDENT, I ASK 9245 05:16:21,001 --> 05:16:23,000 UNANIMOUS CONSENT THAT THE CALL 9246 05:16:23,001 --> 05:16:24,000 OF THE QUORUM BE REAS I UNDERSTANDED. 9247 05:16:24,001 --> 05:16:25,000 THE PRESIDING OFFICER: WITHOUT 9248 05:16:25,001 --> 05:16:27,000 OBJECTION. 9249 05:16:27,001 --> 05:16:28,000 MR. DODD: I AM BEA TO PROPOUND 9250 05:16:28,001 --> 05:16:29,000 A UNANIMOUS CONSENT REQUEST. 9251 05:16:29,001 --> 05:16:31,000 MR. PRESIDENT, I ASK UNANIMOUS 9252 05:16:31,001 --> 05:16:32,000 CONSENT THAT AT 9253 05:16:32,001 --> 05:16:35,000 THE SENATE PROCEED TO VOTE IN 9254 05:16:35,001 --> 05:16:36,000 RELATION TO THE FOLLOWING 9255 05:16:36,001 --> 05:16:37,000 AMENDMENTS AND MOTION TO COMMIT 9256 05:16:37,001 --> 05:16:39,000 AS LISTED IN THIS AGREEMENT, 9257 05:16:39,001 --> 05:16:41,000 THAT NO OTHER AGREEMENT -- 9258 05:16:41,001 --> 05:16:42,000 AMENDMENTS, MOTIONS TOOMMIT, 9259 05:16:42,001 --> 05:16:45,000 OR ANY OTHER MOTION, EXCEPT A 9260 05:16:45,001 --> 05:16:47,000 MOTION TO RECONSIDER AND TABLE 9261 05:16:47,001 --> 05:16:49,000 UPON CONCLUSION OF 9262 05:16:49,001 --> 05:16:50,000 BEING IN ORDER DURING THE 9263 05:16:50,001 --> 05:16:51,000 PENDONNIVE THIS DPREAMENT. 9264 05:16:51,001 --> 05:16:53,000 FURTHER THAT PRIOR TO THE SECOND 9265 05:16:53,001 --> 05:16:54,000 AND SUCCEEDING VOTES, THERE BE 9266 05:16:54,001 --> 05:16:57,000 TWO MINUTES OF DEBATE WITH ALL 9267 05:16:57,001 --> 05:16:59,000 TIME CONTROLLED IN THE USUAL FORM 9268 05:16:59,001 --> 05:17:00,000 THAT ANY AMENDMENT OR MOTION 9269 05:17:00,001 --> 05:17:02,000 COVERED UNDER THIS AGREEMENT BE 9270 05:17:02,001 --> 05:17:04,000 SUBJECT TO AN AFFIRMATIVE 9271 05:17:04,001 --> 05:17:07,000 60-VOTE THRESHOLD, AND THAT IF 9272 05:17:07,001 --> 05:17:10,000 ANY ACHIEVE THAT THRESHOLD 9273 05:17:10,001 --> 05:17:11,000 THE AAGREED TO AND THE MOTION 9274 05:17:11,001 --> 05:17:13,000 TUBE TO RECONSIDER BE MADE AND 9275 05:17:13,001 --> 05:17:15,000 LAID ON THE ABLE THAT 9276 05:17:15,001 --> 05:17:16,000 NOT ACHIEVE THAT 60-VOTE 9277 05:17:16,001 --> 05:17:17,000 THRESHOLD HOLD, IT BE WITHDRAWN. 9278 05:17:17,001 --> 05:17:19,000 AFTER THE FIRST VOTE IN THE 9279 05:17:19,001 --> 05:17:22,000 SEQUENCE, THE SUCCEEDING VOTES 9280 05:17:22,001 --> 05:17:24,000 BE TEN MINUTES IN DURATION. 9281 05:17:24,001 --> 05:17:27,000 SENATOR WHITEHOUSE AMENDMENT RE 9282 05:17:27,001 --> 05:17:28,000 SOCIAL SECURITY, FISCAL 9283 05:17:28,001 --> 05:17:29,000 RESPONSIBILITY; THE REPUBLICAN 9284 05:17:29,001 --> 05:17:32,000 LEADER'S DESIGNEE OR THE 9285 05:17:32,001 --> 05:17:34,000 REPUBLICAN LEADER'S AMENDMENT, 9286 05:17:34,001 --> 05:17:36,000 FISCAL RESPONSIBILITY; SENATOR 9287 05:17:36,001 --> 05:17:37,000 STABENOW'S SIDE-BY-SIDE 9288 05:17:37,001 --> 05:17:40,000 AMENDMENT RE MEDICARE ADVANTAGE, 9289 05:17:40,001 --> 05:17:42,000 AND SENATOR 9290 05:17:42,001 --> 05:17:43,000 RECOMMIT MEDICARE ADVANTAGE. 9291 05:17:43,001 --> 05:17:45,000 FURTHER, ONCE THIS AGREEMENT IS 9292 05:17:45,001 --> 05:17:46,000 INTERKSD THE REPUBLICAN LEADER'S 9293 05:17:46,001 --> 05:17:48,000 DESIGNEE BE RECOGNIZED TO CALL 9294 05:17:48,001 --> 05:17:49,000 UP THE FISCAL RESPONSIBILITY 9295 05:17:49,001 --> 05:17:51,000 AMENDMENT AND THAT ONCE IT HAS 9296 05:17:51,001 --> 05:17:53,000 BEEN REPORTED BY NUMBER, SENATOR 9297 05:17:53,001 --> 05:17:55,000 STABENOW BE RECOGNIZED TO CALL 9298 05:17:55,001 --> 05:17:56,000 UP THE MEDICAL ADVANTAGE 9299 05:17:56,001 --> 05:17:58,000 SIDE-BY-SIDE AMENDMENT. 9300 05:17:58,001 --> 05:18:00,000 THAT UPON DISPOSITION OF THE 9301 05:18:00,001 --> 05:18:01,000 AMENDMENT AND THE MOTION TO THIS 9302 05:18:01,001 --> 05:18:03,000 AGREEMENT, THE NEXT TWO MATTERS 9303 05:18:03,001 --> 05:18:04,000 FOR CONSIDERATION WILL BE A 9304 05:18:04,001 --> 05:18:07,000 SENATOR LINCOLN AMENDMENT 9305 05:18:07,001 --> 05:18:08,000 REGARDING THE INSURANCE 9306 05:18:08,001 --> 05:18:10,000 EXECUTIVE COMPENSATION AND 9307 05:18:10,001 --> 05:18:11,000 REPUBLICAN LEADER'S DESIGNEE 9308 05:18:11,001 --> 05:18:12,000 MOTION TO COMMIT REGARDING HOME 9309 05:18:12,001 --> 05:18:15,000 HEALTH AGENCIES THAT. 9310 05:18:15,001 --> 05:18:17,000 FOR THE REMAINERDER OF TODAY'S 9311 05:18:17,001 --> 05:18:19,000 SESSION, NO FURTHER AMENDMENTS 9312 05:18:19,001 --> 05:18:20,000 OR MOTION TO COMMIT BE IN ORDER. 9313 05:18:20,001 --> 05:18:22,000 AT THE SAME TIME -- FOR THE SAME 9314 05:18:22,001 --> 05:18:24,000 TIME UNTIL THEN BE EQUALLY 9315 05:18:24,001 --> 05:18:25,000 DIVIDED BETWEEN THE LEADERS OR 9316 05:18:25,001 --> 05:18:27,000 THEIR DESIGNEES, WITH MEMBERS 9317 05:18:27,001 --> 05:18:29,000 PERMITTED TO SPEAK UP TO TEN 9318 05:18:29,001 --> 05:18:30,000 MINUTES EACH. THE PRESIDING OFFICER: IS 9319 05:18:30,001 --> 05:18:31,000 THERE OBJECTION? 9320 05:18:31,001 --> 05:18:33,000 MR. McCONNELL: MR. PRESIDENT, 9321 05:18:33,001 --> 05:18:37,000 RESERVING THE RIGHT TO OBJECT, 9322 05:18:37,001 --> 05:18:39,000 AND I WILL OBJECTING, 9323 05:18:39,001 --> 05:18:41,000 I SEE THE ASSISTANT MAJORITY LEADER ON THE FLOOMPLET I THINK 9324 05:18:41,001 --> 05:18:42,000 IT WOULD BE 9325 05:18:42,001 --> 05:18:46,000 THE MAJORITY LEADER OR SOMEONE 9326 05:18:46,001 --> 05:18:48,000 ON 9327 05:18:48,001 --> 05:18:50,000 WHAT POINT DURING THE DAY 9328 05:18:50,001 --> 05:18:52,000 TOMORROW AND AT WHAT POINT 9329 05:18:52,001 --> 05:18:53,000 DURING THE DAY ON SUNDAY WE 9330 05:18:53,001 --> 05:18:55,000 MIGHT BE HAVING ADDITIONAL VOTES. 9331 05:18:55,001 --> 05:18:56,000 IT MIGHT BE HELPFUL TO OUR 9332 05:18:56,001 --> 05:18:58,000 COLLEAGUES ON BOTH SIDE OF THE 9333 05:18:58,001 --> 05:19:06,000 NILE TERMS OF PLANNING FOR THE 9334 05:19:06,001 --> 05:19:09,000 WEEKEND. 9335 05:19:09,001 --> 05:19:11,000 MR. REID: MR. PRESIDENT, WEE 9336 05:19:11,001 --> 05:19:12,000 GOING TO COME IN AT 10:00 IN THE 9337 05:19:12,001 --> 05:19:14,000 MORNING. AT THIS TIME IT APPEARS THAT WE 9338 05:19:14,001 --> 05:19:15,000 WILL HAVE SENATOR LINCOLN OFFER 9339 05:19:15,001 --> 05:19:17,000 AN AMENDMENT AND WOULD HOPE 9340 05:19:17,001 --> 05:19:20,000 THAT WE CAN BE READY THAT THE 9341 05:19:20,001 --> 05:19:21,000 TIME TO HAVE WHATEVER THE 9342 05:19:21,001 --> 05:19:23,000 MINORITY WANTS TO IN REGARD TO 9343 05:19:23,001 --> 05:19:26,000 THAT AMENDMENT. 9344 05:19:26,001 --> 05:19:28,000 AND THEN WE ARE GOING TO HAVE AN 9345 05:19:28,001 --> 05:19:29,000 AMENDMENT OFFERED BY THE 9346 05:19:29,001 --> 05:19:33,000 REPUBLICANS, AND I WOULD HOPE 9347 05:19:33,001 --> 05:19:34,000 THAT WE 9348 05:19:34,001 --> 05:19:37,000 AMENDMENTS TOMORROW, MAYBE IN 9349 05:19:37,001 --> 05:19:40,000 THE EARLY AFTERNOON, BY MAYBE 9350 05:19:40,001 --> 05:19:41,000 2:00, MR. McCONNELL: SO AM I CORRECT 9351 05:19:41,001 --> 05:19:44,000 IN ASSUMING THAT THE VOTES ARE 9352 05:19:44,001 --> 05:19:45,000 MOST LIKELY GOING TO BE IN THE 9353 05:19:45,001 --> 05:19:47,000 AFTERNOON TOMORROW OR BOTH MORNING AND NIGHT? 9354 05:19:47,001 --> 05:19:48,000 MR. REID: YES, IN THE AFTERNOON. 9355 05:19:48,001 --> 05:19:49,000 I THINK WE'LL NEED SOME DEBATE 9356 05:19:49,001 --> 05:19:50,000 IN THE MORNING. 9357 05:19:50,001 --> 05:19:51,000 THEN SUNDAY MORNING, AT THE 9358 05:19:51,001 --> 05:19:53,000 REQUEST OF THE REPUBLICAN 9359 05:19:53,001 --> 05:19:55,000 LEADER, WE AREN'T GOING TO COME 9360 05:19:55,001 --> 05:19:56,000 IN UNTIL 9361 05:19:56,001 --> 05:19:57,000 MR. McCONNELL: I THINK WE'RE 9362 05:19:57,001 --> 05:20:00,000 PROBABLY GOING TO NEED SOME 9363 05:20:00,001 --> 05:20:01,000 DEBATE TIME, A 9364 05:20:01,001 --> 05:20:02,000 WELL, WE'RE HAPPY TO HAVE IT IN 9365 05:20:02,001 --> 05:20:04,000 THE AFTERNOON. 9366 05:20:04,001 --> 05:20:06,000 AND THEN ON SUNDAY, OBVIOUSLY, 9367 05:20:06,001 --> 05:20:07,000 WE WON'T GO IN UNTIL NOON ON 9368 05:20:07,001 --> 05:20:10,000 SUNDAY AND THEN 9369 05:20:10,001 --> 05:20:11,000 MR. REID: YES, THERE IS AN 9370 05:20:11,001 --> 05:20:13,000 EVENT IN WASHINGTON THAT A 9371 05:20:13,001 --> 05:20:14,000 NUMBER OF SENATORS ARE OBLIGATED 9372 05:20:14,001 --> 05:20:15,000 TO GO TO. 9373 05:20:15,001 --> 05:20:17,000 THAT'S IN THE EVENING. 9374 05:20:17,001 --> 05:20:20,000 SO WE'LL GET EVERYBODY OUT OF 9375 05:20:20,001 --> 05:20:22,000 HERE BY 6:00-6:30 THAT NIGHT AT 9376 05:20:22,001 --> 05:20:23,000 THE LATEST. 9377 05:20:23,001 --> 05:20:25,000 THE PRESIDING OFFICER: IS THERE OBJTION? 9378 05:20:25,001 --> 05:20:28,000 MR. REID: I WOULD ALSO SAY, 9379 05:20:28,001 --> 05:20:31,000 MR. PRESIDENT, THROUGH YOU TO MY FRIE, WE DEMOCRATS ARE GOING 9380 05:20:31,001 --> 05:20:33,000 TO HAVE A CAUCUS -- WE'RE 9381 05:20:33,001 --> 05:20:35,000 TTENTIVELY GOING TO HAVE ONE 9382 05:20:35,001 --> 05:20:36,000 SUNDAY AFTERNOON. 9383 05:20:36,001 --> 05:20:39,000 THE PRESIDING OFFICER: IS 9384 05:20:39,001 --> 05:20:47,000 THERE OBJ 9385 05:20:47,001 --> 05:20:52,000 WITHOUT OBJECTION, SO ORDERED. 9386 05:20:52,001 --> 05:20:53,000 MR. THUNE: THE PRESIDING OFFICER: THE 9387 05:20:53,001 --> 05:20:54,000 SENATOR FROM SOUTH 9388 05:20:54,001 --> 05:20:57,000 MR. THUNE: MR. PRESIDENT, I'D 9389 05:20:57,001 --> 05:20:58,000 LIKE TO CALL 9390 05:20:58,001 --> 05:21:10,000 AND ASK FOR ITS IMMEDIATE 9391 05:21:10,001 --> 05:21:11,000 CONSIDERATION. 9392 05:21:11,001 --> 05:21:12,000 THE PRESIDING OFFICER: THE CLERK WILL REPORT. 9393 05:21:12,001 --> 05:21:13,000 THE CLERK: THE SENATOR FROM 9394 05:21:13,001 --> 05:21:15,000 SOUTH DAKOTA, MR. THUNE, 9395 05:21:15,001 --> 05:21:18,000 PROPOSES AN AMENDMENT NUMBERED 9396 05:21:18,001 --> 05:21:21,000 2901 TO AMENDMENT NUMBERED 2786. 9397 05:21:21,001 --> 05:21:22,000 BEGINNING ON PAGE 1925, STRIKE 9398 05:21:22,001 --> 05:21:27,000 LINE 15 AND ALL THAT FOLLOWS 9399 05:21:27,001 --> 05:21:29,000 THROUGH LIN 9400 05:21:29,001 --> 05:21:30,000 MR. THUNE: 9401 05:21:30,001 --> 05:21:31,000 THE PRESIDING OFFICER: THE 9402 05:21:31,001 --> 05:21:32,000 SENATOR FROM SOUTH DAKOTA. 9403 05:21:32,001 --> 05:21:33,000 MR. THUNE: MR. PRESIDENT, I WOULD LIKE TO SPEAK TO THE 9404 05:21:33,001 --> 05:21:34,000 AMENDMENT THAT WE JUST FILED AT 9405 05:21:34,001 --> 05:21:36,000 THE DES 9406 05:21:36,001 --> 05:21:37,000 AND WHAT THIS AMENDMENT WOULD DO 9407 05:21:37,001 --> 05:21:38,000 -- IT'S VERY STRAIGHTFORWARD AND 9408 05:21:38,001 --> 05:21:39,000 VERY SIMPLE. 9409 05:21:39,001 --> 05:21:41,000 IT DOES WHAT A NUMBER OF MY 9410 05:21:41,001 --> 05:21:44,000 COLLEAGUES ON THE OTHER SIDE 9411 05:21:44,001 --> 05:21:47,000 HAVE ASKED TO DO, AND THAT IS TO 9412 05:21:47,001 --> 05:21:49,000 STRIKE THE CLASS ACT FROM THE 9413 05:21:49,001 --> 05:21:50,000 UNDERLYING HEALTH REFORM BILL -- 9414 05:21:50,001 --> 05:21:52,000 THE HEALTH CARE REFORM BILL THAT'S BEING DEBATED ON THE 9415 05:21:52,001 --> 05:21:55,000 FLOOR OF THE SENATE RIGHT KNEW. 9416 05:21:55,001 --> 05:21:58,000 AND I WANT TO READ FOR YOU SOME 9417 05:21:58,001 --> 05:21:59,000 EXCERPTS FROM A LETTER THAT 9418 05:21:59,001 --> 05:22:00,000 SEVEN DEMOCRAT SENATORS, 9419 05:22:00,001 --> 05:22:02,000 INCLUDING THE CHAIRMAN OF THE 9420 05:22:02,001 --> 05:22:05,000 SENATE BUDGET COMMITTEE, SENATOR 9421 05:22:05,001 --> 05:22:07,000 CONRAD, 9422 05:22:07,001 --> 05:22:09,000 THIS CLASS ACT NOT BE INCLUDED 9423 05:22:09,001 --> 05:22:11,000 AS PART OF THIS LEGISLATION. 9424 05:22:11,001 --> 05:22:12,000 THEY SAID THIS, "WE URGE YOU NOT 9425 05:22:12,001 --> 05:22:14,000 TO INCLUDE THESE PROVISIONS IN 9426 05:22:14,001 --> 05:22:17,000 THE SENATE'S MERGED BILL, NOR TO 9427 05:22:17,001 --> 05:22:20,000 USE THE SAVINGS AS AN OFFSET FOR 9428 05:22:20,001 --> 05:22:21,000 OTHER HEALTH ITEMS IN THE MERGER. 9429 05:22:21,001 --> 05:22:23,000 WHILE THE GOALS OF THE CLASS ACT 9430 05:22:23,001 --> 05:22:24,000 ARE LAUDABLE, FINDING A WAY TO 9431 05:22:24,001 --> 05:22:26,000 PROVIDE LONG-TERM CARE INSURANCE 9432 05:22:26,001 --> 05:22:27,000 TO INDIVIDUALS, THE EFFECT OF 9433 05:22:27,001 --> 05:22:29,000 INCLUDING THIS LEGISLATION IN 9434 05:22:29,001 --> 05:22:31,000 THE MERGED SENATE BILL WOULD NOT 9435 05:22:31,001 --> 05:22:32,000 BE FISCALLY RESPONSIBLE FOR 9436 05:22:32,001 --> 05:22:34,000 SERAL REASONS. 9437 05:22:34,001 --> 05:22:35,000 " AND IT GOES ON TO SAY THAT 9438 05:22:35,001 --> 05:22:38,000 NEARLY ALL THE SAVINGS RESULT 9439 05:22:38,001 --> 05:22:40,000 FROM THE FACT THAT THE INITIAL 9440 05:22:40,001 --> 05:22:42,000 PAYOUT OF B 9441 05:22:42,001 --> 05:22:44,000 BEGIN UNTIL 2016 EVEN THOUGH THE PROGRAM BEGINS COLLECTING 9442 05:22:44,001 --> 05:22:45,000 PREMIUMS IN 2011. 9443 05:22:45,001 --> 05:22:47,000 IT IS ALSO CLEAR THAT THE 9444 05:22:47,001 --> 05:22:49,000 LEGISLATION INCREASES THE 9445 05:22:49,001 --> 05:22:50,000 DEFICIT IN DECADES FOLLOWING THE 9446 05:22:50,001 --> 05:22:52,000 FIRST TEN YEARS." 9447 05:22:52,001 --> 05:22:54,000 THEY GO ON TO SAY HAD THIS 9448 05:22:54,001 --> 05:22:56,000 LETT, MR. PRESIDENT, "WE 9449 05:22:56,001 --> 05:22:57,000 GRAVE CONCERNS THAT THE REAL 9450 05:22:57,001 --> 05:22:59,000 EFFECT OF THE PROVISIONS WOULD 9451 05:22:59,001 --> 05:23:01,000 BE TO CREATE A NEW FEDERAL 9452 05:23:01,001 --> 05:23:03,000 ENTITLEMENT PROGRAM WITH LARGE, 9453 05:23:03,001 --> 05:23:06,000 LONG-TERM SPENDING INCREASES 9454 05:23:06,001 --> 05:23:07,000 THAT FAR EXCEED REVENUES. 9455 05:23:07,001 --> 05:23:08,000 THIS IS ESPECIALLY THE CASE IF 9456 05:23:08,001 --> 05:23:11,000 SAVINGS FROM THE FIRST DECADE OF 9457 05:23:11,001 --> 05:23:12,000 THE PROGRAM 9458 05:23:12,001 --> 05:23:14,000 HEALTH REFORM PRIORITIES." 9459 05:23:14,001 --> 05:23:16,000 THAT, MR. PRESIDENT, IS A LETTER 9460 05:23:16,001 --> 05:23:17,000 THAT WAS SIGNED BY THE CHAIRMAN 9461 05:23:17,001 --> 05:23:20,000 OFHE SENATE BUDGET COMMITTEE, 9462 05:23:20,001 --> 05:23:22,000 SENATOR CONRAD FROM NORTH 9463 05:23:22,001 --> 05:23:24,000 DAKOTA, SENATOR LIEBERMAN, 9464 05:23:24,001 --> 05:23:26,000 SENATOR LANDRIEU, SENATOR 9465 05:23:26,001 --> 05:23:29,000 LINCOLN, SENATOR WARNER, SENATOR 9466 05:23:29,001 --> 05:23:30,000 NELSON, AND SENATOR BAYH. 9467 05:23:30,001 --> 05:23:32,000 SEVEN DEMOCRAT SENATORS WHO HAVE 9468 05:23:32,001 --> 05:23:34,000 GO ON THE RECORD SAYING THE 9469 05:23:34,001 --> 05:23:36,000 CLASS ACT SHOULDN'T BE INCLUDED 9470 05:23:36,001 --> 05:23:37,000 IN THIS LEGISLATION BECAUSE IT'S 9471 05:23:37,001 --> 05:23:39,000 NOT 9472 05:23:39,001 --> 05:23:40,000 THE FACT OF THE MATTER IS, 9473 05:23:40,001 --> 05:23:42,000 MR. PRESIDENT, THE SENATE -- THE 9474 05:23:42,001 --> 05:23:43,000 CHAIRMAN OF THE 9475 05:23:43,001 --> 05:23:46,000 COMMITTEE, SENATOR CONRAD, HAS 9476 05:23:46,001 --> 05:23:51,000 GONE ON TO SAY AND DESCRIBE THIS 9477 05:23:51,001 --> 05:23:53,000 AS A PONZI SCHEME OF THE FIRST 9478 05:23:53,001 --> 05:23:56,000 ORDER, SOMETHING 9479 05:23:56,001 --> 05:23:58,000 MADOFF WOULD BE PROUD OF. I'VE MY COLLEAGUES ON THE OTHER 9480 05:23:58,001 --> 05:23:59,000 SIDE GET UP AND TALK ABOUT HOW 9481 05:23:59,001 --> 05:24:00,000 SOLVENT THIS IS AND WHAT GREAT 9482 05:24:00,001 --> 05:24:01,000 PROGRAM THIS IS. 9483 05:24:01,001 --> 05:24:02,000 WELL, ERE ARE PROGRAMS OUT 9484 05:24:02,001 --> 05:24:05,000 THERE THAT ARE AVAILABLE FOR 9485 05:24:05,001 --> 05:24:08,000 PEOPLE TO BUY LONG-TERM CARE INSURANCE. 9486 05:24:08,001 --> 05:24:09,000 THE PROBLEM 9487 05:24:09,001 --> 05:24:12,000 TAKES ALL THE MONEY THAT COMES 9488 05:24:12,001 --> 05:24:14,000 IN IN THE EARLY YRS AND SPENDS 9489 05:24:14,001 --> 05:24:16,000 IT ON OTHER GOVERNMENT PROGRAMS, 9490 05:24:16,001 --> 05:24:17,000 IN THIS CASE HEALTH CARE REFORM, 9491 05:24:17,001 --> 05:24:18,000 BUT WHO KNOWS WHAT OTHER 9492 05:24:18,001 --> 05:24:21,000 GOVERNMENT PROGRAMS RADIO GOING 9493 05:24:21,001 --> 05:24:22,000 TO BE CREATED THAT OTHER GOVERNMENT PROGRAMS ARE 9494 05:24:22,001 --> 05:24:24,000 GOING TO BE CREATED THAT 9495 05:24:24,001 --> 05:24:25,000 USE THE REVENUE FROM THIS PLAN 9496 05:24:25,001 --> 05:24:27,000 THAT SUPPOSEDLY A LOT OF PEOPLE 9497 05:24:27,001 --> 05:24:29,000 ARE GOING TO SIGN UP FOR. 9498 05:24:29,001 --> 05:24:30,000 C.B.O. SAYS THAT FEWER 9499 05:24:30,001 --> 05:24:32,000 OF PEOPLE WILL ACTUALLY SIGN UP FOR IT. 9500 05:24:32,001 --> 05:24:33,000 IN FACT, NO SENIOR TODAY IS 9501 05:24:33,001 --> 05:24:35,000 GOING TO BENEFIT FROM IT BECAUSE 9502 05:24:35,001 --> 05:24:36,000 YOU HAVE TO WORK FOR FIVE YEARS. 9503 05:24:36,001 --> 05:24:37,000 IF YOU ARE A SENIOR WHO IS 9504 05:24:37,001 --> 05:24:39,000 RETIRED, YOU ARE NOT GOING TO 9505 05:24:39,001 --> 05:24:41,000 SEE ANY BENEFIT FROM THIS. 9506 05:24:41,001 --> 05:24:42,000 THIS DOESN'T IMPACT SENIORS, 9507 05:24:42,001 --> 05:24:44,000 CONTRARY TO THE ASSERTIONS OF 9508 05:24:44,001 --> 05:24:45,000 SOME OF MY COLLEAGUES ON THE 9509 05:24:45,001 --> 05:24:47,000 OTHER SIEVMENTD WHO IT WILL 9510 05:24:47,001 --> 05:24:48,000 IMPACT ARE FUTURE GENERATIONS OF 9511 05:24:48,001 --> 05:24:49,000 AMERICANS WHO ARE GOING TO BE 9512 05:24:49,001 --> 05:24:54,000 STUCK WITH THE DEFICITS AND THE 9513 05:24:54,001 --> 05:24:55,000 DEBT THAT GETS PILED ON THEM 9514 05:24:55,001 --> 05:24:57,000 LIABILITY IS INCURRED, PEOPLE 9515 05:24:57,001 --> 05:25:00,000 START GETTING PAI 9516 05:25:00,001 --> 05:25:02,000 HAVING PAID IN, THERE'S NO MONEY THERE. 9517 05:25:02,001 --> 05:25:04,000 IT IS -- IT IS A CLASSIC 9518 05:25:04,001 --> 05:25:06,000 DEFINITION OF A PONZI SCHEME. 9519 05:25:06,001 --> 05:25:09,000 THE MONEY COMES IN TODAY, GETS 9520 05:25:09,001 --> 05:25:11,000 SPENT ON OTHER THINGS, AND 9521 05:25:11,001 --> 05:25:12,000 SOMEDAY WHEN THE LIABILITY COMES 9522 05:25:12,001 --> 05:25:14,000 IN AND PEOPLE START SAYING, OH, 9523 05:25:14,001 --> 05:25:16,000 I PAID INTO THIS PROGRAM; I 9524 05:25:16,001 --> 05:25:17,000 SHOULD GET SOME BENEFIT, THERE'S 9525 05:25:17,001 --> 05:25:18,000 GOING TO BE NO MON THERE. 9526 05:25:18,001 --> 05:25:21,000 SO WE'RE GOING TOO BORROW FOR IT 9527 05:25:21,001 --> 05:25:23,000 OR TAX FOR IT OR SOMETHING ELSE. 9528 05:25:23,001 --> 05:25:26,000 BUT BECAUSE THEY SAY -- THEY SAY 9529 05:25:26,001 --> 05:25:28,000 WE'LL TAX YOU OVER 75 YEARS, 9530 05:25:28,001 --> 05:25:29,000 WELL, MAYBE BECAUSE YOU'RE 9531 05:25:29,001 --> 05:25:31,000 RUNNING SURPLUSES IN THE EARLY 9532 05:25:31,001 --> 05:25:32,000 YEARS BUT IN THE LATER YEARS 9533 05:25:32,001 --> 05:25:34,000 YOU'RE RUNNING HUGE OF THE DEFICITS. 9534 05:25:34,001 --> 05:25:35,000 IN THE EARLY YEAR, THE SURPLUSES 9535 05:25:35,001 --> 05:25:37,000 REASONABLE CARE SPENT. 9536 05:25:37,001 --> 05:25:39,000 PAYING BENEFITS OUT FOR THIS 9537 05:25:39,001 --> 05:25:40,000 PROGRAM WHEN THE BENEFITS START 9538 05:25:40,001 --> 05:25:42,000 BEING DEMAND BY THE PEOPLE WHO 9539 05:25:42,001 --> 05:25:44,000 PARTICIPATED IN THE PROGRAM. 9540 05:25:44,001 --> 05:25:45,000 BUT JUST LOOK WHAT THE OTHERS 9541 05:25:45,001 --> 05:25:46,000 HAVE SAID ABOUT THIS PROGRAM, 9542 05:25:46,001 --> 05:25:49,000 MR. PRESIDENT. 9543 05:25:49,001 --> 05:25:50,000 I'M -- I QUOTED FOR YOU WHAT THE CHAIRMAN OF THE BUDGET 9544 05:25:50,001 --> 05:25:52,000 COMMITTEE, SENATOR CONRAD, SAID 9545 05:25:52,001 --> 05:25:54,000 WITH REGARD TO THIS PROGRAM. 9546 05:25:54,001 --> 05:25:55,000 THAT IT 9547 05:25:55,001 --> 05:25:58,000 FIRST ORDER. 9548 05:25:58,001 --> 05:26:03,000 BUT THAT IS BEING ECHOED BY OTHERS. 9549 05:26:03,001 --> 05:26:04,000 THIS IS WHAT THE CHIEF ACTUARY 9550 05:26:04,001 --> 05:26:05,000 IN THE ADMINISTRATION -- THE 9551 05:26:05,001 --> 05:26:06,000 ADMINISTRATION'S CHIEF ACTUARY 9552 05:26:06,001 --> 05:26:08,000 SAID ABOUT THE CLASS ACT. 9553 05:26:08,001 --> 05:26:10,000 SAID IT WOULD RESULT IN A NET 9554 05:26:10,001 --> 05:26:11,000 FEDERAL COST IN THE LONGER TERM. 9555 05:26:11,001 --> 05:26:14,000 THE CHIEF ACTUARY ALSO 9556 05:26:14,001 --> 05:26:16,000 DETERMINED THE PROGRAM FACES A 9557 05:26:16,001 --> 05:26:17,000 SIGNIFICANT RISK OF FAILURE 9558 05:26:17,001 --> 05:26:19,000 BECAUSE THE HIGH COST WILL 9559 05:26:19,001 --> 05:26:22,000 ATTRACT SICKER PEOPLAND LEAD 9560 05:26:22,001 --> 05:26:23,000 TO LOW P 9561 05:26:23,001 --> 05:26:25,000 THE CONGRESSIONAL BUDGET OFFICE 9562 05:26:25,001 --> 05:26:26,000 AGREED, SAYING THE CLASS PROGRAM 9563 05:26:26,001 --> 05:26:28,000 INCLUDED IN THE BILL WOULD 9564 05:26:28,001 --> 05:26:29,000 GENERATE NET RECEIPTS FOR THE 9565 05:26:29,001 --> 05:26:31,000 PROGRAM IN THE INITIAL YEARS 9566 05:26:31,001 --> 05:26:32,000 WHEN TOTAL PREMIUMS WOULD EXCEED 9567 05:26:32,001 --> 05:26:35,000 TOTAL BENEFIT PAYMENTS BUT IT 9568 05:26:35,001 --> 05:26:37,000 WOULD EVENTUALLY LEAD TO NET 9569 05:26:37,001 --> 05:26:39,000 OUTLAYS WHEN BENEFITS EXCEED PREMIUMS. 9570 05:26:39,001 --> 05:26:42,000 IN THE DECADE FOLLOWING 2029, 9571 05:26:42,001 --> 05:26:44,000 THE CLASS PROGRAM WOULD BEGIN TO 9572 05:26:44,001 --> 05:26:48,000 INCREASE BUDGET DEFICITS. 9573 05:26:48,001 --> 05:26:50,000 NOW, THIS PARTICULAR QUOTE COULD 9574 05:26:50,001 --> 05:26:52,000 BECAUSE THIS COMES 9575 05:26:52,001 --> 05:26:53,000 C.B.O. OR THE C.M.S. ACTUARY, 9576 05:26:53,001 --> 05:26:56,000 BUT IT COMES FROM "THE 9577 05:26:56,001 --> 05:26:57,000 WASHINGTON POST." 9578 05:26:57,001 --> 05:27:03,000 "THE WASHINGTON POST" CALLED THE 9579 05:27:03,001 --> 05:27:05,000 CLASS ACT "A GIMMICK DESIGNED TO 9580 05:27:05,001 --> 05:27:07,000 FULLY PAID FOR." 9581 05:27:07,001 --> 05:27:08,000 THE "POST" G.N.P. GOES ON TO 9582 05:27:08,001 --> 05:27:10,000 SAY, MR. PRESIDENT, THAT THE 9583 05:27:10,001 --> 05:27:12,000 MONEY THAT FLOWS IN DURING THE 9584 05:27:12,001 --> 05:27:13,000 TEN-YEAR BUDGET WINDOW WILL FLOW 9585 05:27:13,001 --> 05:27:16,000 BACK OUT AGAIN. 9586 05:27:16,001 --> 05:27:17,000 "THESE ARE NOT SAVINGS THAT CAN 9587 05:27:17,001 --> 05:27:21,000 HONESTLY BE COUNTED ON THE 9588 05:27:21,001 --> 05:27:22,000 BALANCE SHEET OF 9589 05:27:22,001 --> 05:27:23,000 EVEN "THE WASHINGTON POST" 9590 05:27:23,001 --> 05:27:25,000 RECOGNIZES THIS FOR WHAT IT IS. 9591 05:27:25,001 --> 05:27:26,000 IT IS A SHAM. 9592 05:27:26,001 --> 05:27:27,000 THIS IS A BUDGET GIMMICK, 9593 05:27:27,001 --> 05:27:29,000 MR. 9594 05:27:29,001 --> 05:27:31,000 TO OBSCURE THE COST OF THIS 9595 05:27:31,001 --> 05:27:34,000 PROGRAM BY GEN 9596 05:27:34,001 --> 05:27:36,000 IN THE EARLY YEARS. 9597 05:27:36,001 --> 05:27:38,000 $72 BILLION IT'S SUPPOSED TO 9598 05:27:38,001 --> 05:27:40,000 GENERATE IN THE FIRST TEN-YEAR WINDOW 9599 05:27:40,001 --> 05:27:41,000 SO THAT COUNTS ON THE BALANCE 9600 05:27:41,001 --> 05:27:42,000 SHEET OF HEALTH CARE REFORM TO 9601 05:27:42,001 --> 05:27:45,000 KE IT LOOK BETTER. 9602 05:27:45,001 --> 05:27:46,000 BUT THIS PROGRAM IS GOIN 9603 05:27:46,001 --> 05:27:47,000 DEFICITS -- DEFICITS, AS FAR AS 9604 05:27:47,001 --> 05:27:49,000 THE EYE CAN SEE. 9605 05:27:49,001 --> 05:27:50,000 ONCE THE CHICKENS COME HOME TO ROOST. 9606 05:27:50,001 --> 05:27:52,000 AND WHO IS GOING TO PAY THE BILL 9607 05:27:52,001 --> 05:27:54,000 FOR THAT? 9608 05:27:54,001 --> 05:27:57,000 FUTURE GENERATIONS OF AMERICANS. 9609 05:27:57,001 --> 05:27:58,000 MR. PRESIDENT, THIS IS NOT GOOD 9610 05:27:58,001 --> 05:27:59,000 POLICY. 9611 05:27:59,001 --> 05:28:00,000 CERTAINLY, IF YOU LOOK AT 9612 05:28:00,001 --> 05:28:01,000 PROGRAMS THAT WE ALREADY HAVE ON 9613 05:28:01,001 --> 05:28:04,000 THE BOOKS, MEDICARE IS DESTINED 9614 05:28:04,001 --> 05:28:06,000 TO BE BANKRUPT IN THE YEAR 2017. 9615 05:28:06,001 --> 05:28:09,000 WE GOT BIG PROBLEMS DOWN THE 9616 05:28:09,001 --> 05:28:10,000 ROAD, UNFUNDED LIABILITIES IN 9617 05:28:10,001 --> 05:28:12,000 SOCIAL SECURITY. 9618 05:28:12,001 --> 05:28:14,000 WHAT THIS WOULD DO 9619 05:28:14,001 --> 05:28:16,000 HUGE NEW LIABILITY DOWN THE ROAD 9620 05:28:16,001 --> 05:28:17,000 THAT WOULD BE UNFUNDED BECAUSE 9621 05:28:17,001 --> 05:28:21,000 ALL THE MONEY THAT COMES IN IN 9622 05:28:21,001 --> 05:28:26,000 THE EARLY YEARS IS GOING TO BE SPENT. 9623 05:28:26,001 --> 05:28:28,000 THIS IS MORE OF BUSINESS-AS-USUAL IN WASHINGTON, 9624 05:28:28,001 --> 05:28:29,000 D.C., THAT THE AMERICAN PEOPLE 9625 05:28:29,001 --> 05:28:31,000 ARE FED UP WITH. 9626 05:28:31,001 --> 05:28:32,000 WE CAN MAKE PEOPLE HAPPY TODAY 9627 05:28:32,001 --> 05:28:35,000 BY SAYING WE'RE CREATING THIS 9628 05:28:35,001 --> 05:28:36,000 NEW PROGRAM 9629 05:28:36,001 --> 05:28:39,000 MAJORITY'S HEALTH CARE REFORM 9630 05:28:39,001 --> 05:28:41,000 BILL LOOK BETTER BECAUSE IT 9631 05:28:41,001 --> 05:28:43,000 OBSCURES THE REAL COST 9632 05:28:43,001 --> 05:28:45,000 THING BY ROLLING IN THESE 9633 05:28:45,001 --> 05:28:47,000 REVENUES IN THE EARLY YEARS, BUT 9634 05:28:47,001 --> 05:28:50,000 THE LONG-TERM IMPACT, ACCORDING 9635 05:28:50,001 --> 05:28:52,000 TO THE C.B.O., ACCORDING TO THE 9636 05:28:52,001 --> 05:28:54,000 ACTUARY AT HEALTH AND HUMAN 9637 05:28:54,001 --> 05:28:55,000 SERVICES, ACCORDING TO A LOT OF 9638 05:28:55,001 --> 05:28:56,000 OUR COLLEAGUES ON THE OTHER SIDE 9639 05:28:56,001 --> 05:28:57,000 -- SEVEN DEMOCRATS WHO SIGNED A 9640 05:28:57,001 --> 05:28:59,000 LETTER, INCLUDING THE CHAIRMAN 9641 05:28:59,001 --> 05:29:01,000 OF THE BUDGET COMMIEE, WHO, AS 9642 05:29:01,001 --> 05:29:03,000 I SAID, HAS CALLED THIS PROGRAM 9643 05:29:03,001 --> 05:29:04,000 A PONZI SCHEME OF THE FIRST 9644 05:29:04,001 --> 05:29:06,000 ORDER, SOMETHING THAT WOULD MAKE 9645 05:29:06,001 --> 05:29:08,000 BERNIE 9646 05:29:08,001 --> 05:29:09,000 NOW, I DON'T KNOW HOW MY 9647 05:29:09,001 --> 05:29:10,000 COLLEAGUES ON THE OTHER SIDE 9648 05:29:10,001 --> 05:29:12,000 WITH A STRAIGHT FACE COULD COME 9649 05:29:12,001 --> 05:29:14,000 OVER HERE AND SAY, WELL, THIS IS 9650 05:29:14,001 --> 05:29:16,000 A REALLY GREAT PROGRAM. 9651 05:29:16,001 --> 05:29:18,000 IT IS ACTUARIALLY SOUND. 9652 05:29:18,001 --> 05:29:19,000 AND SURE IT MAY BE OF BENEFIT TO 9653 05:29:19,001 --> 05:29:21,000 A FEW PEOPLE. 9654 05:29:21,001 --> 05:29:23,000 BUT I GOT TO TICIALTION 9655 05:29:23,001 --> 05:29:24,000 SOMEWHERE DOWN THE ROAD WHEN THE 9656 05:29:24,001 --> 05:29:25,000 CHICKENS COME TO ROOST, THERE IS 9657 05:29:25,001 --> 05:29:30,000 GOING TO A HUGE LIABILITY THAT 9658 05:29:30,001 --> 05:29:33,000 WILL BE FACING FUTURE TMTIO TAXPAYERS, 9659 05:29:33,001 --> 05:29:34,000 FUTURE 9660 05:29:34,001 --> 05:29:36,000 AS WE PILE UP MORE DEBT AS A 9661 05:29:36,001 --> 05:29:39,000 RESULT OF THIS PONZI SCEESM THAT IS SHAM, MR. PRESIDENT. 9662 05:29:39,001 --> 05:29:40,000 I HOPE THAT MY COLLEAGUES WILL 9663 05:29:40,001 --> 05:29:41,000 SUPPORT THIS AMENDMENT. 9664 05:29:41,001 --> 05:29:44,000 IT WOULD STRIKE THE CLASS ACT 9665 05:29:44,001 --> 05:29:46,000 FROM THE UNDERLYING BILL, NOT 9666 05:29:46,001 --> 05:29:48,000 ALLOW THOSE REVENUES TO BE 9667 05:29:48,001 --> 05:29:49,000 ASSUMED IN PAYING FOR OR 9668 05:29:49,001 --> 05:29:51,000 UNDERSTATING THE COST OF THIS 9669 05:29:51,001 --> 05:29:52,000 BILL AND NOT PILE MOUNTAINS OF 9670 05:29:52,001 --> 05:29:53,000 DEBT ON FUTURE GENERATIONS. 9671 05:29:53,001 --> 05:29:57,000 MR. PRESIDENT, I RESERVE THE 9672 05:29:57,001 --> 05:29:58,000 BALANCE OF MY TIME. 9673 05:29:58,001 --> 05:29:59,000 MR. DODD: MR. PRESIDENT, HOW 9674 05:29:59,001 --> 05:30:00,000 MUCH TIME REMAINS? 9675 05:30:00,001 --> 05:30:01,000 THE PRESIDING OFFICER: THE 9676 05:30:01,001 --> 05:30:02,000 SENATOR FROM CONNECTICUT. 9677 05:30:02,001 --> 05:30:04,000 19 MINUTES. 9678 05:30:04,001 --> 05:30:06,000 REPUBLICAN SIDE, 10 1/2. 9679 05:30:06,001 --> 05:30:08,000 MR. DODD: I SEE MY COLLEAGUE FROM MNESOTA. 9680 05:30:08,001 --> 05:30:12,000 DOES HE WISH TO BE HEARD? 9681 05:30:12,001 --> 05:30:18,000 HOW MUCH TIME DOES MY COLLEAGUE 9682 05:30:18,001 --> 05:30:20,000 NEED? 9683 05:30:20,001 --> 05:30:21,000 MR. FRANKEN: THANK YOU, SENATOR 9684 05:30:21,001 --> 05:30:22,000 DODD. 9685 05:30:22,001 --> 05:30:25,000 I NEED THREE MINUTES. 9686 05:30:25,001 --> 05:30:26,000 MR. DODD: TAKE FOUR. 9687 05:30:26,001 --> 05:30:29,000 MR. FRANKEN: I'LL TAKE IT. 9688 05:30:29,001 --> 05:30:30,000 MR. PRESIDENT, I RISE TODAY TO 9689 05:30:30,001 --> 05:30:33,000 ASK UNANIMOUS CONSENT TO BE 9690 05:30:33,001 --> 05:30:35,000 ADDED AS A COSPONSOR TO SENATOR 9691 05:30:35,001 --> 05:30:37,000 COBURN TOFS AMENDMENT NUMBER 9692 05:30:37,001 --> 05:30:39,000 2789 TO REQUIRE ALL MEMBERS OF 9693 05:30:39,001 --> 05:30:41,000 CONGRESS TO ENROLL IN THE PUBLIC OPTION. 9694 05:30:41,001 --> 05:30:42,000 I'M PLEASED TO COSPONSOR THIS 9695 05:30:42,001 --> 05:30:44,000 AMENDMENT BECAUSE I STRONGLY 9696 05:30:44,001 --> 05:30:47,000 SUPPORT THE PUBLIC OPTION, AND I 9697 05:30:47,001 --> 05:30:48,000 WILL HAVE NO QUALMS AT ALL 9698 05:30:48,001 --> 05:30:50,000 ENROLLING IN THIS PLAN. 9699 05:30:50,001 --> 05:30:51,000 YOU KNOW, THERE'S A LOT OF 9700 05:30:51,001 --> 05:30:52,000 MISINFORMATION ABOUT THE PUBLIC 9701 05:30:52,001 --> 05:30:56,000 OPTION, SO I WANT TO BE CLEAR 9702 05:30:56,001 --> 05:30:57,000 ABOUT WHY WEEED A PUBLIC 9703 05:30:57,001 --> 05:31:00,000 OPTION AND WHY I WOULD BE PROUD 9704 05:31:00,001 --> 05:31:02,000 TO ENROLL IN A PUBLIC HEALTH 9705 05:31:02,001 --> 05:31:04,000 INSURANCE PLAN. 9706 05:31:04,001 --> 05:31:06,000 WE NEED A PUBLIC OPTION BECAUSE 9707 05:31:06,001 --> 05:31:09,000 HEALTH INSURANCE PREMIUMS FOR 9708 05:31:09,001 --> 05:31:21,000 MINNESOTA RESIDENTS HAVE RISEN 9709 05:31:21,001 --> 05:31:22,000 90% SINCE 2000, BECAUSE 440,000 9710 05:31:22,001 --> 05:31:25,000 MINNESOTANS WENT WITHOUT HEALTH 9711 05:31:25,001 --> 05:31:30,000 INSURANCE IN 1998. 9712 05:31:30,001 --> 05:31:31,000 WE NEED A PUBLIC OPTION BECAUSE 9713 05:31:31,001 --> 05:31:34,000 INSURANCE EXECUTIVES CONTINUE TO 9714 05:31:34,001 --> 05:31:39,000 MAKE BLOATED, OBSCENE SALARIES 9715 05:31:39,001 --> 05:31:42,000 TPR-FPLT -- SALARIES. 9716 05:31:42,001 --> 05:31:43,000 FROM TWROU-2007 AMERICANS SAW 9717 05:31:43,001 --> 05:31:48,000 PREMIUMS DOU 9718 05:31:48,001 --> 05:31:49,000 DURING THAT SAME TIME WE SAW 9719 05:31:49,001 --> 05:31:51,000 AMERICANS BECOME UNINSURED. 9720 05:31:51,001 --> 05:31:55,000 DURING THAT SAME PERIOD 9721 05:31:55,001 --> 05:31:57,000 INSURANCE COMPANY PROFITS ROSE 428%. 9722 05:31:57,001 --> 05:31:59,000 428% IN EIGHT YEARS. 9723 05:31:59,001 --> 05:32:01,000 THEY'RE MAKING OUTRAGEOUS 9724 05:32:01,001 --> 05:32:03,000 PROFITS BY GOUGING AMERICAN 9725 05:32:03,001 --> 05:32:05,000 FAMILIES, AND THAT'S WHY WE NEED 9726 05:32:05,001 --> 05:32:09,000 A PUBLIC OPTION. 9727 05:32:09,001 --> 05:32:10,000 THE PUBLIC OPTION WILL OFFER 9728 05:32:10,001 --> 05:32:11,000 AFFORDABLE PREMIUMS AND A 9729 05:32:11,001 --> 05:32:13,000 COMPREHENSIVE BENEFITS PACKAGE 9730 05:32:13,001 --> 05:32:14,000 FOR AMERICANS STRUGGLING WITH 9731 05:32:14,001 --> 05:32:16,000 THEIR HEALTH CARE COSTS. 9732 05:32:16,001 --> 05:32:17,000 IT'S GOING TO PROVIDE THE KIND 9733 05:32:17,001 --> 05:32:19,000 OF COVERAGE THAT AMERICANS NEED 9734 05:32:19,001 --> 05:32:21,000 TO BE HEALTHY. 9735 05:32:21,001 --> 05:32:24,000 THE PUBLIC OPTION WILL FOSTER A 9736 05:32:24,001 --> 05:32:27,000 A COMPETITION AMONG PRIVATE 9737 05:32:27,001 --> 05:32:31,000 HEALTH INSURANCE COMPANIES AND 9738 05:32:31,001 --> 05:32:32,000 LOWER LONG-TERM COSTS FOR 9739 05:32:32,001 --> 05:32:33,000 MINNESOTANS AND FAMILIES ACROSS 9740 05:32:33,001 --> 05:32:34,000 THE COUNTRY. 9741 05:32:34,001 --> 05:32:36,000 AND THERE I NO COST FOR THE 9742 05:32:36,001 --> 05:32:39,000 PUBLIC OPTION TO THE TREASURY. 9743 05:32:39,001 --> 05:32:40,000 IN FACT, C.B.O. ESTIMATES IT 9744 05:32:40,001 --> 05:32:43,000 SAVES $3 BILLION. 9745 05:32:43,001 --> 05:32:44,000 IT'S A WIN-WIN SITUATION. 9746 05:32:44,001 --> 05:32:46,000 IT'S IMPORTANT TO REMBER THAT 9747 05:32:46,001 --> 05:32:48,000 THE PUBLIC OPTION DOESN'T MEAN THAT PRIVATE HEALTH INSURANCE 9748 05:32:48,001 --> 05:32:51,000 GOES AWAY. 9749 05:32:51,001 --> 05:32:54,000 IN FACT, AFTER HEALTH REFORM, 9750 05:32:54,001 --> 05:32:56,000 188 MILLION AMERICANS WILL HAVE 9751 05:32:56,001 --> 05:32:59,000 COVERAGE THROUGH A PRIVATE INSURER. 9752 05:32:59,001 --> 05:33:01,000 ONLY 2% OF THE OVERALL INSURED 9753 05:33:01,001 --> 05:33:03,000 POPULATION IS PROJECTED TO 9754 05:33:03,001 --> 05:33:08,000 ENROLL IN THEUBLIC OPTION. 9755 05:33:08,001 --> 05:33:09,000 THIS IS JUST ANOTHER OPTION THAT 9756 05:33:09,001 --> 05:33:11,000 YOU'LL HAVE. 9757 05:33:11,001 --> 05:33:17,000 IT 9758 05:33:17,001 --> 05:33:19,000 BECAUSE THAT'S WHAT THE BILL IS 9759 05:33:19,001 --> 05:33:20,000 ABOUT. 9760 05:33:20,001 --> 05:33:24,000 A SENATOR: WOULD THE SENATOR 9761 05:33:24,001 --> 05:33:25,000 FROM MINNESOTA YIELD? 9762 05:33:25,001 --> 05:33:26,000 MR. FRANKEN:ABSOLUTELY. 9763 05:33:26,001 --> 05:33:28,000 PWR-PB PWREUPB KNOW YOU JOINED 9764 05:33:28,001 --> 05:33:30,000 TO PUSH THIS AMENDMENT -- 9765 05:33:30,001 --> 05:33:32,000 MR. BROWN: I 9766 05:33:32,001 --> 05:33:34,000 MEMBERS GO ON THE PUBLIC OPTION 9767 05:33:34,001 --> 05:33:35,000 PARTLY TO SHOW THAT WE BELIEVE 9768 05:33:35,001 --> 05:33:36,000 IN IT. 9769 05:33:36,001 --> 05:33:38,000 IT'S A LITTLE CURIOUS THAT TWO 9770 05:33:38,001 --> 05:33:41,000 OF THE SPONSORS AT LEAST -- 9771 05:33:41,001 --> 05:33:43,000 SENATOR COBURN, SENATOR VITTER 9772 05:33:43,001 --> 05:33:44,000 AND SOME OTHERS -- ARE SO MUCH 9773 05:33:44,001 --> 05:33:45,000 AGAINST THE PUBLIC OPTION BUT 9774 05:33:45,001 --> 05:33:47,000 THEY WANT TO PAS THIS AMENDMENT. 9775 05:33:47,001 --> 05:33:50,000 IT SOUNDS TO ME 9776 05:33:50,001 --> 05:33:52,000 SERIOUS ABOUT GOING ON IT AS I 9777 05:33:52,001 --> 05:33:55,000 AM. 9778 05:33:55,001 --> 05:33:57,000 MR. FRANKEN:I TALKED TO MY FRANIE. 9779 05:33:57,001 --> 05:33:59,000 WE'VE BEEN MARRIED 34 YEARS NOW. 9780 05:33:59,001 --> 05:34:01,000 I SAID IF THIS PASSES, WE SHOULD 9781 05:34:01,001 --> 05:34:02,000 DO THE PUBLIC OPTION. 9782 05:34:02,001 --> 05:34:04,000 SHE SAID ABSOLUTELY. 9783 05:34:04,001 --> 05:34:05,000 SO, YEAH, I'M PERFECTLY SERIOUS 9784 05:34:05,001 --> 05:34:06,000 ABOUT THIS. 9785 05:34:06,001 --> 05:34:08,000 THE PRESIDING OFFICER: THE SENATOR FROM MINNESOTA HAS 9786 05:34:08,001 --> 05:34:11,000 CONSUMED THE FOUR MINUTES 9787 05:34:11,001 --> 05:34:12,000 ALLOTTED BY THE SENATOR FROM CONNECTICUT. 9788 05:34:12,001 --> 05:34:13,000 MR. GRASSLEY: MR. PRESIDENT? 9789 05:34:13,001 --> 05:34:14,000 THE PRESIDING OFFICER: THE 9790 05:34:14,001 --> 05:34:15,000 SENATOR FROM MINNESOTA HAS THE 9791 05:34:15,001 --> 05:34:16,000 FLOOR. 9792 05:34:16,001 --> 05:34:17,000 MR. GRASSLEY: I'M SORRY. 9793 05:34:17,001 --> 05:34:21,000 THE PRESIDING OFFICER: WHO 9794 05:34:21,001 --> 05:34:22,000 YIELDS TIME? 9795 05:34:22,001 --> 05:34:24,000 THE SENATOR FROM UTAH IS 9796 05:34:24,001 --> 05:34:25,000 RECOGNIZED FOR FIVE MINUTES. 9797 05:34:25,001 --> 05:34:27,000 WITHOUT OBJECTION, THE SENATOR 9798 05:34:27,001 --> 05:34:29,000 FROM MINNESOTA'S REQUEST TO BE 9799 05:34:29,001 --> 05:34:32,000 ADDED AS A COSPONSOR OF THE 9800 05:34:32,001 --> 05:34:35,000 COBURN AMENDMENT ISPPROVED. 9801 05:34:35,001 --> 05:34:36,000 THE SENATOR FROM 9802 05:34:36,001 --> 05:34:38,000 MR. HATCH: MR. PRESIDENT, 9803 05:34:38,001 --> 05:34:41,000 THANK YOU SO MUCH. 9804 05:34:41,001 --> 05:34:44,000 WE'RE TALKING RIGHT NOW ABOUT A 9805 05:34:44,001 --> 05:34:50,000 PROGRAM THAT'S WELL THOUGHT OUT, 9806 05:34:50,001 --> 05:34:52,000 THAT WASEANT TO HELP THE POOR 9807 05:34:52,001 --> 05:34:54,000 AND MINORITIES, THAT WAS 9808 05:34:54,001 --> 05:34:57,000 REQUESTED BY BIPARTISAN 9809 05:34:57,001 --> 05:35:01,000 DEMOCRATS AND REPUBLICANS, AND 9810 05:35:01,001 --> 05:35:07,000 HAS WORKED AMAZINGLY WELL, WHICH 9811 05:35:07,001 --> 05:35:08,000 IS AVAILABLE TO ALL RECIPIENTS 9812 05:35:08,001 --> 05:35:09,000 OF MEDICARE. 9813 05:35:09,001 --> 05:35:16,000 MEDICARE ADVANTAGE CAME ABOUT IN 9814 05:35:16,001 --> 05:35:17,000 A BIPARTISAN WAY TO SOLVE REAL PROBLEMS. 9815 05:35:17,001 --> 05:35:19,000 WE WEREN'T GETTING HEALTH CARE 9816 05:35:19,001 --> 05:35:20,000 TO RURAL AMERICA. 9817 05:35:20,001 --> 05:35:23,000 WE WEREN'T GETTING HEALTH CARE 9818 05:35:23,001 --> 05:35:24,000 IN MANY RESPECTS TO SOME OF THE 9819 05:35:24,001 --> 05:35:27,000 POOR AND SOME OF THE MINORITY 9820 05:35:27,001 --> 05:35:30,000 FOLKS IN OUR COUNTRY. 9821 05:35:30,001 --> 05:35:33,000 I JUST WANT TO READ A SPECIAL 9822 05:35:33,001 --> 05:35:34,000 LETTER HERE. 9823 05:35:34,001 --> 05:35:37,000 IN RESPONSE TO THIS LETTER -- 9824 05:35:37,001 --> 05:35:38,000 LET ME READ THIS LETTER, AEUPBD 9825 05:35:38,001 --> 05:35:40,000 KNOW IT MAY HAVE BEEN -- AND I 9826 05:35:40,001 --> 05:35:43,000 KNOW IT MAY HAVE BEEN READ BEFORE. 9827 05:35:43,001 --> 05:35:47,000 THIS IS DATED SEPTEMBER 30, 2003. 9828 05:35:47,001 --> 05:35:48,000 "DEAR MEDICARE CONFEREES" -- I 9829 05:35:48,001 --> 05:35:49,000 HAPPENED TO BE ON THAT 9830 05:35:49,001 --> 05:35:50,000 CONFERENCE. 9831 05:35:50,001 --> 05:35:52,000 I WAS ONE OF THOSE WHO LED THE 9832 05:35:52,001 --> 05:35:54,000 FIGHT FOR MEDICARE ADVANTAGE. 9833 05:35:54,001 --> 05:35:55,000 "WE ARE WRITING TO ASK YOU AS A 9834 05:35:55,001 --> 05:35:56,000 MEMBER OF THE MEDICARE 9835 05:35:56,001 --> 05:35:58,000 CONFERENCE COMMITTEE TO ENSURE 9836 05:35:58,001 --> 05:36:01,000 THE FINAL MEDICARE BILL INCLUDES 9837 05:36:01,001 --> 05:36:03,000 A MEANINGFUL INCREASE IN 9838 05:36:03,001 --> 05:36:04,000 MEDICARE-PLUS CHOICE -- THE 9839 05:36:04,001 --> 05:36:05,000 PREDECESSOR TO MEDICARE 9840 05:36:05,001 --> 05:36:07,000 ADVANTAGE -- FUNDING IN FISCAL 9841 05:36:07,001 --> 05:36:08,000 YEARS 2004 AND 2005. 9842 05:36:08,001 --> 05:36:10,000 WHILE THE SENATE BILL MAKES A 9843 05:36:10,001 --> 05:36:11,000 MODEST STEP TOWARD THIS GOAL, WE 9844 05:36:11,001 --> 05:36:12,000 HOPE THE STRONGER PROVISIONS IN 9845 05:36:12,001 --> 05:36:14,000 THE HOUSE BILL WILL BE PRESERVED 9846 05:36:14,001 --> 05:36:16,000 IN CONGRESS. 9847 05:36:16,001 --> 05:36:19,000 FOR NEARLY 5 MILLION MEDICARE 9848 05:36:19,001 --> 05:36:20,000 BENEFICIARIES ACROSS AMERICA, 9849 05:36:20,001 --> 05:36:21,000 MEDICARE-PLUS CHOICE, THE 9850 05:36:21,001 --> 05:36:23,000 PREDECESSOR, IS AN ESSENTIAL 9851 05:36:23,001 --> 05:36:25,000 PROGRAM THAT PROVIDES 9852 05:36:25,001 --> 05:36:26,000 HIGH-QUALITY, COMPREHENSIVE 9853 05:36:26,001 --> 05:36:27,000 AFFORDABLE HEALTH COVERAGE. 9854 05:36:27,001 --> 05:36:28,000 THESE SENIORS AND DISABLED 9855 05:36:28,001 --> 05:36:31,000 AMERICANS HAVE VOLUNTARILY 9856 05:36:31,001 --> 05:36:32,000 CHOSEN TO RECEIVE THEIR HEALTH 9857 05:36:32,001 --> 05:36:34,000 COVERAGE THROUGH MEDICARE 9858 05:36:34,001 --> 05:36:35,000 H.M.O.'S AND OTHER PLANS BECAUSE 9859 05:36:35,001 --> 05:36:37,000 OF THEIR EXCELLENT VALUE. 9860 05:36:37,001 --> 05:36:38,000 TO PRESERVE THIS IMPORTANT 9861 05:36:38,001 --> 05:36:39,000 OPTION FOR SENIORS ACROSS THE 9862 05:36:39,001 --> 05:36:42,000 COUNTRY, BIPARTISAN LEGISLATION 9863 05:36:42,001 --> 05:36:43,000 WAS INTRODUCED IN THE SENATE AS 9864 05:36:43,001 --> 05:36:46,000 S. 509, THE MEDICARE-PLUS CHOICE 9865 05:36:46,001 --> 05:36:49,000 EQUITY AND ACCESS ACT. 9866 05:36:49,001 --> 05:36:50,000 THAT BECAME MEDICARE ADVANTAGE. 9867 05:36:50,001 --> 05:36:52,000 COSPONSORS BY SENATORS SCHUMER 9868 05:36:52,001 --> 05:36:53,000 AND SANTORUM, IT SOUGHT TO 9869 05:36:53,001 --> 05:36:55,000 INCREASE REIMBURSEMENT RATES AND 9870 05:36:55,001 --> 05:36:57,000 ADD NEW REIMBURSEMENT OPTIONS 9871 05:36:57,001 --> 05:36:58,000 FOR MEDICARE-PLUS CHOICE 9872 05:36:58,001 --> 05:36:59,000 PROGRAMS. 9873 05:36:59,001 --> 05:37:02,000 IF GOES ON TO MAKE A COMPELLING 9874 05:37:02,001 --> 05:37:05,000 CASE FOR WHAT BECAME FROM THAT 9875 05:37:05,001 --> 05:37:09,000 CONFERENCE AS MEDICARE ADVANTAGE 9876 05:37:09,001 --> 05:37:11,000 TO THE UTTER PLEASING OF 9877 05:37:11,001 --> 05:37:12,000 EVERYBODY WHO SIGNED THIS 9878 05:37:12,001 --> 05:37:13,000 LETTER. 9879 05:37:13,001 --> 05:37:15,000 AND, BY THE WAY, LET ME JUST 9880 05:37:15,001 --> 05:37:20,000 MENTION THE DEMOCRATS WHO SIGNED 9881 05:37:20,001 --> 05:37:24,000 THIS LETTER, WHO WANTED MEDICARE ADVANTAGE. 9882 05:37:24,001 --> 05:37:27,000 JOHN KERRY, ARLEN SPECTER, 9883 05:37:27,001 --> 05:37:30,000 DIANNE FEINSTEIN, JOE LIEBERMAN, 9884 05:37:30,001 --> 05:37:34,000 PATTY MURRAY, CHARLES SCHUMER, 9885 05:37:34,001 --> 05:37:38,000 FRANK LAUTENBERG, HILLARY RODHAM 9886 05:37:38,001 --> 05:37:44,000 CLINTON, RON WYDEN, MARK DAYTON, 9887 05:37:44,001 --> 05:37:45,000 MARY LANDRIEU, MARIA CANTWELL, 9888 05:37:45,001 --> 05:37:47,000 AND CHRISTOPHER DODD. 9889 05:37:47,001 --> 05:37:49,000 14 DEMOCRATS SIGNED THIS LETTER 9890 05:37:49,001 --> 05:37:50,000 ALONG WITH A NUMBER OF 9891 05:37:50,001 --> 05:37:54,000 BIPARTISAN REPUBLICANS WHO 9892 05:37:54,001 --> 05:37:57,000 BELIEVED THAT WE REALLY NEEDED 9893 05:37:57,001 --> 05:38:01,000 TO 9894 05:38:01,001 --> 05:38:03,000 AND NOW TO TAKE ADVANTAGE, OUR 9895 05:38:03,001 --> 05:38:06,000 COLLEAGUES ON THE OTHER SIDE 9896 05:38:06,001 --> 05:38:07,000 WANT TO DO AWAY WITH MEDICARE 9897 05:38:07,001 --> 05:38:09,000 ADVANTAGE EXCEPT IN FOUR STATES 9898 05:38:09,001 --> 05:38:11,000 THAT ARE FOR THE MOST PART 9899 05:38:11,001 --> 05:38:14,000 DEMOCRAT STATES, WHILE LEAVING 9900 05:38:14,001 --> 05:38:16,000 ALL THE OTHER 46 STATES HIGH AND DRY. 9901 05:38:16,001 --> 05:38:21,000 NOW LET ME JUST SAY THIS LETTER 9902 05:38:21,001 --> 05:38:23,000 IS IN RESPONSE -- WAS A LETTER 9903 05:38:23,001 --> 05:38:25,000 GIVEN TO THE MEDICARE 9904 05:38:25,001 --> 05:38:26,000 MODERNIZATION CONFERENCE 9905 05:38:26,001 --> 05:38:27,000 COMMITTEE. 9906 05:38:27,001 --> 05:38:28,000 THIS CONFERENCE COMMITTEE GAVE 9907 05:38:28,001 --> 05:38:29,000 THEM EVERYTHING THEY WANTED IN 9908 05:38:29,001 --> 05:38:30,000 MEDICARE ADVANTAGE. 9909 05:38:30,001 --> 05:38:34,000 THIS LEGISLATIVE GRANT OF POWER 9910 05:38:34,001 --> 05:38:37,000 GAVE THE SENATORS THE MEDICARE 9911 05:38:37,001 --> 05:38:39,000 ADVANTAGE PROGRAM WHICH NOW 11 9912 05:38:39,001 --> 05:38:40,000 MILLION SENIOR CITIZENS ENJOY 9913 05:38:40,001 --> 05:38:41,000 TODAY. 9914 05:38:41,001 --> 05:38:43,000 NOW THOSE ON THE LEFT WANT TO DO 9915 05:38:43,001 --> 05:38:46,000 AWAY WITH THIS IMPORTANT PROGRAM 9916 05:38:46,001 --> 05:38:49,000 THAT BENEFITS SENIORS AND 9917 05:38:49,001 --> 05:38:51,000 MINORITIES IN AN AMAZING SET OF WAYS. 9918 05:38:51,001 --> 05:38:53,000 WELL, I'M AGAINST THAT. 9919 05:38:53,001 --> 05:38:54,000 I HOPE OUR COLLEAGUES ON THE 9920 05:38:54,001 --> 05:38:55,000 OTHER SIDE WILL REALIZE WHAT 9921 05:38:55,001 --> 05:38:57,000 THEY'RE DOING. 9922 05:38:57,001 --> 05:39:00,000 IT JUST ISN'T RIGHT. 9923 05:39:00,001 --> 05:39:02,000 VISION CARE AND DENTAL CARE AND 9924 05:39:02,001 --> 05:39:03,000 SO MANY OTHER APPROACHES THAT 9925 05:39:03,001 --> 05:39:06,000 REALLY WORKED FOR THIS PROGRAM 9926 05:39:06,001 --> 05:39:08,000 WILL BE TAKEN AWAY FROM THESE PEOPLE. 9927 05:39:08,001 --> 05:39:12,000 AND THEY'RE GOING TO HAVE TO 9928 05:39:12,001 --> 05:39:14,000 SPEND $175 TO $200 A MONTH TO 9929 05:39:14,001 --> 05:39:16,000 GET WHAT THEY GOT FOR AN AVERAGE 9930 05:39:16,001 --> 05:39:18,000 OF ABOUT $54 A MONTH. 9931 05:39:18,001 --> 05:39:20,000 AND THESE ARE PEOPLE WHO NEED OUR HELP. 9932 05:39:20,001 --> 05:39:21,000 LET ME JUST CHANGE THE SUBJECT 9933 05:39:21,001 --> 05:39:22,000 FOR A MINUTE BECAUSE I 9934 05:39:22,001 --> 05:39:24,000 UNDERSTAND MY COLLEAGUE FROM 9935 05:39:24,001 --> 05:39:27,000 OREGON WAS DISCUSSING MEDICARE 9936 05:39:27,001 --> 05:39:28,000 ADVANTAGE AND TALKING 9937 05:39:28,001 --> 05:39:29,000 C.E.O.'S OF MECARE ADVANTAGE 9938 05:39:29,001 --> 05:39:32,000 COMPANIES LIVING -- QTE -- 9939 05:39:32,001 --> 05:39:37,000 "HIGH OFF THE HOG" SAYING THAT 9940 05:39:37,001 --> 05:39:38,000 THAT IS A RATIONALE FOR $120 9941 05:39:38,001 --> 05:39:40,000 BILLION IN MEDICARE ADVANTAGE CUTS. 9942 05:39:40,001 --> 05:39:44,000 I HAVE TWO RESPONSES TO MY GOOD 9943 05:39:44,001 --> 05:39:45,000 FRIEND FROM OREGON: THIS IS NOT 9944 05:39:45,001 --> 05:39:46,000 ABOUT MEDICARE INSURANCE MPANY 9945 05:39:46,001 --> 05:39:47,000 C.E.O.'S. 9946 05:39:47,001 --> 05:39:49,000 THIS IS ABOUT PRESERVING THE 9947 05:39:49,001 --> 05:39:50,000 CHOICE OF COVERAGE FOR SENIORS. 9948 05:39:50,001 --> 05:39:52,000 THE PRESIDING OFFICER: THE 9949 05:39:52,001 --> 05:39:54,000 SENATOR HAS USED THE FIVE MINUTES. 9950 05:39:54,001 --> 05:39:55,000 MR. HATCH: I WOULD ASK FOR 9951 05:39:55,001 --> 05:39:56,000 ANOTHER TWO MINUTES. 9952 05:39:56,001 --> 05:40:00,000 THE PRESIDING OFFICER: IS 9953 05:40:00,001 --> 05:40:02,000 THERE OBJECTION? 9954 05:40:02,001 --> 05:40:03,000 MR. DODD: HOW MUCH TIME 9955 05:40:03,001 --> 05:40:05,000 REMAINS, MR. PRESIDENT? THE PRESIDING OFFICER: THE 9956 05:40:05,001 --> 05:40:07,000 SENATOR FROM IOWA CONTROLS 4 9957 05:40:07,001 --> 05:40:09,000 MINUTES AND 46 SECONDS. 9958 05:40:09,001 --> 05:40:13,000 THE SENATOR FROM CONNECTICUT, 14 9959 05:40:13,001 --> 05:40:16,000 MINUTES AND 43 SECONDS. 9960 05:40:16,001 --> 05:40:17,000 MR. DODD: WE HAVE 4 LEFT. 9961 05:40:17,001 --> 05:40:19,000 MR. HATCH: I'LL PUT THE REST 9962 05:40:19,001 --> 05:40:20,000 OF MY REMARKS IN THE RECORD. 9963 05:40:20,001 --> 05:40:33,000 THE PRESIDING OFFICER: WHO 9964 05:40:33,001 --> 05:40:34,000 YIELDS TIME? 9965 05:40:34,001 --> 05:40:36,000 MR. DODD: FOUR MINUTES TO THE 9966 05:40:36,001 --> 05:40:37,000 SENATOR FROM MICHIGAN. THE PRESIDING OFFICER: THE 9967 05:40:37,001 --> 05:40:39,000 SENATOR FROM MICHI 9968 05:40:39,001 --> 05:40:40,000 RECOGNIZED FOR FOUR MINUTES. 9969 05:40:40,001 --> 05:40:43,000 MS. STABENOW: THANK YOU, MR. PRESIDENT. 9970 05:40:43,001 --> 05:40:45,000 I HAVE AN AMENDMENT THAT WILL BE 9971 05:40:45,001 --> 05:40:50,000 SENT TO THE DESK PURSUANT TO THE CONSENT AGREEMENT. 9972 05:40:50,001 --> 05:40:51,000 I WOULD NOW CALL UP MY AME 2899. 9973 05:40:51,001 --> 05:40:52,000 THE PRESIDING OFFICER: THE 9974 05:40:52,001 --> 05:40:53,000 CLERK WILL REPORT. 9975 05:40:53,001 --> 05:40:55,000 THE CLERK: THE SENATOR FROM 9976 05:40:55,001 --> 05:40:56,000 MICHIGAN, MS. STABENOW, PROPOSES 9977 05:40:56,001 --> 05:40:57,000 AN AMENDMENT NUMBERED 2899. 9978 05:40:57,001 --> 05:40:59,000 AT THE APPROPRIATE PLACE INSERT 9979 05:40:59,001 --> 05:41:00,000 THE FOLLOWING: SECTION, NO CUTS 9980 05:41:00,001 --> 05:41:03,000 IN GUARANTEED BENEF 9981 05:41:03,001 --> 05:41:04,000 NOTHING IN THIS 9982 05:41:04,001 --> 05:41:05,000 MS. STABENOW: I WOULD ASK THAT 9983 05:41:05,001 --> 05:41:06,000 THE AMENDMENT BE CONSIDERED 9984 05:41:06,001 --> 05:41:07,000 READ. 9985 05:41:07,001 --> 05:41:08,000 THE PRESIDING OFFICER: WITHOUT OBJECTION. 9986 05:41:08,001 --> 05:41:09,000 MS. STABENOW: THANK YOU, 9987 05:41:09,001 --> 05:41:11,000 MR. PRESIDENT. 9988 05:41:11,001 --> 05:41:13,000 MR. PRESIDENT, THIS IS A VERY 9989 05:41:13,001 --> 05:41:17,000 IMPORTANT AMENDMENT TO CLARIFY 9990 05:41:17,001 --> 05:41:19,000 ONCE AGAIN THAT WE ARE NOT 9991 05:41:19,001 --> 05:41:23,000 CUTTING ANY MEDICARE BENEFITS. 9992 05:41:23,001 --> 05:41:25,000 WE ARE NOT CUTTING ANY OF THE 9993 05:41:25,001 --> 05:41:27,000 GUARANTEED MEDICARE BENEFITS 9994 05:41:27,001 --> 05:41:30,000 THAT PEOPLE RECEIVE RIGHT NOW. 9995 05:41:30,001 --> 05:41:33,000 IN FACT, AARP WHO HAS BEEN 9996 05:41:33,001 --> 05:41:35,000 SAYINGHIS ON 9997 05:41:35,001 --> 05:41:38,000 FOR MONTHS HAS RELEASED A LETTER 9998 05:41:38,001 --> 05:41:40,000 NOW, AND IT QUOTES THIS 9999 05:41:40,001 --> 05:41:42,000 SENTENCE: "MOST IMPORTANTLY, 10000 05:41:42,001 --> 05:41:44,000 THE LEGISLATION DOES NOT REDUCE 10001 05:41:44,001 --> 05:41:45,000 ANY GUARANTEED MEDICARE 10002 05:41:45,001 --> 05:41:49,000 BENEFITS." 10003 05:41:49,001 --> 05:41:51,000 NOT ONLY AARP, BUT THE 10004 05:41:51,001 --> 05:41:54,000 ASSOCIATION FOR THEROTECTION 10005 05:41:54,001 --> 05:41:57,000 OF MEDICARE AND SOCIAL SECURITY, 10006 05:41:57,001 --> 05:42:00,000 ALLIANCE FOR RETIRED AMERICANS, 10007 05:42:00,001 --> 05:42:02,000 AND OTHER SENIOR ORGANIZATIONS 10008 05:42:02,001 --> 05:42:04,000 ALL AGREE. 10009 05:42:04,001 --> 05:42:07,000 WHAT WE ARE TALKING ABOUT IS 10010 05:42:07,001 --> 05:42:08,000 SAVING MEDICARE, MR. PRESIDENT. 10011 05:42:08,001 --> 05:42:10,000 CUTTING DOWN ON OVERPAYMENTS 10012 05:42:10,001 --> 05:42:13,000 THAT HAVE BEEN IN PLACE. 10013 05:42:13,001 --> 05:42:15,000 RIGHT NOW THE 80% TO 85% OF THE 10014 05:42:15,001 --> 05:42:17,000 SENIORS THAT GET THEIR BENEFITS, 10015 05:42:17,001 --> 05:42:18,000 THEIR HEALTH CARE THROUGH 10016 05:42:18,001 --> 05:42:21,000 TRADITIONAL MEDICARE ARE PAYING 10017 05:42:21,001 --> 05:42:22,000 MORE IN PREMIUMS, ACCORDING TO 10018 05:42:22,001 --> 05:42:25,000 THE CONGRESSIONAL BUDGET OFFICE, 10019 05:42:25,001 --> 05:42:28,000 THAN THEY OTHERWISE WOULD 10020 05:42:28,001 --> 05:42:31,000 BECAUSE MEDPAC ESTIMATES THAT WE 10021 05:42:31,001 --> 05:42:35,000 ARE PAYING ABOUT $12 BILLION 10022 05:42:35,001 --> 05:42:36,000 MORE FOR PEOPLE IN THE PRIVATE 10023 05:42:36,001 --> 05:42:39,000 FOR-PROFIT INSURANCE SYSTEM 10024 05:42:39,001 --> 05:42:40,000 RIGHT NOW THAT'S CALLED MEDICARE 10025 05:42:40,001 --> 05:42:43,000 ADVANTAGE. 10026 05:42:43,001 --> 05:42:45,000 SO THE MAJORITY OF SENIORS ARE 10027 05:42:45,001 --> 05:42:47,000 SUBSIDIZING HIGH INSURANCE 10028 05:42:47,001 --> 05:42:49,000 COMPANY PROFITS AND OVERPAYMENTS. 10029 05:42:49,001 --> 05:42:52,000 WHAT WE HAVE DONE IN THIS BILL 10030 05:42:52,001 --> 05:42:55,000 IS TAKE OUT THE OVERPAYMENTS AND 10031 05:42:55,001 --> 05:42:56,000 IN FACT PUT IN COMPETION, 10032 05:42:56,001 --> 05:42:58,000 COMPETITIVE BIDDING. 10033 05:42:58,001 --> 05:42:59,000 I THOUGHT THAT'S SOMETHING THAT 10034 05:42:59,001 --> 05:43:02,000 OUR COLLEAGUES ON THE OTHER SIDE 10035 05:43:02,001 --> 05:43:05,000 OF THE AISLE SUPPORTED. 10036 05:43:05,001 --> 05:43:06,000 COMPETITIVELY BIDDING FOR 10037 05:43:06,001 --> 05:43:07,000 REIMBURSEMENT SO WE'RE NOT 10038 05:43:07,001 --> 05:43:11,000 CONTINUING THE OVERPAYMENTS IN 10039 05:43:11,001 --> 05:43:13,000 MEDICARE ADVANTAGE THAT ARE 10040 05:43:13,001 --> 05:43:17,000 CAUSING MEDICARE TO GO BROKE 10041 05:43:17,001 --> 05:43:19,000 MORE SOONER AND CAUSING THE 10042 05:43:19,001 --> 05:43:20,000 MAJORITY OF SENIORS TO SUBSIDIZE 10043 05:43:20,001 --> 05:43:22,000 HIGH INSURANCE COMPANY PROFITS. 10044 05:43:22,001 --> 05:43:24,000 WHAT WE ARE SEEING ON THE 10045 05:43:24,001 --> 05:43:25,000 EFFORT, UNFORTUNATELY, FROM MY 10046 05:43:25,001 --> 05:43:27,000 FRIENDS ON THE OTHER SIDE OF THE 10047 05:43:27,001 --> 05:43:29,000 AISLE IS AN EFFORT TO SUPPORT 10048 05:43:29,001 --> 05:43:31,000 HUGE SUBSIDIES INSTEAD OF 10049 05:43:31,001 --> 05:43:33,000 SUPPORTING COMPETIVE BIDDING 10050 05:43:33,001 --> 05:43:36,000 THAT IS IN THE BILL. 10051 05:43:36,001 --> 05:43:40,000 THE REALITY IS, MR. PRESIDENT, 10052 05:43:40,001 --> 05:43:42,000 THAT THE GUARANTEED BENEFITS, 10053 05:43:42,001 --> 05:43:46,000 INPATIENT CARE, DOCTOR 10054 05:43:46,001 --> 05:43:47,000 LAB TESTS, PREVENTIVE 10055 05:43:47,001 --> 05:43:49,000 SCREENINGS, SKILLED NURSING 10056 05:43:49,001 --> 05:43:51,000 FACILITIES, HOME HEALTH CARE, 10057 05:43:51,001 --> 05:43:52,000 PRESCRIPTION DRUGS, AMBULANCE 10058 05:43:52,001 --> 05:43:54,000 SERVICES, DURABLE MEDICAL 10059 05:43:54,001 --> 05:43:56,000 EQUIPMENT, EMERGENCY ROOM CARE, 10060 05:43:56,001 --> 05:43:59,000 KIDNEY DIALYSIS, OUTPATIENT 10061 05:43:59,001 --> 05:44:01,000 MENTAL HEALTH CARE, OCCUPATIONAL 10062 05:44:01,001 --> 05:44:05,000 AND PHYSICAL THERAPY, IMAGING 10063 05:44:05,001 --> 05:44:07,000 LIKE X-RAYS. 10064 05:44:07,001 --> 05:44:09,000 E.K.G.'S, ORGAN 10065 05:44:09,001 --> 05:44:11,000 ALL COVERED AS THEY HAVE BEEN 10066 05:44:11,001 --> 05:44:13,000 FOR ALL MEDICARE BENEFICIARIES. 10067 05:44:13,001 --> 05:44:15,000 WHAT WE ARE DOING IS TAKING 10068 05:44:15,001 --> 05:44:16,000 OVERPAYMTS TO FOR-PROFIT 10069 05:44:16,001 --> 05:44:19,000 INSURANCE COMPANIES AND PUTTING 10070 05:44:19,001 --> 05:44:21,000 THAT BACK INTO INCREASED 10071 05:44:21,001 --> 05:44:22,000 BENEFITS FOR EVERY SENIOR, 10072 05:44:22,001 --> 05:44:25,000 CUTTING DOWN ON PRESCRIPTION 10073 05:44:25,001 --> 05:44:27,000 DRUG COSTS BY KHROEGS THE 10074 05:44:27,001 --> 05:44:30,000 DOUGH -- CLOSING THE 10075 05:44:30,001 --> 05:44:31,000 HOLE AND STRENGTHENING 10076 05:44:31,001 --> 05:44:32,000 PREVENTIVE CARE, AND THE MOST 10077 05:44:32,001 --> 05:44:34,000 IMPORTANT PIECE OF ALL 10078 05:44:34,001 --> 05:44:35,000 LENGTHENING THE SOLVENCY OF THE 10079 05:44:35,001 --> 05:44:37,000 MEDICARE TRUST FUND. 10080 05:44:37,001 --> 05:44:38,000 I WOULD URGE THE ADOPTION OF 10081 05:44:38,001 --> 05:44:41,000 AMENDMENT AT THE APPROPRIATE TIME. 10082 05:44:41,001 --> 05:44:42,000 THANK 10083 05:44:42,001 --> 05:44:43,000 YOU. 10084 05:44:43,001 --> 05:44:44,000 THE PRESIDING OFFICER: WHO 10085 05:44:44,001 --> 05:44:45,000 YIELDS TIME? 10086 05:44:45,001 --> 05:44:46,000 MR. GRASSLEY: MR. PRESIDENT, I 10087 05:44:46,001 --> 05:44:47,000 YIELD TWO MINUTES TO THE SENATOR 10088 05:44:47,001 --> 05:44:49,000 FROM THE PRESIDING OFFICER: THE 10089 05:44:49,001 --> 05:44:56,000 SENATOR FROM FLORIDA'S 10090 05:44:56,001 --> 05:44:59,000 RECOGNIZED. 10091 05:44:59,001 --> 05:45:02,000 A SENATOR: MR. PRESIDENT? 10092 05:45:02,001 --> 05:45:03,000 -- MR. PRESIDENT, I'D LIKE TO 10093 05:45:03,001 --> 05:45:06,000 ASK UNANIMOUS CONSENT -- 10094 05:45:06,001 --> 05:45:07,000 MR. LeMIEUX AND IF MY 10095 05:45:07,001 --> 05:45:08,000 COLLEAGUE FROM MICHIGAN, 10096 05:45:08,001 --> 05:45:10,000 CONCERNING HER AMENDMENT. 10097 05:45:10,001 --> 05:45:11,000 THIS AMENDMENT, THAT I'VE BEEN 10098 05:45:11,001 --> 05:45:12,000 REVIEWING, IT'S VERY IMPORTANT 10099 05:45:12,001 --> 05:45:14,000 TO THE PEOPLE OF FLORIDA, 10100 05:45:14,001 --> 05:45:15,000 BECAUSE IT HAS TO DO WITH 10101 05:45:15,001 --> 05:45:17,000 MEDICARE ADVANTAGE. 10102 05:45:17,001 --> 05:45:18,000 AND MEDICARE ADVANTAGE IS A VERY 10103 05:45:18,001 --> 05:45:20,000 IMPORTANT PROGRAM. 10104 05:45:20,001 --> 05:45:22,000 AND IT ISOT JUST SOME EXTRA FRILS. 10105 05:45:22,001 --> 05:45:24,000 THE IDEA THAT -- FRILLS. 10106 05:45:24,001 --> 05:45:27,000 THE IDEA THAT OUR FOLKS IN 10107 05:45:27,001 --> 05:45:30,000 FLORIDA CAN GET EYE CARE, 10108 05:45:30,001 --> 05:45:32,000 HEARING CARE, DIABETIC SUPPLIES. 10109 05:45:32,001 --> 05:45:35,000 LAST WEEK I WENT DOWN TO A 10110 05:45:35,001 --> 05:45:37,000 MEDICARE ADVANTAGE CLINIC, THESE 10111 05:45:37,001 --> 05:45:39,000 ARE WONDERFUL PLACES WHERE OUR 10112 05:45:39,001 --> 05:45:42,000 SENIORS ARE GETTING WHO 10113 05:45:42,001 --> 05:45:43,000 WILLISTIC HEALTH CARE -- 10114 05:45:43,001 --> 05:45:47,000 HOLLISTIC HEALTH CARE. 10115 05:45:47,001 --> 05:45:48,000 I THINK THIS IS TO GUARANTEE THE 10116 05:45:48,001 --> 05:45:49,000 BENEFITS IN MEDICARE ADVANTAGE. 10117 05:45:49,001 --> 05:45:50,000 I'M NOT SURE IT IS PHRASED THAT 10118 05:45:50,001 --> 05:45:53,000 WAY. 10119 05:45:53,001 --> 05:45:54,000 I'VE BEEN READING THE BILL. 10120 05:45:54,001 --> 05:45:58,000 ACT. 10121 05:45:58,001 --> 05:45:59,000 AND I CANNOT FIND THE PHRASE, 10122 05:45:59,001 --> 05:46:00,000 "GUARANTEED BENEFITS." 10123 05:46:00,001 --> 05:46:02,000 I WOULD ASK UNANIMOUS CONSENT, 10124 05:46:02,001 --> 05:46:05,000 MR. PRESIDENT, THAT THE 10125 05:46:05,001 --> 05:46:07,000 GUARANTEE BY LAW PHRASE IN THIS 10126 05:46:07,001 --> 05:46:08,000 AMENDMENT FROM MY COLLEAGUE FROM 10127 05:46:08,001 --> 05:46:12,000 MICHIGAN BE ELIMINATED SO THAT 10128 05:46:12,001 --> 05:46:15,000 WE WOULD ENSURE THAT BENEFITS OF 10129 05:46:15,001 --> 05:46:17,000 EYE CARE, DENTAL CARE, 10130 05:46:17,001 --> 05:46:19,000 PREVENTIVE CARE, DIABETIC 10131 05:46:19,001 --> 05:46:20,000 SUPPLIES, ALL OF THE THINGS 10132 05:46:20,001 --> 05:46:22,000 SUPPLIED IN THE MEDICARE 10133 05:46:22,001 --> 05:46:24,000 ADVANTAGE ARE ACTUALLY PRESERVED. 10134 05:46:24,001 --> 05:46:26,000 NO ONE IS OBJECTING TO LOWER COSTS. 10135 05:46:26,001 --> 05:46:28,000 NO ONE'S OBJECTING TO A 10136 05:46:28,001 --> 05:46:29,000 COMPETITIVE SITUATION WHERE WE 10137 05:46:29,001 --> 05:46:31,000 HAVE THESE COMPANIES PROVIDING 10138 05:46:31,001 --> 05:46:32,000 MORE SERVI 10139 05:46:32,001 --> 05:46:34,000 BUT WE WANT TO MAKE SURE THAT 10140 05:46:34,001 --> 05:46:35,000 THE SERVICES ARE STILL THERE. 10141 05:46:35,001 --> 05:46:38,000 I WOULD ASK UNANIMOUS CONSENT 10142 05:46:38,001 --> 05:46:40,000 TO HAVE THAT PHRASE GUARANTEED 10143 05:46:40,001 --> 05:46:41,000 BY LAW TO BE ELIMINATED FROM THE 10144 05:46:41,001 --> 05:46:42,000 AMENDMENT. 10145 05:46:42,001 --> 05:46:43,000 THE PRESIDING OFFICER: IS THERE 10146 05:46:43,001 --> 05:46:45,000 OBJECTION? MS. STABENOW: RESERVING THE 10147 05:46:45,001 --> 05:46:46,000 RIGHT TO 10148 05:46:46,001 --> 05:46:49,000 THE PRESIDING OFFICER: T 10149 05:46:49,001 --> 05:46:51,000 SENATOR'S TIME HAS EXPIRE. 10150 05:46:51,001 --> 05:46:52,000 IS THERE OBJECTION? 10151 05:46:52,001 --> 05:46:54,000 MS. STABENOW: RESERVING THE 10152 05:46:54,001 --> 05:46:56,000 RIGHT TO OBJECT. 10153 05:46:56,001 --> 05:46:59,000 I WOULD ASK THAT MY COLLEAGUE -- 10154 05:46:59,001 --> 05:47:00,000 WE WERE HAPPY TO TALK ABOUT HOW 10155 05:47:00,001 --> 05:47:03,000 WE MIGHT ADDRESS WHAT HE'S 10156 05:47:03,001 --> 05:47:04,000 CONCERNED ABOUT, BUT, 10157 05:47:04,001 --> 05:47:06,000 UNFORTUNATELY, THE REALITY IS 10158 05:47:06,001 --> 05:47:08,000 THAT THE FOR-PROFIT COMPANIES 10159 05:47:08,001 --> 05:47:09,000 ARE OBJECTING TO COMPETIVE 10160 05:47:09,001 --> 05:47:10,000 BIDDING. 10161 05:47:10,001 --> 05:47:12,000 AND THE LANGUAGE THAT MY 10162 05:47:12,001 --> 05:47:14,000 COLLEAGUE HAS SUGGESTED, WOULD 10163 05:47:14,001 --> 05:47:16,000 INCLUDE ITEMS THAT HAVE BEEN 10164 05:47:16,001 --> 05:47:19,000 OFFERED TO GET PEOPLE IN 10165 05:47:19,001 --> 05:47:20,000 FOR-PROFIT PLANS, LIKE GYM 10166 05:47:20,001 --> 05:47:21,000 MEMBERSHIPS AND OTHER THINGS 10167 05:47:21,001 --> 05:47:23,000 THAT HAVE BEEN OF GREAT CONCERN. 10168 05:47:23,001 --> 05:47:25,000 AND, 10169 05:47:25,001 --> 05:47:26,000 HAVE TO OBJECT AT THIS POINT. THE PRESIDING OFFICER: OBJECTION 10170 05:47:26,001 --> 05:47:31,000 IS HEARD. 10171 05:47:31,001 --> 05:47:35,000 WHO YIELDS TIME? 10172 05:47:35,001 --> 05:47:36,000 THE SENATOR FROM OHIO IS RECOGNIZED. 10173 05:47:36,001 --> 05:47:38,000 MR. BROWN: THANK YOU, MR. PRESIDENT. 10174 05:47:38,001 --> 05:47:40,000 THANK YOU, SENATOR HARKIN. 10175 05:47:40,001 --> 05:47:42,000 I WATCHED FROM MY OFFICE ON 10176 05:47:42,001 --> 05:47:44,000 C-SPAN AND THEN ON THIS FLOOR 10177 05:47:44,001 --> 05:47:45,000 COUNT -- BEEN ON THIS FLOOR 10178 05:47:45,001 --> 05:47:46,000 COUNTLESS TIMES IN THE LAST 10179 05:47:46,001 --> 05:47:48,000 THREE OR FOUR DAYS, LISTENING TO 10180 05:47:48,001 --> 05:47:50,000 MY 10181 05:47:50,001 --> 05:47:51,000 THE AISLE CONTINUE TO DO THE 10182 05:47:51,001 --> 05:47:54,000 BIDDING OF THE INSURANCE COMPANIES. 10183 05:47:54,001 --> 05:47:55,000 AND, YOU KNOW, I HEAR THEM TALK 10184 05:47:55,001 --> 05:47:57,000 ABOUT MEDICARE ADVANTAGE, HOW 10185 05:47:57,001 --> 05:47:58,000 I WAS HERE, I WAS IN THE HOUSE 10186 05:47:58,001 --> 05:48:00,000 OF RRENTATIVES 10 YEARS AGO 10187 05:48:00,001 --> 05:48:01,000 WHEN 10188 05:48:01,001 --> 05:48:04,000 WHEN THE INSURANCE COMPANY SAID, 10189 05:48:04,001 --> 05:48:06,000 WE CAN SAVE MEDICARE 5% ON ALL 10190 05:48:06,001 --> 05:48:07,000 OF ITS COSTS BY BRINGING FORWARD 10191 05:48:07,001 --> 05:48:08,000 MEDICARE ADVANTAGE. 10192 05:48:08,001 --> 05:48:11,000 WELL, THEN WHEN THE REPUBLICANS 10193 05:48:11,001 --> 05:48:13,000 TOOK CONTROL OF EVERYTHING, THAT 10194 05:48:13,001 --> 05:48:17,000 SAVING 5%, THE INSURANCE 10195 05:48:17,001 --> 05:48:18,000 COMPANIES DECIDED, NO, WE CAN'T 10196 05:48:18,001 --> 05:48:20,000 SAVE 5% ANYMORE. 10197 05:48:20,001 --> 05:48:23,000 WE NEED A 13% BONUS. 10198 05:48:23,001 --> 05:48:25,000 THE CHICKENS HAVE COME HOME TO 10199 05:48:25,001 --> 05:48:27,000 ROOST F COMPANIES. 10200 05:48:27,001 --> 05:48:29,000 AN ARTICLE IN THE DOW JONES 10201 05:48:29,001 --> 05:48:33,000 STORY, ENTITLED HUMANA THIRD 10202 05:48:33,001 --> 05:48:35,000 QUARTER PROFITS 10203 05:48:35,001 --> 05:48:39,000 STRONG MEDICARE ADVANTAGE GAINS. 10204 05:48:39,001 --> 05:48:41,000 LET ME EXCERPT FROM THE FIRST 10205 05:48:41,001 --> 05:48:43,000 FEW PARAGRAPHS. 10206 05:48:43,001 --> 05:48:45,000 HUMANA'S FIRST THIRD QUARTER 10207 05:48:45,001 --> 05:48:48,000 EARNINGS ROSE 65%. 10208 05:48:48,001 --> 05:48:52,000 THE 10209 05:48:52,001 --> 05:48:54,000 FORECAST WHICH THE PROTECTS 10210 05:48:54,001 --> 05:48:57,000 SUBSTANTIAL MEDICARE ADVANTAGE 10211 05:48:57,001 --> 05:49:00,000 MEMBERSHIP GROWTH RESULTING I 10212 05:49:00,001 --> 05:49:03,000 IN $32 TO $34 BILLION, WELL 10213 05:49:03,001 --> 05:49:05,000 ABOVE THE ESTIMAT OF $29.6 BILLION. 10214 05:49:05,001 --> 05:49:07,000 TH 10215 05:49:07,001 --> 05:49:09,000 ACCOUNT REDUCTIONSF MEDICARE 10216 05:49:09,001 --> 05:49:11,000 ADVANTAGE 10217 05:49:11,001 --> 05:49:14,000 AS THE SENATOR FROM RHODE ISLAND 10218 05:49:14,001 --> 05:49:17,000 KNOWS AND SENATOR HARKIN 10219 05:49:17,001 --> 05:49:18,000 SENATOR STABENOW, ALL STRONG 10220 05:49:18,001 --> 05:49:21,000 SUPPORTERS OF MEDICARE. 10221 05:49:21,001 --> 05:49:22,000 WHEN WE SEE PEOPLE WHO OPPOSE 10222 05:49:22,001 --> 05:49:24,000 MEDICARE AND POSED THE CREATION 10223 05:49:24,001 --> 05:49:26,000 40 YEARS A. 10224 05:49:26,001 --> 05:49:27,000 THEY TRIED TO PRIVATIZE MEDICARE 10225 05:49:27,001 --> 05:49:28,000 WITH SPEAKER GINGRICH DOWN THE 10226 05:49:28,001 --> 05:49:30,000 HOWL IN THE HOUSE OF 10227 05:49:30,001 --> 05:49:33,000 REPRESENTATIVES A DOZEN AGO. 10228 05:49:33,001 --> 05:49:34,000 NOW THEIR MEDICARE'S BIGGEST 10229 05:49:34,001 --> 05:49:35,000 DEFENDERS, I DON'T THINK SO. 10230 05:49:35,001 --> 05:49:37,000 WHAT THEY HAVE BEEN IS THE 10231 05:49:37,001 --> 05:49:39,000 INSURANCE INDUSTRY'S BIGGEST DEFENDERS. 10232 05:49:39,001 --> 05:49:41,000 THAT'S REALLY WHAT THAT DEBATE 10233 05:49:41,001 --> 05:49:43,000 THE LAST THREE DAYS WAS ALL ABOUT. 10234 05:49:43,001 --> 05:49:45,000 WHAT'S IMPORTANT IS WE GUARANTEE 10235 05:49:45,001 --> 05:49:47,000 MEDICARE SERVICES AS WE WILL. 10236 05:49:47,001 --> 05:49:50,000 WE QUIT SUBSIDIZING INSURANCE 10237 05:49:50,001 --> 05:49:53,000 COMPANIES, AS WE SHOULD QUIT SUBSIDIZING THEM. 10238 05:49:53,001 --> 05:49:55,000 AN THEN THAT $90 TAX THAT EVERY 10239 05:49:55,001 --> 05:49:59,000 MEDICARE BENEFICIARY HAS TO PAY, 10240 05:49:59,001 --> 05:50:01,000 THAT $90 -- THAT $90 THAT GOES 10241 05:50:01,001 --> 05:50:03,000 TO INSURANCE SUBSIDI 10242 05:50:03,001 --> 05:50:07,000 TAKEN AWAY. 10243 05:50:07,001 --> 05:50:09,000 REGULAR MEDICARE MEMBERS, 81%, 10244 05:50:09,001 --> 05:50:12,000 82% OF MEDICARE BENEFICIARIES 10245 05:50:12,001 --> 05:50:13,000 WON'T PAY BE THE -- PAY THE 10246 05:50:13,001 --> 05:50:17,000 INSURANCE COMPANY REPUBLICAN TAX 10247 05:50:17,001 --> 05:50:19,000 THAT THEY HAD 10248 05:50:19,001 --> 05:50:21,000 SUBSIDIES TONSURANCE COMPANIES WERE INCREASED. 10249 05:50:21,001 --> 05:50:23,000 WE NEED TO GET THE BILL 10250 05:50:23,001 --> 05:50:24,000 THE 10251 05:50:24,001 --> 05:50:33,000 THE PRESIDING OFFICER: WHO WILL 10252 05:50:33,001 --> 05:50:35,000 YIELD TIME? 10253 05:50:35,001 --> 05:50:38,000 THE SENATOR FROM IOWA CONTROLS 10254 05:50:38,001 --> 05:50:40,000 SIX MINUTES 10255 05:50:40,001 --> 05:50:47,000 THE SENATOR FROM IOWA CONTROLS 10256 05:50:47,001 --> 05:50:49,000 TWO MINUTES AND 24 SECONDS. 10257 05:50:49,001 --> 05:50:50,000 MR. GRASSLEY: SENATOR CORKER HAS 10258 05:50:50,001 --> 05:50:52,000 ASKED 10259 05:50:52,001 --> 05:50:53,000 I YIELD -- ONE MINUTE. I YIELD IT. 10260 05:50:53,001 --> 05:50:55,000 THE PRESIDING OFFICER: THE 10261 05:50:55,001 --> 05:50:56,000 SENATOR FROM TENNESSEE IS RECOGNIZED. 10262 05:50:56,001 --> 05:50:58,000 MR. CORKER: THANK YOU, MR. PRESIDENT. 10263 05:50:58,001 --> 05:51:00,000 INTERESTING TO HEAR MY FRIEND 10264 05:51:00,001 --> 05:51:02,000 FROM OHIO A MINUTE AGO. 10265 05:51:02,001 --> 05:51:05,000 I WANT TO SAY THAT I PLAN T 10266 05:51:05,001 --> 05:51:07,000 SUPPORT THE HATCH AMENDMENT REGARDING MEDICARE ADVANTAGE. 10267 05:51:07,001 --> 05:51:08,000 BUT IT'S NOT BECAUSE THAT I 10268 05:51:08,001 --> 05:51:10,000 DON'T BELIEVE WE NEED TO DO SOME 10269 05:51:10,001 --> 05:51:11,000 THINGS TO CAUSE MEDICARE TO BE 10270 05:51:11,001 --> 05:51:12,000 MORE SOLVENT. 10271 05:51:12,001 --> 05:51:14,000 AND I DO BELIEVE THAT MEDICARE 10272 05:51:14,001 --> 05:51:15,000 ADVANTAGE DOES HAVE SOME 10273 05:51:15,001 --> 05:51:17,000 SUBSIDIES TO INSURANCE COMPANIES 10274 05:51:17,001 --> 05:51:18,000 THAT ARE HIGHER THAN THEY SHOULD 10275 05:51:18,001 --> 05:51:20,000 BE. 10276 05:51:20,001 --> 05:51:23,000 THE FACT IS, THOUGH, THAT THIS 10277 05:51:23,001 --> 05:51:27,000 BILL IS TAKING MONEY FROM A 10278 05:51:27,001 --> 05:51:30,000 PROGRAM THAT IS INSOLVENT, 10279 05:51:30,001 --> 05:51:33,000 MEDICARE, AND USING THAT TO CREATE AN ENTITLEMENT. 10280 05:51:33,001 --> 05:51:34,000 SO I'M GOING TO SUPPORT THE 10281 05:51:34,001 --> 05:51:36,000 HATCH AMENDMENT EVEN THOUGH I 10282 05:51:36,001 --> 05:51:37,000 WOULD LOOF TO WORK WITH -- LOVE 10283 05:51:37,001 --> 05:51:39,000 TO WORK WITH MY FRIENDS ON THE 10284 05:51:39,001 --> 05:51:41,000 OTHER SIDE OF THE AISLE TO DO 10285 05:51:41,001 --> 05:51:42,000 THOSE THINGS TO MAKE MEDICARE 10286 05:51:42,001 --> 05:51:44,000 MORE SOLVENT. 10287 05:51:44,001 --> 05:51:46,000 BUT I THINK WHAT IS SO 10288 05:51:46,001 --> 05:51:49,000 OBJECTIONABLE TO ALL OF US IS TO 10289 05:51:49,001 --> 05:51:50,000 KNOW THAT WE HAVE AN INSOLVENT 10290 05:51:50,001 --> 05:51:51,000 MEDICARE PROGRAM THAT THE 10291 05:51:51,001 --> 05:51:54,000 TRUSTEES HAVE SAID WILL BE 10292 05:51:54,001 --> 05:51:55,000 BANKRUPT IN THE YEAR 2017 AND MY 10293 05:51:55,001 --> 05:51:58,000 FRIENDS ON THE OTHER SIDE OF THE 10294 05:51:58,001 --> 05:52:00,000 AISLE ARE TAKING MONEY FROM THE 10295 05:52:00,001 --> 05:52:01,000 PROGRAM TO LEVERAGE A NEW ENTITLEMENT. 10296 05:52:01,001 --> 05:52:05,000 THANK YOU, MR. PRESIDENT. THE PRESID 10297 05:52:05,001 --> 05:52:07,000 YIELDS TIME? 10298 05:52:07,001 --> 05:52:09,000 THE SENATOR FROM ILLINOIS. 10299 05:52:09,001 --> 05:52:12,000 MR. DUIN: CHOICE. 10300 05:52:12,001 --> 05:52:14,000 WILL WE CONTINUE TO SUBSIDIZE PRIVATE HEALTH INSURANCE 10301 05:52:14,001 --> 05:52:18,000 COMPANIES WHO ARE OVERCHARGING 10302 05:52:18,001 --> 05:52:20,000 THE MEDICARE PROGRAM BY 14%? 10303 05:52:20,001 --> 05:52:22,000 WILL WE TAKE THAT MONEY OUT OF 10304 05:52:22,001 --> 05:52:24,000 MEDICARE TO CONTINUE THE SUBSIDY 10305 05:52:24,001 --> 05:52:26,000 FOR PROFITABLE, PRIVATE HEALTH 10306 05:52:26,001 --> 05:52:27,000 INSURANCE COMPANIES? 10307 05:52:27,001 --> 05:52:29,000 IT IS THAT BASIC. 10308 05:52:29,001 --> 05:52:30,000 I WOULD SAY TO THE SENATOR FROM 10309 05:52:30,001 --> 05:52:32,000 TENNESSEE, 10310 05:52:32,001 --> 05:52:34,000 BUDGET OFFICE TELLS US, YES, 10311 05:52:34,001 --> 05:52:37,000 UNTOUCHED THE MEDICARE PROGRAM 10312 05:52:37,001 --> 05:52:39,000 IN SEVEN 10313 05:52:39,001 --> 05:52:41,000 IN-- FACES INSOLVENCY. 10314 05:52:41,001 --> 05:52:43,000 BUT 10315 05:52:43,001 --> 05:52:45,000 SOLVENCY TO MEDICARE RIGHT OFF THE TOP. 10316 05:52:45,001 --> 05:52:46,000 RIGHT OFF THE TOP, FIVE MORE 10317 05:52:46,001 --> 05:52:47,000 YEAR 10318 05:52:47,001 --> 05:52:49,000 SOMETHING THAT YOU WON'T 10319 05:52:49,001 --> 05:52:51,000 ACKNOWLEDGE, BUT YOU SHOULD. 10320 05:52:51,001 --> 05:52:52,000 LET ME ALSO ADD, IF WE'RE GOING 10321 05:52:52,001 --> 05:52:55,000 TO BRING DOWN THE COST OF 10322 05:52:55,001 --> 05:52:56,000 MEDICARE SO THAT RECIPIENTS GET 10323 05:52:56,001 --> 05:52:58,000 QUALITY CARE, WE 10324 05:52:58,001 --> 05:52:59,000 OF THE OUTRAGEOUS SUBSIDIES TO 10325 05:52:59,001 --> 05:53:00,000 PRIVATE HEALTH INSURANCE 10326 05:53:00,001 --> 05:53:01,000 COMPANIES, THE MEDICARE 10327 05:53:01,001 --> 05:53:03,000 ADVANTAGE PROGRAM. 10328 05:53:03,001 --> 05:53:05,000 WE ALSO HAVE TO BE HONEST ABOUT 10329 05:53:05,001 --> 05:53:06,000 THOSE PROVIDERS OVERCHARGING 10330 05:53:06,001 --> 05:53:08,000 MEDICARE. 10331 05:53:08,001 --> 05:53:10,000 WHY DOES IT COST TWICE AS MUCH 10332 05:53:10,001 --> 05:53:13,000 IN MIAMI FOR THE SAME SERVICES 10333 05:53:13,001 --> 05:53:16,000 THAT GIVEN TO MEDICARE PATIENTS 10334 05:53:16,001 --> 05:53:17,000 IN ROCHESTER, MINNESOTA? 10335 05:53:17,001 --> 05:53:19,000 IT SHOULDN'T. 10336 05:53:19,001 --> 05:53:22,000 SOMEBODY'S RIPPING OFF THE SYSTEM. 10337 05:53:22,001 --> 05:53:23,000 IF WE CAN'T ASK THOSE HONEST 10338 05:53:23,001 --> 05:53:25,000 QUESTIONS, THEN'M AFRAID WE'RE 10339 05:53:25,001 --> 05:53:26,000 NOT GOING TO PUT MEDICARE ON 10340 05:53:26,001 --> 05:53:27,000 SOUND FINANCIAL FOOTING. 10341 05:53:27,001 --> 05:53:28,000 WE CAN DO THAT. 10342 05:53:28,001 --> 05:53:32,000 BUT WE CAN'T DO THAT BY SAYING 10343 05:53:32,001 --> 05:53:33,000 WE HAVE TO CONTINUE TO SUBSIDIZE 10344 05:53:33,001 --> 05:53:36,000 PRIVATE HEALTH INSURANCE 10345 05:53:36,001 --> 05:53:39,000 COMPANIES OUT OF MEDICARE. 10346 05:53:39,001 --> 05:53:41,000 THAT'S THE AMENDMENT. 10347 05:53:41,001 --> 05:53:42,000 I YIELD THE FLOOR. 10348 05:53:42,001 --> 05:53:46,000 THE PRESIDING OFFICER: WHO 10349 05:53:46,001 --> 05:53:47,000 YIELDS TIME? 10350 05:53:47,001 --> 05:53:48,000 THE SENATOR FRO 10351 05:53:48,001 --> 05:53:50,000 THE TIME. 10352 05:53:50,001 --> 05:53:52,000 FIVE MINUTES. 10353 05:53:52,001 --> 05:53:53,000 THE SENATOR FROM RHODE ISLAND IS 10354 05:53:53,001 --> 05:53:54,000 RECOGNIZED. 10355 05:53:54,001 --> 05:53:56,000 MR. WHITEHOUSE: I THANK THE 10356 05:53:56,001 --> 05:53:57,000 DISTINGUISHED SENATOR FROM IOWA 10357 05:53:57,001 --> 05:53:59,000 FOR THE RECOGNITION. 10358 05:53:59,001 --> 05:54:00,000 I WOULD MAKE ONE P 10359 05:54:00,001 --> 05:54:02,000 MINUTES, WHICH IS THAT THOSE OF 10360 05:54:02,001 --> 05:54:03,000 US WHO HAVE BEEN PRIVILEGED TO 10361 05:54:03,001 --> 05:54:06,000 HEAR OUR FRIENDS ON THE OTHER 10362 05:54:06,001 --> 05:54:10,000 SIDE DEBATE THE PUBLIC OPTION 10363 05:54:10,001 --> 05:54:11,000 HAVE SEEN A RELENTLS 10364 05:54:11,001 --> 05:54:13,000 INSISTENCE ON THE PUBLIC OPTION 10365 05:54:13,001 --> 05:54:15,000 OPERATING ON A LEVEL PLAYING 10366 05:54:15,001 --> 05:54:16,000 FIELD WITH THE PRIVATE INSURANCE 10367 05:54:16,001 --> 05:54:18,000 INDUSTRY. 10368 05:54:18,001 --> 05:54:21,000 I CAN'T TELL THE NUMBE 10369 05:54:21,001 --> 05:54:23,000 INDEED, EVEN WHEN WE DESIGNED 10370 05:54:23,001 --> 05:54:26,000 THE PUBLIC OPTION S 10371 05:54:26,001 --> 05:54:28,000 OPERATE ON A LEVEL PLAYING FIELD 10372 05:54:28,001 --> 05:54:29,000 WITH PRIVATE INSURANCE INDUSTRY, 10373 05:54:29,001 --> 05:54:31,000 THEY STILL COMPLAINED. 10374 05:54:31,001 --> 05:54:33,000 BUT NOW WE HAVE A SITUATION IN 10375 05:54:33,001 --> 05:54:38,000 WHICH WE HAVE PRIVATE INDUSTRY 10376 05:54:38,001 --> 05:54:40,000 OPERATING AT A 14% ADVANTAGE IN 10377 05:54:40,001 --> 05:54:42,000 SUBSIDY AGAINST MEDICARE. 10378 05:54:42,001 --> 05:54:44,000 AND SUDDENLY THE OTHER SIDE'S 10379 05:54:44,001 --> 05:54:47,000 INTEREST IN A LEVEL PLAYING 10380 05:54:47,001 --> 05:54:48,000 FIEL 10381 05:54:48,001 --> 05:54:50,000 SUDDENLY THEIR INTEREST IS IN 10382 05:54:50,001 --> 05:54:54,000 DOING WHAT IS, ONCE AGAIN, IN 10383 05:54:54,001 --> 05:54:56,000 THE ASTONISHING COINCIDENCE 10384 05:54:56,001 --> 05:54:57,000 CHARACTERIZED THIS DEBATE IN THE 10385 05:54:57,001 --> 05:54:59,000 INTEREST OF THE INSURANCE INDUSTRY. 10386 05:54:59,001 --> 05:55:01,000 I HAVE YET TO SEE AN ARGUMENT 10387 05:55:01,001 --> 05:55:02,000 MADE BY THE OTHER -- FROM THE 10388 05:55:02,001 --> 05:55:04,000 OTHER SIDE OF THE AISLE THAT 10389 05:55:04,001 --> 05:55:05,000 DOESN'T HAPPEN TO COINCIDE WITH 10390 05:55:05,001 --> 05:55:07,000 THE INTEREST OF THE INSURANCE INDUSTRY. 10391 05:55:07,001 --> 05:55:08,000 IT COULD NOT BE MORE STARK ON 10392 05:55:08,001 --> 05:55:10,000 THIS POINT. 10393 05:55:10,001 --> 05:55:11,000 IF IT'S A PUBLIC OPTION, THEY 10394 05:55:11,001 --> 05:55:12,000 WANT TO COMPETE ON A LEVEL 10395 05:55:12,001 --> 05:55:14,000 PLAYING FIELD. 10396 05:55:14,001 --> 05:55:17,000 EVEN THEN THEY'RE AGAINST IT. 10397 05:55:17,001 --> 05:55:18,000 IF IT'S PRIVATELY SUBSIDIZED 10398 05:55:18,001 --> 05:55:21,000 COVERAGE GETTING ADVANTAGE IN 10399 05:55:21,001 --> 05:55:23,000 THE SYSTEM, THEN F 10400 05:55:23,001 --> 05:55:25,000 THAT WE SUPPORT THE EFFORTS TO 10401 05:55:25,001 --> 05:55:26,000 BRING SOME DISCIPLINE TO 10402 05:55:26,001 --> 05:55:29,000 MEDICARE ADVANTAGE AS THE 10403 05:55:29,001 --> 05:55:30,000 PRIVATE INSURANCE INDUSTRY 10404 05:55:30,001 --> 05:55:32,000 PROMISED. 10405 05:55:32,001 --> 05:55:33,000 THEM TO THEIR 10406 05:55:33,001 --> 05:55:34,000 I YIELD THE FLOOR. 10407 05:55:34,001 --> 05:55:37,000 THE PRESIDING OFFICER: WHO 10408 05:55:37,001 --> 05:55:39,000 YIELDS TIME 10409 05:55:39,001 --> 05:55:40,000 THE SENATOR FROM TEXAS IS RECOGNIZED. 10410 05:55:40,001 --> 05:55:42,000 MRS. HUTCHISON: MR. PRESIDENT, I 10411 05:55:42,001 --> 05:55:44,000 ASK UNANIMOUS CONSENT TO SUBMIT 10412 05:55:44,001 --> 05:55:45,000 SENATOR KYL'S REMARKS FOR THE RECORD. 10413 05:55:45,001 --> 05:55:47,000 THE PRESIDING OFFICER: WITHOUT 10414 05:55:47,001 --> 05:55:48,000 OBJECTION. 10415 05:55:48,001 --> 05:55:50,000 MRS. HUTCHISON: I YIELD 30 10416 05:55:50,001 --> 05:55:52,000 SECONDS TOENATOR THE PRESIDING OFFICER: THE 10417 05:55:52,001 --> 05:55:55,000 SENATOR FROM ARIZONA. MR. McCAIN: MR. PRESIDENT, I 10418 05:55:55,001 --> 05:55:57,000 UNDERSTAND THAT THE SENATOR 10419 05:55:57,001 --> 05:56:01,000 PENNSYLVANIA, SENATOR CASEY, HAS 10420 05:56:01,001 --> 05:56:02,000 AN AMENDMENT TO TWEND 10421 05:56:02,001 --> 05:56:06,000 TWEND $2.5 BILLION TO PROTECT 10422 05:56:06,001 --> 05:56:07,000 MEDICARE BENEFITS FOR PENNSYLVANIANS. 10423 05:56:07,001 --> 05:56:10,000 WHAT'S GOING ON. 10424 05:56:10,001 --> 05:56:12,000 WHY CAN'T WE PROTECT EVERY CITIZEN. 10425 05:56:12,001 --> 05:56:14,000 THAT'S FIVE STATES PROTECTED AND 10426 05:56:14,001 --> 05:56:15,000 SPENDING EXTRA DOLLARS. 10427 05:56:15,001 --> 05:56:17,000 LET'S HAVE AN AMENDMENT THAT 10428 05:56:17,001 --> 05:56:18,000 EVERY STATE IS TREATED THE SAME. 10429 05:56:18,001 --> 05:56:20,000 LET'S DO THAT. 10430 05:56:20,001 --> 05:56:21,000 I TELL MY COLLEAGUES I INTEND TO 10431 05:56:21,001 --> 05:56:23,000 INTRODUCE AN AMENDMENT THAT WILL 10432 05:56:23,001 --> 05:56:25,000 DO SO D THAT WILL TAKE AWAY 10433 05:56:25,001 --> 05:56:27,000 THE SPECIAL EXCEPTIONS THAT ARE 10434 05:56:27,001 --> 05:56:28,000 TAKEN FOR SPECIAL STATES WHO 10435 05:56:28,001 --> 05:56:30,000 HAVE 10436 05:56:30,001 --> 05:56:31,000 HERE. 10437 05:56:31,001 --> 05:56:33,000 MRS. HUTCHISON: MR. PRESIDENT, 10438 05:56:33,001 --> 05:56:34,000 JUST TO PUT THIS 10439 05:56:34,001 --> 05:56:37,000 PERSPECTIVE. 10440 05:56:37,001 --> 05:56:39,000 WHEN I HEAR ALL OF THIS DEBATE, 10441 05:56:39,001 --> 05:56:40,000 IT'S LIKE EVERYTHING HAS TO B 10442 05:56:40,001 --> 05:56:41,000 MORE GOVERNMENT, BIGGER 10443 05:56:41,001 --> 05:56:43,000 GOVERNMENT, GOVERNMENT IS BETTER 10444 05:56:43,001 --> 05:56:46,000 THAN THE 10445 05:56:46,001 --> 05:56:49,000 MR. PRESIDENT, MEDICARE 10446 05:56:49,001 --> 05:56:50,000 ADVANTAGE IS AN OPTION. 10447 05:56:50,001 --> 05:56:53,000 IT'S NOT A MANDATE. 10448 05:56:53,001 --> 05:56:55,000 IT'S AN OPTION THAT ALLOWS 10449 05:56:55,001 --> 05:56:56,000 SENIORS ANOTHER CHOICE TO GET 10450 05:56:56,001 --> 05:56:59,000 HEARING AIDS. 10451 05:56:59,001 --> 05:57:00,000 MR. PRESIDENT, 10452 05:57:00,001 --> 05:57:02,000 SENIORS HAVE AN OPTION. 10453 05:57:02,001 --> 05:57:03,000 WE NEED MORE COMPETION, NOT 10454 05:57:03,001 --> 05:57:04,000 LESS. 10455 05:57:04,001 --> 05:57:06,000 THANK YOU, PURCHASE. 10456 05:57:06,001 --> 05:57:07,000 AND I -- MR. PRESIDENT, AND I YIELD THE TIME. 10457 05:57:07,001 --> 05:57:08,000 THE PRESIDING OFFICER: WHO 10458 05:57:08,001 --> 05:57:10,000 YIELDS TIME? 10459 05:57:10,001 --> 05:57:11,000 MR. HARKIN: HOW MUCH TIME IS LEFT? 10460 05:57:11,001 --> 05:57:12,000 THE PRESIDING OFFICER: 2 1/2 10461 05:57:12,001 --> 05:57:13,000 MINUTES. 10462 05:57:13,001 --> 05:57:15,000 MR. HARKIN: MR. PRESIDENT, IT'S 10463 05:57:15,001 --> 05:57:17,000 INTERESTING TO HEAR THE LAST 10464 05:57:17,001 --> 05:57:18,000 SPEAKER SAY, DON'T TAKE AWAY THE 10465 05:57:18,001 --> 05:57:19,000 OPTION FOR SENIORS ON MEDICARE 10466 05:57:19,001 --> 05:57:20,000 ADVANTAGE. 10467 05:57:20,001 --> 05:57:22,000 YET, THEY HAVE AN AMENDMENT TO 10468 05:57:22,001 --> 05:57:24,000 TAKE AWAY THE OPTION FOR PEOPLE 10469 05:57:24,001 --> 05:57:27,000 TO BUY INSURANCE AGAINST HAVING 10470 05:57:27,001 --> 05:57:29,000 A DISABILITY SO THEY CAN STAY 10471 05:57:29,001 --> 05:57:30,000 THEIR OWN HOMES AND HAVE SUPPORT. 10472 05:57:30,001 --> 05:57:31,000 IT'S VOLUNTARY. 10473 05:57:31,001 --> 05:57:34,000 IT'S NOT MANDATORY. 10474 05:57:34,001 --> 05:57:36,000 NONE'S FORCING ANYBODY TO DO 10475 05:57:36,001 --> 05:57:37,000 ANYTHING M 10476 05:57:37,001 --> 05:57:39,000 FROM TEXAS, YET, THERE'S AN 10477 05:57:39,001 --> 05:57:40,000 AMENDMENT ON THAT SIDE TO TAKE 10478 05:57:40,001 --> 05:57:42,000 THAT AWAY. 10479 05:57:42,001 --> 05:57:43,000 TO TAKE AWAY THAT VOLUNTARY 10480 05:57:43,001 --> 05:57:45,000 PROGRAM, THE CLASS ACT, S THAT 10481 05:57:45,001 --> 05:57:47,000 PEOPLE CAN VOLUNTARILY PUT MONEY 10482 05:57:47,001 --> 05:57:49,000 INTO IT TO PROTECT THEMSELVES 10483 05:57:49,001 --> 05:57:51,000 AGAINST FUTURE 10484 05:57:51,001 --> 05:57:52,000 SO I -- LET'S KIND OF KEEP OUR 10485 05:57:52,001 --> 05:57:53,000 ARGUMENTS A LITTLE BIT STRAIGHT 10486 05:57:53,001 --> 05:57:55,000 AROUND HERE. 10487 05:57:55,001 --> 05:57:57,000 MR. PRESIDENT, A LOT OF PEOPLE 10488 05:57:57,001 --> 05:57:59,000 HAVE TALKED ABOUT MEDICARE 10489 05:57:59,001 --> 05:58:01,000 ADVANTAGE. 10490 05:58:01,001 --> 05:58:02,000 I'M GOING TO CLOSE ON THE 10491 05:58:02,001 --> 05:58:04,000 NECESSITY OF KEEPING THE CLASS 10492 05:58:04,001 --> 05:58:06,000 ACT IN THIS BILL. 10493 05:58:06,001 --> 05:58:07,000 I'VE SPOKEN MANY TIMES ABOUT THAT. 10494 05:58:07,001 --> 05:58:09,000 'S NOT PARTISAN ISSUE. 10495 05:58:09,001 --> 05:58:11,000 IT'S LIKE WHEN WE PASSED THE 10496 05:58:11,001 --> 05:58:13,000 AMERICANS WITH DISABILITIES ACT. 10497 05:58:13,001 --> 05:58:17,000 IT WAS NOT A PARTISAN ISSUE. 10498 05:58:17,001 --> 05:58:19,000 THIS SHOULD NOT BE A PARTISAN ISSUE. 10499 05:58:19,001 --> 05:58:22,000 WE SHOULD NOT L 10500 05:58:22,001 --> 05:58:23,000 INVOLVED IN IT. 10501 05:58:23,001 --> 05:58:27,000 OVER 275 GROUPS REPRESENTING 10502 05:58:27,001 --> 05:58:28,000 GROUPS FROM DISABILITIES, TO THE 10503 05:58:28,001 --> 05:58:29,000 INTERFAITH COALITION SUPPORT THE 10504 05:58:29,001 --> 05:58:32,000 CLASS ACT. 10505 05:58:32,001 --> 05:58:33,000 IT WAS UNANIMOUSLY ADOPTED BY 10506 05:58:33,001 --> 05:58:34,000 THE "HELP" COMMITTEE, 10507 05:58:34,001 --> 05:58:36,000 UNANIMOUSLY ADOPTED BY 10508 05:58:36,001 --> 05:58:38,000 REPUBLICANS AND DEMOCRATS. 10509 05:58:38,001 --> 05:58:40,000 SENATOR GREGG OFFERED AN 10510 05:58:40,001 --> 05:58:43,000 AMENDMENT TO MAKE -- INSIST THAT 10511 05:58:43,001 --> 05:58:46,000 IT BE YEARS. 10512 05:58:46,001 --> 05:58:50,000 AND IT IS ACTUARIALLY SOUND OVER 10513 05:58:50,001 --> 05:58:54,000 75 YEARS. 10514 05:58:54,001 --> 05:58:56,000 SECRETARY SEBELIUS HAS SUPPORTED 10515 05:58:56,001 --> 05:58:57,000 IT 10516 05:58:57,001 --> 05:58:58,000 BROAD BASE OF SUPPORT FOR THE 10517 05:58:58,001 --> 05:58:59,000 CLASS ACT. 10518 05:58:59,001 --> 05:59:00,000 MR. PRESIDENT, TODAY WE RECEIVED 10519 05:59:00,001 --> 05:59:01,000 SOME LETTERS FROM PEOPLE AROUND 10520 05:59:01,001 --> 05:59:03,000 THE COUNTRY. 10521 05:59:03,001 --> 05:59:04,000 I DON'T HAVE TIME TO READ THEM 10522 05:59:04,001 --> 05:59:06,000 ALL, BUT JUST A COUPLE MUCH 10523 05:59:06,001 --> 05:59:08,000 HERE'S ONE FROM -- COUPLE. 10524 05:59:08,001 --> 05:59:10,000 HERE'S ONE FROM ARKANSAS. 10525 05:59:10,001 --> 05:59:12,000 MY WIFE HAS A JOURNALISM DEGREE, 10526 05:59:12,001 --> 05:59:17,000 CEREBRAL PALSY 10527 05:59:17,001 --> 05:59:18,000 FROM STATE OF ARKANSAS WITH A 10528 05:59:18,001 --> 05:59:21,000 STAY-AT-HOME JOB. 10529 05:59:21,001 --> 05:59:23,000 SHE CAN STILL EARN MONEY UNDER 10530 05:59:23,001 --> 05:59:25,000 THE CLASS A 10531 05:59:25,001 --> 05:59:28,000 OF AN ATTENDANT RATHER THAN 10532 05:59:28,001 --> 05:59:30,000 HAVING TO GO TO A NURSING HOME. 10533 05:59:30,001 --> 05:59:31,000 HERE'S VIRGINIA, I DON'T 10534 05:59:31,001 --> 05:59:32,000 CURRENTLY NEED THE SERVICES 10535 05:59:32,001 --> 05:59:35,000 UNDER THE CLASS ACT, BUT HAVING 10536 05:59:35,001 --> 05:59:36,000 BEEN BORN WITH A DISABILITY, I 10537 05:59:36,001 --> 05:59:38,000 HAVE ALWAYS BEEN ACUTELY AWARE 10538 05:59:38,001 --> 05:59:39,000 OF THE POSSIBILITY OF SERIOUS 10539 05:59:39,001 --> 05:59:40,000 ISSUES DOWNS THE -- DOWN THE 10540 05:59:40,001 --> 05:59:43,000 ROAD. 10541 05:59:43,001 --> 05:59:45,000 IT WOULD BE A GOOD THING FOR ME, 10542 05:59:45,001 --> 05:59:47,000 A 30-YEAR-OLD WORKING PERSON TO 10543 05:59:47,001 --> 05:59:49,000 BE ABLE TO PUT SOME MONEY AWAY. 10544 05:59:49,001 --> 05:59:53,000 I BEG MY COLLEAGUES FOR THE SAKE 10545 05:59:53,001 --> 05:59:54,000 OF PEOPLE WITH DISABILITIES IN 10546 05:59:54,001 --> 05:59:58,000 THE AMENDMENT OF THE REPUBLICANS 10547 05:59:58,001 --> 06:00:02,000 TO TAKE AWAY THE CLASS ACT. 10548 06:00:02,001 --> 06:00:03,000 IT WAS SENATOR KENNEDY'S PREMIER GOAL -- 10549 06:00:03,001 --> 06:00:05,000 THE PRESIDING OFFICER: THE SENATOR'S TIME HAS EXPIRED. 10550 06:00:05,001 --> 06:00:06,000 ALL TIME HAS EXPIRED. 10551 06:00:06,001 --> 06:00:08,000 UNDE 10552 06:00:08,001 --> 06:00:10,000 QUESTION OCCURS ON AMENDMENT 10553 06:00:10,001 --> 06:00:12,000 NUMBER 2870, OFFERED BY THE 10554 06:00:12,001 --> 06:00:17,000 SENATOR FROM RHODE ISLAND, MR. WHITEHOUSE. 10555 06:00:17,001 --> 06:00:18,000 IS THERE A SUFFICIENT 10556 06:00:18,001 --> 06:00:19,000 THERE APPEARS TO BE A SUFFICI SECOND. 10557 06:00:19,001 --> 06:00:25,000 THE YEAS AND NAYS ARE ORDERED. 10558 06:00:25,001 --> 06:14:39,000 THE CLERK WILL CALL THE ROLL. 10559 06:14:39,001 --> 06:22:53,000 VOTE: 10560 06:22:53,001 --> 06:22:54,000 VOTE: 10561 06:22:54,001 --> 06:22:56,000 THE PRESIDING OFFICER: ARE 10562 06:22:56,001 --> 06:22:59,000 THERE ANY SENATORS WHO WISH TO 10563 06:22:59,001 --> 06:23:02,000 VOTE OR CHANGE THEIR VOTE? 10564 06:23:02,001 --> 06:23:03,000 IF NOT, ON THIS VOTE THE YEAS 10565 06:23:03,001 --> 06:23:05,000 ARE 98. 10566 06:23:05,001 --> 06:23:06,000 THE NAYS ARE ZERO. 10567 06:23:06,001 --> 06:23:07,000 UNDER THE PREVIOUS ORDER 10568 06:23:07,001 --> 06:23:09,000 REQUIRING 60 VOTES FOR THE 10569 06:23:09,001 --> 06:23:11,000 ADOPTION OF THIS AMENDMENT, THE 10570 06:23:11,001 --> 06:23:21,000 AMENDMENT IS AGREED TO. 10571 06:23:21,001 --> 06:23:22,000 THE SENATE WILL 10572 06:23:22,001 --> 06:23:23,000 THE SENATE WILL COME TO ORDER. 10573 06:23:23,001 --> 06:23:24,000 PLEASE REMOVE CONVERSATIONS OFF 10574 06:23:24,001 --> 06:23:25,000 THE FLOOR. 10575 06:23:25,001 --> 06:23:26,000 MRS. HUTCHISON: 10576 06:23:26,001 --> 06:23:29,000 PARLIAMENTARY INQUIRY? 10577 06:23:29,001 --> 06:23:30,000 ARE THE 10578 06:23:30,001 --> 06:23:31,000 TEN-MINUTE VOTES? 10579 06:23:31,001 --> 06:23:33,000 THE PRESID 10580 06:23:33,001 --> 06:23:35,000 SENATOR FROM TEXAS IS CORRECT. 10581 06:23:35,001 --> 06:23:36,000 THEEXT THREE VOTES ARE 10582 06:23:36,001 --> 06:23:46,000 TEN-MINUTE VOTES. 10583 06:23:46,001 --> 06:23:47,000 MRS. HUTCHISON: THANK YOU. 10584 06:23:47,001 --> 06:23:48,000 THE PRESIDING OFFICER: WITHOUT 10585 06:23:48,001 --> 06:23:49,000 OBJECTION. 10586 06:23:49,001 --> 06:23:51,000 UNDER THE PREVIOUS ORDER, THERE 10587 06:23:51,001 --> 06:23:54,000 ARE TWO 10588 06:23:54,001 --> 06:24:01,000 WHO YIELDS TIME? 10589 06:24:01,001 --> 06:24:02,000 THE SENATE WILL COME TO ORDER. 10590 06:24:02,001 --> 06:24:04,000 UNDER THE PREVIOUS ORDER, THERE 10591 06:24:04,001 --> 06:24:05,000 ARE TWO MINUTES EQUALLY DIVIDED. 10592 06:24:05,001 --> 06:24:06,000 WHO YIELDS TIME? 10593 06:24:06,001 --> 06:24:07,000 MR. DODD: 10594 06:24:07,001 --> 06:24:08,000 THE PRESIDING OFFICER: THE 10595 06:24:08,001 --> 06:24:09,000 SENATOR FROM CONNECTICUT. 10596 06:24:09,001 --> 06:24:11,000 MR. DODD: MR. PRESIDENT, I 10597 06:24:11,001 --> 06:24:12,000 URGE MY COLLEAGUES TO SUPPORT 10598 06:24:12,001 --> 06:24:14,000 THE CLASS ACT AND TO VOTE 10599 06:24:14,001 --> 06:24:16,000 AGAINST THE, I BELIEVE IT IS THE THUNE AMENDMENT WHICH WOULD 10600 06:24:16,001 --> 06:24:18,000 STRIKE THE CLASS ACT FROM THE BILL. 10601 06:24:18,001 --> 06:24:20,000 AS YOU HEARD, I HOPE, THIS 10602 06:24:20,001 --> 06:24:21,000 AFTERNOON, THIS BILL IS TOTALLY 10603 06:24:21,001 --> 06:24:22,000 VOLUNTARY. 10604 06:24:22,001 --> 06:24:23,000 THERE IS NO REQUIREMENT BY 10605 06:24:23,001 --> 06:24:24,000 EMPLOYERS OR EMPLOYEES TO BE 10606 06:24:24,001 --> 06:24:26,000 INVOLVED IN THIS. 10607 06:24:26,001 --> 06:24:27,000 THIS IS A VERY C 10608 06:24:27,001 --> 06:24:29,000 USING INDIVIDUALS' MONEY TO 10609 06:24:29,001 --> 06:24:30,000 CONTRIBUTE TO THEIR OWN 10610 06:24:30,001 --> 06:24:32,000 LONG-TERM FINANCIAL SECURITY IF 10611 06:24:32,001 --> 06:24:33,000 THEY'RE FACED WITH DISABILITIES. 10612 06:24:33,001 --> 06:24:35,000 WE HAVE NOW, WITH THE ADOPTION 10613 06:24:35,001 --> 06:24:36,000 OF 10614 06:24:36,001 --> 06:24:38,000 SECURED THAT THESE FUNDS CAN 10615 06:24:38,001 --> 06:24:39,000 NEVER BE USED FOR ANY OTHER 10616 06:24:39,001 --> 06:24:43,000 PURPOSE THAN FOR THE CLASS ACT. 10617 06:24:43,001 --> 06:24:45,000 THAT WAS THE CONCERN MOST OF OUR 10618 06:24:45,001 --> 06:24:46,000 FUNDS DRIFT OFF. 10619 06:24:46,001 --> 06:24:47,000 AS A RESULT OF THE GREGG 10620 06:24:47,001 --> 06:24:49,000 AMENDMENT IOUR COMMITTEE, IT 10621 06:24:49,001 --> 06:24:50,000 HAS BEEN DETERMINED THESE 10622 06:24:50,001 --> 06:24:52,000 PROGRAMS WILL BE ACTUARIALLY 10623 06:24:52,001 --> 06:24:55,000 SOUND FOR 75 YEARS. 10624 06:24:55,001 --> 06:24:56,000 WE FIX 10625 06:24:56,001 --> 06:24:58,000 RAISED WITH IT. 10626 06:24:58,001 --> 06:25:01,000 IT IS A SOLID PROGRAM THAT CAN 10627 06:25:01,001 --> 06:25:03,000 MAKE A HUGE DIFFERENCE FOR 10628 06:25:03,001 --> 06:25:05,000 MILLIONS OF AMERICANS, ALLOWING 10629 06:25:05,001 --> 06:25:06,000 THEM TO LEAD INDEPENDENT LIVES 10630 06:25:06,001 --> 06:25:07,000 WITH DIGNITY. 10631 06:25:07,001 --> 06:25:10,000 IT IS DESERVING OF OUR SUPPORT. 10632 06:25:10,001 --> 06:25:12,000 I URGE APPROVAL OF THIS PROGRAM. 10633 06:25:12,001 --> 06:25:13,000 YIELDS TIME? 10634 06:25:13,001 --> 06:25:14,000 MR. THUNE: MR. PRESIDENT? 10635 06:25:14,001 --> 06:25:17,000 THE PRESIDING OFFICER: THE 10636 06:25:17,001 --> 06:25:18,000 SENATOR FROM SOUTH 10637 06:25:18,001 --> 06:25:20,000 THE PRESIDING OFFICER: 10638 06:25:20,001 --> 06:25:21,000 MR. PRESIDENT, THE CLASS -- 10639 06:25:21,001 --> 06:25:23,000 MR. THUNE: MR. PRESIDENT, THE 10640 06:25:23,001 --> 06:25:25,000 CLASS ACT IS THE SAME OLD 10641 06:25:25,001 --> 06:25:26,000 WASHINGTON, SAME OLD SMOKE AND 10642 06:25:26,001 --> 06:25:28,000 MIRRORS, SAME OLD GAMES. 10643 06:25:28,001 --> 06:25:30,000 I WANT TO READ WHAT THE CONGRESSIONAL BUDGET OFFICE AND 10644 06:25:30,001 --> 06:25:31,000 THE 10645 06:25:31,001 --> 06:25:33,000 ADMINISTRATION SAID. 10646 06:25:33,001 --> 06:25:35,000 "THE PROGRAM WOULD ADD TO FUTURE 10647 06:25:35,001 --> 06:25:37,000 FEDERAL BUDGET DEFICITS IN LARGE 10648 06:25:37,001 --> 06:25:38,000 AND GROWING 10649 06:25:38,001 --> 06:25:39,000 MR. PRESIDENT, IF WE DON'T TAKE 10650 06:25:39,001 --> 06:25:42,000 THIS OUT OF THIS LEGISLATION, WE 10651 06:25:42,001 --> 06:25:45,000 ALLOW THIS TO BECOME LAW, WE ARE 10652 06:25:45,001 --> 06:25:46,000 LOCKING IN FUTURE GENERATIONS TO 10653 06:25:46,001 --> 06:25:47,000 DEFICITS AND DEBT AS FAR AS THE 10654 06:25:47,001 --> 06:25:49,000 EYE CAN SEE. 10655 06:25:49,001 --> 06:25:51,000 THIS IS, AS HAS BEEN DESCRIBED 10656 06:25:51,001 --> 06:25:53,000 BY THE OTHER SIDE, A PONZI 10657 06:25:53,001 --> 06:25:54,000 SCHEME OF THE HIGHEST ORDER. 10658 06:25:54,001 --> 06:25:55,000 WE NEED TO TAKE IT OUT OF THIS 10659 06:25:55,001 --> 06:25:56,000 BILL. 10660 06:25:56,001 --> 06:25:59,000 I URGE MY COLLEAGUES TO ADOPT 10661 06:25:59,001 --> 06:26:00,000 THIS AMENDMENT. 10662 06:26:00,001 --> 06:26:02,000 THE PRESIDING OFFICER: 10663 06:26:02,001 --> 06:26:05,000 THE PREVIOUS ORDER, THE QUESTION 10664 06:26:05,001 --> 06:26:06,000 IS ON THE AMENDMENT NUMBER 2901 10665 06:26:06,001 --> 06:26:15,000 OFFERED BY THE SENATOR FROM 10666 06:26:15,001 --> 06:26:18,000 THE YEAS AND NAYS HAVE BEEN REQUESTED. 10667 06:26:18,001 --> 06:26:19,000 ARE THERE SUFFICIENT SONDS? 10668 06:26:19,001 --> 06:26:20,000 THERE APPEARS TO BE A SUFFICIENT 10669 06:26:20,001 --> 06:26:25,000 SECOND. 10670 06:26:25,001 --> 06:29:50,000 THE CLERK WILL CALL THE 10671 06:29:50,001 --> 06:40:46,000 VOTE: 10672 06:40:46,001 --> 06:40:47,000 VOTE: 10673 06:40:47,001 --> 06:40:48,000 THE PRESIDING OFFICER: ARE THERE ANY SENATORS IN THE 10674 06:40:48,001 --> 06:40:49,000 CHAMBER WISHING TO VOTE OR 10675 06:40:49,001 --> 06:40:51,000 CHANGE THEIR VOTE? 10676 06:40:51,001 --> 06:40:54,000 IF NOT, ON THIS VOTE, THE YEAS 10677 06:40:54,001 --> 06:40:56,000 ARE 51, THE NAYS ARE 47. 10678 06:40:56,001 --> 06:40:57,000 UNDER THE PREVIOUS ORDER 10679 06:40:57,001 --> 06:40:59,000 REQUIRING 60 VOTES FOR THE 10680 06:40:59,001 --> 06:41:02,000 ADOPTION OF THIS AMENDMENT, THE 10681 06:41:02,001 --> 06:41:05,000 AMENDMENT IS WITHDRAWN. 10682 06:41:05,001 --> 06:41:06,000 WITHOU 10683 06:41:06,001 --> 06:41:08,000 UNDER THE PREVIOUS ORDER, THERE 10684 06:41:08,001 --> 06:41:11,000 ARE TWO 10685 06:41:11,001 --> 06:41:14,000 WHO 10686 06:41:14,001 --> 06:41:15,000 THE 10687 06:41:15,001 --> 06:41:16,000 THE SENATOR FROM MICHIGAN. 10688 06:41:16,001 --> 06:41:17,000 MS. STABENOW: THANK YOU, 10689 06:41:17,001 --> 06:41:20,000 MR. PRESIDENT. 10690 06:41:20,001 --> 06:41:21,000 THIS AMENDMENT IS VERY CLEAR. 10691 06:41:21,001 --> 06:41:23,000 MY AMENDMENT STATES THAT NOTHING 10692 06:41:23,001 --> 06:41:26,000 IN THIS ACT SHALL RESULT IN THE 10693 06:41:26,001 --> 06:41:28,000 REDUCTION OR ELIMINATION OF ANY 10694 06:41:28,001 --> 06:41:30,000 BENEFITS GUARANTEED BY LAW TO 10695 06:41:30,001 --> 06:41:31,000 PARTICIPANTS IN MEDICARE 10696 06:41:31,001 --> 06:41:33,000 ADVANTAGE PLANS. 10697 06:41:33,001 --> 06:41:37,000 MR. PRESIDENT, RIGHT NOW C.B.O. 10698 06:41:37,001 --> 06:41:38,000 TELLS US $12 BILLION EXTRA -- 10699 06:41:38,001 --> 06:41:40,000 THE PRESIDING OFFICER: THE 10700 06:41:40,001 --> 06:41:42,000 SENATOR WILL SUSPEND. 10701 06:41:42,001 --> 06:41:44,000 THE SENATE WILL COME TO ORDER. 10702 06:41:44,001 --> 06:41:45,000 PLEASE REMOVE YOUR CONVERSATIONS 10703 06:41:45,001 --> 06:41:49,000 OFF THE FLOOR SO THE SENATOR 10704 06:41:49,001 --> 06:41:50,000 FROM MICHIGAN CAN BE HEARD. 10705 06:41:50,001 --> 06:41:51,000 THE SENATOR FROM MICHIGAN. MS. STABENOW: THANK YOU, 10706 06:41:51,001 --> 06:41:53,000 MR. PRESIDENT. 10707 06:41:53,001 --> 06:41:55,000 MR. PRESIDENT, RIGHT NOW WE 10708 06:41:55,001 --> 06:41:58,000 UNDERSTAND FROM MEDPAC THAT 10709 06:41:58,001 --> 06:42:01,000 THERE'S $12 BILLION IN 10710 06:42:01,001 --> 06:42:02,000 OVERPAYMENTS TO FOR-PROFIT 10711 06:42:02,001 --> 06:42:03,000 INSURANCE COMPANIES THAT ARE 10712 06:42:03,001 --> 06:42:06,000 ADDITIONAL COSTS THAT WE PAY -- 10713 06:42:06,001 --> 06:42:08,000 THE TAXPAYERS, MEDICARE 10714 06:42:08,001 --> 06:42:09,000 RECIPIENTS PAY -- BEYOND WHAT IS 10715 06:42:09,001 --> 06:42:12,000 TRADITIONAL MEDICARE. 10716 06:42:12,001 --> 06:42:13,000 85% OF OUR SENIORS -- 10717 06:42:13,001 --> 06:42:14,000 MR. BAUCUS: MR. PRESIDENT, THE 10718 06:42:14,001 --> 06:42:15,000 SENATE IS NOT IN ORDER. 10719 06:42:15,001 --> 06:42:16,000 THE PRESIDING OFFICER: THE 10720 06:42:16,001 --> 06:42:17,000 SENATOR FROM MONTANA IS CORRECT. 10721 06:42:17,001 --> 06:42:18,000 PLEASE TAKE YOUR CONVERSATIONS 10722 06:42:18,001 --> 06:42:19,000 OFF THE FLOOR SO THAT THE 10723 06:42:19,001 --> 06:42:23,000 SENATOR FROM MICHIGAN CAN BE 10724 06:42:23,001 --> 06:42:26,000 HEARD AND ALSO THAT OTHER 10725 06:42:26,001 --> 06:42:28,000 SENATORS 10726 06:42:28,001 --> 06:42:30,000 THE SENATOR FROM MICHIGAN. MS. STABENOW: THANK YOU, 10727 06:42:30,001 --> 06:42:33,000 MR. PRESIDENT. 10728 06:42:33,001 --> 06:42:35,000 85% OF THE SENIORS IN MEDICARE 10729 06:42:35,001 --> 06:42:38,000 ARE IN TRADITIONAL MEDICARE, AND 10730 06:42:38,001 --> 06:42:40,000 RIGHT NOW WE'RE TOLD THAT EVERY 10731 06:42:40,001 --> 06:42:42,000 SINGLE SENIOR CITIZEN AND PERSON 10732 06:42:42,001 --> 06:42:45,000 WITH DISABILITY IN MEDICARE PAYS 10733 06:42:45,001 --> 06:42:49,000 $90 EXTRA, EVE 10734 06:42:49,001 --> 06:42:51,000 $90EXTRA TO PAY FOR THE 10735 06:42:51,001 --> 06:42:52,000 OVERPAYMENTS TO PRIVATE, 10736 06:42:52,001 --> 06:42:53,000 FOR-PROFIT INSURANCE COMPANIES. 10737 06:42:53,001 --> 06:42:56,000 AS AARP HAS SAID THIS 10738 06:42:56,001 --> 06:42:58,000 LEGISLATION DOES NOT REDUCE ANY 10739 06:42:58,001 --> 06:43:00,000 GUARANTEED MEDICAL BENEFITS. 10740 06:43:00,001 --> 06:43:05,000 ALL WE ARE DOING IS ASKING FOR 10741 06:43:05,001 --> 06:43:06,000 COMPETITIVE BIDDING FOR-PROFIT 10742 06:43:06,001 --> 06:43:08,000 CONDITIONS, COMPETIVE BIDDING, 10743 06:43:08,001 --> 06:43:09,000 BRING DOWN THE OVERAT E SAME OVERPAYMENTS AND 10744 06:43:09,001 --> 06:43:10,000 I WOULD ASK FOR SUPPORT SPONSOR 10745 06:43:10,001 --> 06:43:11,000 THE AMENDMENT. THAN 10746 06:43:11,001 --> 06:43:12,000 THE PRESIDING OFFICER: WHO 10747 06:43:12,001 --> 06:43:13,000 YIELDS TIME? 10748 06:43:13,001 --> 06:43:14,000 MR. LeMIEUX: MR. PRESIDENT? 10749 06:43:14,001 --> 06:43:15,000 THE PRESIDING OFFICER: 10750 06:43:15,001 --> 06:43:17,000 SENATOR FROM FLORIDA. 10751 06:43:17,001 --> 06:43:18,000 MR. LeMIEUX: THIS 10752 06:43:18,001 --> 06:43:19,000 MR. PRESIDENT, I HAD A 10753 06:43:19,001 --> 06:43:21,000 CONVERSATION WITH MY COLLEAGUE 10754 06:43:21,001 --> 06:43:23,000 FROM MICHIGAN, THE PHRASE IN 10755 06:43:23,001 --> 06:43:24,000 HERE "GUARANTEED BY LAW" DOESN'T GUARANTEE ANYTHING. 10756 06:43:24,001 --> 06:43:26,000 THIS ISN'T GOING TO PROTECT THE 10757 06:43:26,001 --> 06:43:28,000 BENEFITS OF MEDICARE ADVANTAGE. 10758 06:43:28,001 --> 06:43:32,000 THE BENEFITS THAT OUR SENIOR 10759 06:43:32,001 --> 06:43:34,000 CITIZENS ENJOY -- I CARE, 10760 06:43:34,001 --> 06:43:35,000 HEARING CARE, DENTAL CARE -- 10761 06:43:35,001 --> 06:43:36,000 THEY'RE NOT PROTECTED BY THIS. 10762 06:43:36,001 --> 06:43:39,000 YOU CAN VOTE FOR IT IF YOU WANT TO. 10763 06:43:39,001 --> 06:43:41,000 IT SOUNDS GOOD BUT IT'S JUST 10764 06:43:41,001 --> 06:43:43,000 GIFT WRAPPING ON AN EMPTY BOX. THE PRESIDING OFFICER: UNR 10765 06:43:43,001 --> 06:43:45,000 THE PREVIOUS ORDER, THE QUESTION 10766 06:43:45,001 --> 06:43:48,000 OCCURS ON AMENDMENT NUMBER 2899, 10767 06:43:48,001 --> 06:43:52,000 OFFERED BY THE SENATOR FROM 10768 06:43:52,001 --> 06:43:54,000 THE YEAS AND NAYS HAVE BEEN ORDERED. 10769 06:43:54,001 --> 06:43:55,000 IS THERE A SUFFICIENT SECOND? 10770 06:43:55,001 --> 06:43:56,000 THERE APPEARS TO BE AUFFICIENT 10771 06:43:56,001 --> 06:43:59,000 SECOND. 10772 06:43:59,001 --> 06:44:06,000 THE YEAS AND NAYS 10773 06:44:06,001 --> 06:45:53,000 THE CLERK WILL CALL THE ROLL. 10774 06:45:53,001 --> 06:58:36,000 VOTE: 10775 06:58:36,001 --> 06:58:37,000 VOTE: 10776 06:58:37,001 --> 06:58:38,000 THE PRESIDING OFFICER: ARE THERE 10777 06:58:38,001 --> 06:58:39,000 MY SENATORS WHO WISH TO VOTE OR 10778 06:58:39,001 --> 06:58:42,000 CHANGE THEIR VOTE? 10779 06:58:42,001 --> 06:58:43,000 IF NOT, THE YEAS ARE 97, THE 10780 06:58:43,001 --> 06:58:45,000 NAYS ARE 1. 10781 06:58:45,001 --> 06:58:47,000 UNDER THE PREVIOUS ORDER 10782 06:58:47,001 --> 06:58:48,000 REQUIRING 60 VOTES FOR THE 10783 06:58:48,001 --> 06:59:02,000 ADOPTION OF THIS AMENDMENT, THE 10784 06:59:02,001 --> 06:59:03,000 AMENDMENT IS AGREED TO. 10785 06:59:03,001 --> 06:59:05,000 THE PRESIDING OFFICER: WITHOUT 10786 06:59:05,001 --> 06:59:08,000 OBJECTION. 10787 06:59:08,001 --> 06:59:09,000 THE SENATE WILL COME TO 10788 06:59:09,001 --> 06:59:12,000 UNDER THE PREVIOUS ORDER, THERE 10789 06:59:12,001 --> 06:59:13,000 ARE TWO MINUTES EQUALLY DIDED 10790 06:59:13,001 --> 06:59:15,000 PRIOR TO A VOTE IN RELATION TO 10791 06:59:15,001 --> 06:59:18,000 THE MOTION TO COMMIT OFFERED BY 10792 06:59:18,001 --> 06:59:25,000 THE SENATOR FROM MR. HATCH. 10793 06:59:25,001 --> 06:59:26,000 WHO YIELDS TIME? 10794 06:59:26,001 --> 06:59:27,000 THE SENATE WILL COME TO ORDER. 10795 06:59:27,001 --> 06:59:29,000 PLEASE REMOVE YOUR CONVERSATIONS 10796 06:59:29,001 --> 06:59:37,000 FROM THE FLOOR SO THE SENATOR 10797 06:59:37,001 --> 06:59:38,000 FROM MONTANA CAN BE HEARD. 10798 06:59:38,001 --> 06:59:40,000 THE SENATOR FROM MONTANA. 10799 06:59:40,001 --> 06:59:41,000 MR. BAUCUS: MR. PRESIDENT, THE 10800 06:59:41,001 --> 06:59:42,000 PENDING MOTION WOULD STRIKE THE 10801 06:59:42,001 --> 06:59:45,000 SAVINGS THAT THE BILL ACHIEVES 10802 06:59:45,001 --> 06:59:47,000 FROM MEDICARE ADVANTAGE. 10803 06:59:47,001 --> 06:59:48,000 WHY ARE WE SEEKING SAVINGS FROM 10804 06:59:48,001 --> 06:59:49,000 MEDICARE ADVANTAGE? 10805 06:59:49,001 --> 06:59:51,000 BECAUSE MEDPAC TELLS US THAT THE 10806 06:59:51,001 --> 06:59:53,000 GOVERNMENT PAYS THE PRIVATE 10807 06:59:53,001 --> 06:59:54,000 INSURANCE COMPANIES THAT PROVIDE 10808 06:59:54,001 --> 06:59:56,000 MEDICARE ADVANTAGE 14% MORE THAN 10809 06:59:56,001 --> 06:59:59,000 THEY PAY FOR TRADITIONAL 10810 06:59:59,001 --> 07:00:00,000 MEDICARE. 10811 07:00:00,001 --> 07:00:02,000 BECAUSE THESE EXTRA SUBSIDIES TO 10812 07:00:02,001 --> 07:00:05,000 MEDICARE ADVANTAGE CAUSE THE 10813 07:00:05,001 --> 07:00:08,000 FOUR-FIFTHS OF SENIORS TO 10814 07:00:08,001 --> 07:00:10,000 TRADITIONAL MEDICARE $90 PER 10815 07:00:10,001 --> 07:00:11,000 MONTH EVEN THOUGH THEY GET 10816 07:00:11,001 --> 07:00:13,000 ADDITIONAL ADVANTAGE. 10817 07:00:13,001 --> 07:00:14,000 BECAUSE MEDPAC SAYS THE 10818 07:00:14,001 --> 07:00:16,000 ADDITIONAL MEDICARE ADVANTAGE 10819 07:00:16,001 --> 07:00:18,000 PAYMENTS HASTEN THE SOLVENCY OF 10820 07:00:18,001 --> 07:00:19,000 MEDICARE PART-A TRUST FUND BY 18 10821 07:00:19,001 --> 07:00:20,000 MONTHS. BECAUSE THE PRIVATE INSURANCE 10822 07:00:20,001 --> 07:00:22,000 COMPANIES THAT PROVIDE MEDICARE 10823 07:00:22,001 --> 07:00:24,000 ADVANTAGE ARE MAKING 10824 07:00:24,001 --> 07:00:26,000 THREE-QUARTERS OF THEIR 10825 07:00:26,001 --> 07:00:27,000 FROM THESE GOVERNMENT 10826 07:00:27,001 --> 07:00:28,000 OVERPAYMENTS, THEY CAN FIND SOME 10827 07:00:28,001 --> 07:00:29,000 OF THE SAVINGS THERE. BECAUSE PRIVATE INSURANCE 10828 07:00:29,001 --> 07:00:31,000 COMPANIES WHO PROVIDE MEDICARE 10829 07:00:31,001 --> 07:00:34,000 ADVANTAGE ARE PAYING THEIR 10830 07:00:34,001 --> 07:00:35,000 C.E.O.'S $24 MILLION A YEAR, 10831 07:00:35,001 --> 07:00:36,000 $ MILLION, $8 MILLION AND THEY 10832 07:00:36,001 --> 07:00:38,000 CAN FIND SOME OF THE SAVINGS THERE. 10833 07:00:38,001 --> 07:00:40,000 AND BECAUSE NOTHING WE DO IN OUR 10834 07:00:40,001 --> 07:00:41,000 BILL REDUCES GUARANTEED BENEFITS UNDER MEDICARE. 10835 07:00:41,001 --> 07:00:46,000 THEREFORE, I URGE MY 10836 07:00:46,001 --> 07:00:47,000 TO OPPOSE THE MOTION. A SENATOR: MR. PRESIDENT? 10837 07:00:47,001 --> 07:00:49,000 THE PRESIDING OFFICER: THE 10838 07:00:49,001 --> 07:00:50,000 SENATOR FROM UTAH. 10839 07:00:50,001 --> 07:00:52,000 THE SENATE WILL BE IN ORDER SO 10840 07:00:52,001 --> 07:00:55,000 THAT THE SENAT 10841 07:00:55,001 --> 07:00:56,000 BE HEARD 10842 07:00:56,001 --> 07:00:58,000 THE SENATOR FROM UTAH. 10843 07:00:58,001 --> 07:01:02,000 MRHATCH: MR. PRESIDENT, I URGE 10844 07:01:02,001 --> 07:01:03,000 MY COLLEAGUES TO SUPPORT MY MY 10845 07:01:03,001 --> 07:01:04,000 MOTION TO COMMIT. 10846 07:01:04,001 --> 07:01:06,000 IT PROTECTS MEDICARE 10847 07:01:06,001 --> 07:01:07,000 BENEFICIARIES CURRENTLY 10848 07:01:07,001 --> 07:01:09,000 PARTICIPATING IN THE MEDICARE 10849 07:01:09,001 --> 07:01:11,000 ADVANTAGE PROGRAM BY ELIMINATING 10850 07:01:11,001 --> 07:01:12,000 THE REID'S BILL $120 BILLION IN 10851 07:01:12,001 --> 07:01:14,000 CUTS TO THE MEDICARE ADVANTAGE 10852 07:01:14,001 --> 07:01:15,000 PROGRAM. 10853 07:01:15,001 --> 07:01:16,000 LET ME MAKE THIS POINT AS 10854 07:01:16,001 --> 07:01:18,000 CLEARLY AS I CAN. 10855 07:01:18,001 --> 07:01:22,000 A VOTE AGAINST MY AMENDMENT IS A 10856 07:01:22,001 --> 07:01:24,000 VOTE FOR SLASHING BENEFITS FOR 10857 07:01:24,001 --> 07:01:25,000 11 MILLION SENIORS AND 10858 07:01:25,001 --> 07:01:27,000 LOW-INCOME AMERICANS, INCLUDING 10859 07:01:27,001 --> 07:01:30,000 VISION BENEFITS, DENTAL 10860 07:01:30,001 --> 07:01:31,000 BENEFITS, HOME CARE FOR CHRONIC 10861 07:01:31,001 --> 07:01:33,000 ILLNESS, WELLNESS PROGRAMS, 10862 07:01:33,001 --> 07:01:36,000 DISEASE MANAGEMENT PROGRAMS, 10863 07:01:36,001 --> 07:01:38,000 LIMITS ON COST SHARING FOR 10864 07:01:38,001 --> 07:01:42,000 PRIMARY CARE, PHYSICIAN VISITS, 10865 07:01:42,001 --> 07:01:45,000 REDUCED PREMIUMS FOR PART-B, 10866 07:01:45,001 --> 07:01:47,000 REDUCED PREMIUMS FOR PART-D, 14 10867 07:01:47,001 --> 07:01:49,000 DEMOCRATS, WHEN WE DID THIS, 10868 07:01:49,001 --> 07:01:51,000 MANY OF WHOM ARE SITTING IN THE 10869 07:01:51,001 --> 07:01:52,000 SENATE RIGHT NOW SUPPORTED THIS 10870 07:01:52,001 --> 07:01:53,000 DEVELOPMENT OF MEDICARE 10871 07:01:53,001 --> 07:01:55,000 ADVANTAGE. 10872 07:01:55,001 --> 07:01:56,000 HAVE NO DOUBT WHEN YOU VOTE 10873 07:01:56,001 --> 07:01:58,000 AGAINST MY AMENDMENT, YOU WILL 10874 07:01:58,001 --> 07:02:00,000 BE VOTING TO CUT THESE 10875 07:02:00,001 --> 07:02:01,000 LIFESAVING AND LIFE ENHANCING 10876 07:02:01,001 --> 07:02:02,000 BENEFITS. 10877 07:02:02,001 --> 07:02:03,000 THE CHOICE IS YOURS AND THE 10878 07:02:03,001 --> 07:02:05,000 CHOICE IS CLEAR. 10879 07:02:05,001 --> 07:02:07,000 OUR NATION'S SENIORS ARE WATCHING MUCH. 10880 07:02:07,001 --> 07:02:08,000 THE PRESIDING OFFICER: WATCHING. 10881 07:02:08,001 --> 07:02:12,000 THE PRESIDING OFFICER: THE 10882 07:02:12,001 --> 07:02:14,000 QUESTION IS ON THE MOTION. 10883 07:02:14,001 --> 07:02:22,000 IS THERE A SUFFICIENT SECOND? 10884 07:02:22,001 --> 07:02:29,000 THERE ARE SECONDS. 10885 07:02:29,001 --> 07:18:09,000 THE CLERK WILL CALL THE ROLL. 10886 07:18:09,001 --> 07:18:10,000 VOTE: 10887 07:18:10,001 --> 07:18:11,000 THE PRESIDING OFFICER: ARE THERE 10888 07:18:11,001 --> 07:18:13,000 ANY SENATORS WHO WISH TO VOTE OR 10889 07:18:13,001 --> 07:18:16,000 CHANGE THEIR VOTE? 10890 07:18:16,001 --> 07:18:19,000 IF NOT, ON THIS VOTE, THE YEAS 10891 07:18:19,001 --> 07:18:20,000 ARE 41, THE NAYS ARE 57. 10892 07:18:20,001 --> 07:18:21,000 UNDER THE PREVIOUS ORDER 10893 07:18:21,001 --> 07:18:23,000 REQUIRING 60 VOTES FOR THE 10894 07:18:23,001 --> 07:18:31,000 ADOPTION OF THIS MOTION, THE 10895 07:18:31,001 --> 07:18:32,000 MOTION IS WITHDRAWN. 10896 07:18:32,001 --> 07:18:38,000 MR. BAUCUS: MR. PRESIDENT, I 10897 07:18:38,001 --> 07:18:40,000 MOVE TO RECONSIDER THE VOTE. 10898 07:18:40,001 --> 07:18:42,000 A 10899 07:18:42,001 --> 07:18:43,000 THE PRESIDING OFFICER: WITHOUT OBJECTION. 10900 07:18:43,001 --> 07:18:44,000 THE SENATOR FROM MONTANA. 10901 07:18:44,001 --> 07:18:47,000 MR. BAUCUS: MR. PRESIDENT, I 10902 07:18:47,001 --> 07:18:49,000 THINK THE -- EXCUSE ME. 10903 07:18:49,001 --> 07:18:51,000 THE SENATOR F 10904 07:18:51,001 --> 07:18:52,000 TO BE RECOGNIZED TO OFFER AN 10905 07:18:52,001 --> 07:18:54,000 AMENDMENT. THE PRESIDING OFFICER: THE 10906 07:18:54,001 --> 07:18:56,000 SENATOR FROM ARKANSAS. 10907 07:18:56,001 --> 07:18:58,000 MR. PRESIDENT. 10908 07:18:58,001 --> 07:18:59,000 I WOULD LIKE TO CALL UP MY 10909 07:18:59,001 --> 07:19:00,000 AMENDMENT. 10910 07:19:00,001 --> 07:19:01,000 THE CLERK: THE SENATOR FRO 10911 07:19:01,001 --> 07:19:03,000 ARKANSAS, MRS. LINCOLN, PROPOSES 10912 07:19:03,001 --> 07:19:05,000 AMENDMENT NUMBE 10913 07:19:05,001 --> 07:19:08,000 ON PAGE 2040, STRIKE 10914 07:19:08,001 --> 07:19:09,000 INSERT THE FOLLOWING -- 10915 07:19:09,001 --> 07:19:10,000 MRS. LINCOLN: MR. PRESIDENT, I 10916 07:19:10,001 --> 07:19:11,000 ASK UNANIMOUS CONSENT -- 10917 07:19:11,001 --> 07:19:12,000 THE PRESIDING OFFICER: WITHOUT 10918 07:19:12,001 --> 07:19:13,000 OBJECTION. 10919 07:19:13,001 --> 07:19:14,000 MRS. LINCOLN: THE FURTHER 10920 07:19:14,001 --> 07:19:15,000 READING OF THE AMENDMENT BE DISPENSED WITH. 10921 07:19:15,001 --> 07:19:16,000 THE PRESIDING OFFICER: WITHOUT 10922 07:19:16,001 --> 07:19:17,000 OB 10923 07:19:17,001 --> 07:19:18,000 MRS. LINCOLN: THANK YOU. 10924 07:19:18,001 --> 07:19:19,000 MR. PRESIDENT, I YIELD THE FLOOR. 10925 07:19:19,001 --> 07:19:20,000 THE PRESIDING OFFICER: THE 10926 07:19:20,001 --> 07:19:22,000 SENATOR FROM MONTANA. 10927 07:19:22,001 --> 07:19:24,000 MR. BAUCUS: I THINK THE SENATOR 10928 07:19:24,001 --> 07:19:25,000 RECOGNIZED. 10929 07:19:25,001 --> 07:19:26,000 THE PRESIDING OFFICER: THE 10930 07:19:26,001 --> 07:19:30,000 SENATOR FROM NEW MEXICO IS 10931 07:19:30,001 --> 07:19:32,000 RECOGNIZED. 10932 07:19:32,001 --> 07:19:34,000 MR. UDALL: THANK YOU, MR. PRESIDENT. 10933 07:19:34,001 --> 07:19:38,000 MR. PRESIDENT, TODAY I RISE TO 10934 07:19:38,001 --> 07:19:42,000 HONOR A BRAVE SON OF ANTHONY, NEW MEXICO. 10935 07:19:42,001 --> 07:19:44,000 ARMY CORPORAL ANTHONY COROSCO 10936 07:19:44,001 --> 07:19:45,000 JR. WAS KILLED NOVEMBER 4 AFTER 10937 07:19:45,001 --> 07:19:48,000 BEING HIT BY SNIPER FIRE WHILE 10938 07:19:48,001 --> 07:19:50,000 SERVING HIS COUNTRY IN IRAQ. 10939 07:19:50,001 --> 07:19:53,000 HE WAS 25 YEARS OLD. 10940 07:19:53,001 --> 07:19:55,000 CORPORAL COROSCO, OR TONY AS HE 10941 07:19:55,001 --> 07:19:56,000 WAS CALLED BY HIS FAMILY AND 10942 07:19:56,001 --> 07:19:57,000 FRIENDS, WAS A HUSBAND, FATHER, 10943 07:19:57,001 --> 07:20:00,000 AND SON. 10944 07:20:00,001 --> 07:20:02,000 HE AND HIS WIFE JOHANNA ARE 10945 07:20:02,001 --> 07:20:03,000 EXPECTING A CHILD, AND HE HAD 10946 07:20:03,001 --> 07:20:05,000 TWO SMALL STEPCHILDREN WHO 10947 07:20:05,001 --> 07:20:07,000 ADORED HIM. 10948 07:20:07,001 --> 07:20:08,000 TONY SERVED AS A TRUCK COMMANDER 10949 07:20:08,001 --> 07:20:12,000 FOR ARMORED VEHICLES. 10950 07:20:12,001 --> 07:20:13,000 IT WAS HIS JOB TO DIRECT HIS 10951 07:20:13,001 --> 07:20:15,000 VEHICLE DOWN STREETS INFESTED 10952 07:20:15,001 --> 07:20:17,000 WITH ROADSIDE BOMBS AND TARGETED 10953 07:20:17,001 --> 07:20:19,000 BY INSURGENTS, ATTACKING FROM 10954 07:20:19,001 --> 07:20:20,000 THE SHADOWS OF BUILDINGS. 10955 07:20:20,001 --> 07:20:23,000 TONY UNDERSTOOD THE DANGER. 10956 07:20:23,001 --> 07:20:25,000 HE ACCEPTED THE RISK, 10957 07:20:25,001 --> 07:20:27,000 DIED DOING WHAT HE LOVED -- 10958 07:20:27,001 --> 07:20:30,000 SERVING A COUNTRY HE LOVED. 10959 07:20:30,001 --> 07:20:33,000 HIS FELLOW SOLDIERS DESCRIBE 10960 07:20:33,001 --> 07:20:38,000 TONY AS AN OPT 10961 07:20:38,001 --> 07:20:40,000 -- AS AN OPTIMIST. 10962 07:20:40,001 --> 07:20:41,000 HIS PLATOON SERGEANT PUT IT 10963 07:20:41,001 --> 07:20:42,000 BEST -- TONY SAW THE GOOD I 10964 07:20:42,001 --> 07:20:45,000 EVERYTHING. 10965 07:20:45,001 --> 07:20:46,000 HE WAS A SOLDIER WHO NEVER, EVER COMPLAINED. 10966 07:20:46,001 --> 07:20:48,000 SERGEANT BROWN CALLED TONY THE 10967 07:20:48,001 --> 07:20:50,000 BEST SOLDIER I EVER HAD. 10968 07:20:50,001 --> 07:20:51,000 AS SENATORS OR AS CITIZENS, WE 10969 07:20:51,001 --> 07:20:53,000 CANNOT FULLY EXPERIENCE THE 10970 07:20:53,001 --> 07:20:55,000 SADNESS THAT TONY'S FAMILY AND 10971 07:20:55,001 --> 07:20:57,000 FRIENDS ARE FEELING, BUT WHEN A 10972 07:20:57,001 --> 07:21:00,000 SOLDIER DIES, THE NATION AS A 10973 07:21:00,001 --> 07:21:03,000 WHOLE FEELS THE LOSS. 10974 07:21:03,001 --> 07:21:05,000 WE'RE LINKED TO CORPORAL COROSCO 10975 07:21:05,001 --> 07:21:08,000 BY THE TIES THAT BIND A GRATEFU 10976 07:21:08,001 --> 07:21:09,000 NATION TO ITS FAITHFUL SERVANT. 10977 07:21:09,001 --> 07:21:11,000 HIS LOSS IS OURS. 10978 07:21:11,001 --> 07:21:14,000 PLEASE JOIN ME 10979 07:21:14,001 --> 07:21:16,000 ANTHONY COROSCO IN EXTENDING OUR 10980 07:21:16,001 --> 07:21:20,000 SYMPATHIES TO HIS WIFE JOHANNA 10981 07:21:20,001 --> 07:21:22,000 AND HIS FATHER ANTONIO, HIS 10982 07:21:22,001 --> 07:21:23,000 MOTHER AND THE REST OF THE 10983 07:21:23,001 --> 07:21:24,000 COROSCO FAMILY. 10984 07:21:24,001 --> 07:21:26,000 BEFORE I CLOSE, I WANT TO 10985 07:21:26,001 --> 07:21:29,000 ACKNOWLEDGE THE RECENT PASSING 10986 07:21:29,001 --> 07:21:31,000 OF ANOTHER BRAVE NEW MEXICAN, 10987 07:21:31,001 --> 07:21:34,000 JOSEPH GIAGOS, A SPECIALIST WITH 10988 07:21:34,001 --> 07:21:35,000 THE NEW MEXICO ARMY NATIONAL 10989 07:21:35,001 --> 07:21:37,000 GUARD, DD OF A HEART ATTACK 10990 07:21:37,001 --> 07:21:38,000 WHILE SERVING IN IRAQ. 10991 07:21:38,001 --> 07:21:41,000 WHILE HIS DEATH WASN'T DUE TO 10992 07:21:41,001 --> 07:21:42,000 INJURIES SUFFERED IN COMBAT, 10993 07:21:42,001 --> 07:21:45,000 THAT FACT DOES NOT LESSEN THE 10994 07:21:45,001 --> 07:21:47,000 PAIN OF HIS LOSS. 10995 07:21:47,001 --> 07:21:48,000 SPECIALIST GIAGOS WAS 39 YEARS 10996 07:21:48,001 --> 07:21:50,000 OLD. 10997 07:21:50,001 --> 07:21:52,000 HE SERVED WITH THE GUARD AS A 10998 07:21:52,001 --> 07:21:54,000 LIGHT WHEEL VEHICLE MECHANIC. 10999 07:21:54,001 --> 07:21:58,000 WHILE NOT SERVING HIS COUNTRY, 11000 07:21:58,001 --> 07:22:01,000 HE WORKED FOR THE FOREST SERVICE 11001 07:22:01,001 --> 07:22:02,000 ON THE CARSON BACK HOME IN 11002 07:22:02,001 --> 07:22:03,000 QUESTA, NEW MEXICO. 11003 07:22:03,001 --> 07:22:04,000 THROUGHOUT HIS LIFE, HE ALSO 11004 07:22:04,001 --> 07:22:07,000 WORKED AS A FIREFIGHTER, AN 11005 07:22:07,001 --> 07:22:11,000 AMBULANCE DRIVER, A POLICEMAN. 11006 07:22:11,001 --> 07:22:13,000 SPECIALIST GIAGOS GRAVITATED 11007 07:22:13,001 --> 07:22:14,000 TOWARD WORK THAT ALLOWED HIM TO 11008 07:22:14,001 --> 07:22:15,000 HELP HIS FELLOW CITIZENS. 11009 07:22:15,001 --> 07:22:17,000 WHILE WORKING FOR THE FOREST 11010 07:22:17,001 --> 07:22:19,000 SERVICE, HE EVEN SAVED A LIFE. 11011 07:22:19,001 --> 07:22:21,000 SPOTTING A BURNING TRUCK ONE 11012 07:22:21,001 --> 07:22:22,000 DAY, HE SAW A MAN INSIDE AND 11013 07:22:22,001 --> 07:22:24,000 PULLED HIM TO SAFETY. 11014 07:22:24,001 --> 07:22:26,000 AS SPECIALIST GIAGOS' BROTHER 11015 07:22:26,001 --> 07:22:27,000 DONALD SAID, HE WAS ALWAYS 11016 07:22:27,001 --> 07:22:29,000 TAKING DIFFERENT JOBS, BUT THEY 11017 07:22:29,001 --> 07:22:30,000 ALWAYS PUT HIM IN THE SERVICE OF 11018 07:22:30,001 --> 07:22:32,000 OTHERS. 11019 07:22:32,001 --> 07:22:35,000 TODAY I ASK YOU TO JOIN ME IN 11020 07:22:35,001 --> 07:22:37,000 THANKING SPECIALIST GIAGOS' 11021 07:22:37,001 --> 07:22:39,000 FAMILY FOR HIS SERVICE AND F HIS SACRIFICE. 11022 07:22:39,001 --> 07:22:44,000 THANK YOU, MR. PRESIDENT. 11023 07:22:44,001 --> 07:22:47,000 I YIELD T A. 11024 07:22:47,001 --> 07:22:50,000 A SENATOR:: MR. PRESIDENT? 11025 07:22:50,001 --> 07:22:54,000 THE PRES 11026 07:22:54,001 --> 07:22:55,000 SENATOR FROM NEBRASKA. MR. JONES: I HAVE A MOTION AT 11027 07:22:55,001 --> 07:22:58,000 THE DESK. 11028 07:22:58,001 --> 07:23:01,000 THE CLERK: THE SENATOR FROM 11029 07:23:01,001 --> 07:23:04,000 NEBRASKA MOVES TO COMMIT THE 11030 07:23:04,001 --> 07:23:06,000 BILL BACK TO COMMITTEE WITH 11031 07:23:06,001 --> 07:23:09,000 INSTRUCTIONS ON CHANGES THAT DO 11032 07:23:09,001 --> 07:23:13,000 NOT INCLUDE CUTS IN PAYMENTS TO 11033 07:23:13,001 --> 07:23:15,000 HOME HEALTH AGENCIES TOTALING 11034 07:23:15,001 --> 07:23:16,000 NEGATIVE $42.1 BILLION. 11035 07:23:16,001 --> 07:23:17,000 MR. JOHANNS: THANK YOU. 11036 07:23:17,001 --> 07:23:18,000 MR. SPEAKER, I RISE TODAY TO 11037 07:23:18,001 --> 07:23:19,000 SPEAK IN FAVOR OF THE MOTION 11038 07:23:19,001 --> 07:23:21,000 THAT WAS JUST READ. 11039 07:23:21,001 --> 07:23:22,000 ONE OF THE THINGS THAT I SAY IS 11040 07:23:22,001 --> 07:23:27,000 SO VERY IMPORTANT ABOUT A DEBATE 11041 07:23:27,001 --> 07:23:28,000 ON THE SENATE FLOOR IS WE BEGIN 11042 07:23:28,001 --> 07:23:30,000 TO UNDERSTAND WHAT THIS 11043 07:23:30,001 --> 07:23:34,000 LEGISLATION DOES TO REAL PEOPLE, 11044 07:23:34,001 --> 07:23:39,000 AND WE HAVE COME TO REALLY 11045 07:23:39,001 --> 07:23:40,000 UNDERSTAND THAT $466 BILLION IN 11046 07:23:40,001 --> 07:23:44,000 MEDICA 11047 07:23:44,001 --> 07:23:46,000 OVER MY LEFT SHOULDER HERE HAVE 11048 07:23:46,001 --> 07:23:49,000 REAL CONSEQUENCES TO REAL PEOPLE 11049 07:23:49,001 --> 07:23:52,000 ALL ACROSS THE UNITED STATES. 11050 07:23:52,001 --> 07:23:54,000 THESE CUTS COMPROMISE CARE, THEY 11051 07:23:54,001 --> 07:23:57,000 COMPROMISE ACCESS TO SERVICES 11052 07:23:57,001 --> 07:23:59,000 THAT REAL PEOPLE NEED IN THEIR 11053 07:23:59,001 --> 07:24:00,000 DAILY LIVES. 11054 07:24:00,001 --> 07:24:03,000 ROBBING THESE FUNDS FROM 11055 07:24:03,001 --> 07:24:05,000 MEDICARE TO CREATE A DRAMATIC 11056 07:24:05,001 --> 07:24:07,000 NEW ENTITLEMENT PROGRAM, IN MY 11057 07:24:07,001 --> 07:24:10,000 JUDGMENT, IS NOT SOUND POLICY 11058 07:24:10,001 --> 07:24:12,000 AND IT'S NOT SOUND GOVERNMENT. 11059 07:24:12,001 --> 07:24:15,000 THAT'S ESPECIALLY TRUE IN THIS 11060 07:24:15,001 --> 07:24:17,000 CASE, MR. PRESIDENT, WHEN THE 11061 07:24:17,001 --> 07:24:20,000 IMPACT ON SENIORSR SENIORS' 11062 07:24:20,001 --> 07:24:22,000 HEALTH CARE IS SO PROFOUND. 11063 07:24:22,001 --> 07:24:24,000 THESE CUTS WILL REDUCE THE 11064 07:24:24,001 --> 07:24:28,000 QUALITY OF CARE THAT MANY 11065 07:24:28,001 --> 07:24:31,000 AMERICANS ARE RECEIVING TODAY 11066 07:24:31,001 --> 07:24:32,000 AND REDUCE THE CARE THAT THESE 11067 07:24:32,001 --> 07:24:35,000 AMERICANS DESERVE. 11068 07:24:35,001 --> 07:24:37,000 I HAVE TO TELL YOU, OUT OF ALL 11069 07:24:37,001 --> 07:24:40,000 OF THESE MEDICARE CUTS, ONE OF 11070 07:24:40,001 --> 07:24:43,000 THE LARGEST HEAD-SCRATCHING CUTS 11071 07:24:43,001 --> 07:24:48,000 IS THE ONE TO HOME HEALTH. 11072 07:24:48,001 --> 07:24:51,000 THE SENATE BILL CUTS 11073 07:24:51,001 --> 07:24:54,000 CUTS $42.1 BILLION FOR HOME HEALTH CARE. 11074 07:24:54,001 --> 07:24:55,000 HOME HEALTH IS ABOUT 3.7% OF THE 11075 07:24:55,001 --> 07:24:59,000 MEDICARE BUDGET. 11076 07:24:59,001 --> 07:25:02,000 IT'S AN IMPORTANT PROGRAM, YET 11077 07:25:02,001 --> 07:25:04,000 9.1% OF THE MEDICARE CUTS IN THE 11078 07:25:04,001 --> 07:25:06,000 SENATE BILL ARE TAKEN OUT OF 11079 07:25:06,001 --> 07:25:09,000 HOME HEALTH. 11080 07:25:09,001 --> 07:25:13,000 MEDICARE HOME HEALTH SPENDS LESS 11081 07:25:13,001 --> 07:25:15,000 TODAY THAN IT DID OVER A DECADE 11082 07:25:15,001 --> 07:25:18,000 AGO, WHILE SERVING A SIMILAR 11083 07:25:18,001 --> 07:25:19,000 NUMBER OF BENEFICIARIES AT LESS 11084 07:25:19,001 --> 07:25:22,000 COST PER PATIENT. 11085 07:25:22,001 --> 07:25:27,000 THAT'S THE KIND OF PROGRAM THAT 11086 07:25:27,001 --> 07:25:31,000 WE SHOULD CELEBRATE, YET THIS 11087 07:25:31,001 --> 07:25:32,000 BILL HAS THEM ON THE CHOPPING 11088 07:25:32,001 --> 07:25:34,000 BLOCK. 11089 07:25:34,001 --> 07:25:36,000 NOW, MAYBE THERE IS SOME 11090 07:25:36,001 --> 07:25:40,000 MISUNDERSTANDINGBOUT 11091 07:25:40,001 --> 07:25:42,000 HEALTH PROVIDES, SO LET ME CLEAR 11092 07:25:42,001 --> 07:25:45,000 UP THE CONFUSION. 11093 07:25:45,001 --> 07:25:48,000 HOME HEALTH CARE AGENCY CARES 11094 07:25:48,001 --> 07:25:51,000 FOR PATIENTS OF ALL AGES. 11095 07:25:51,001 --> 07:25:54,000 IT PROVIDES A BROAD RANGE OF 11096 07:25:54,001 --> 07:25:56,000 ESSENTIAL HEALTH CARE AND 11097 07:25:56,001 --> 07:25:59,000 SUPPORT SERVICES, REAL SECURITY 11098 07:25:59,001 --> 07:26:01,000 IN THE COMFORT OF A PATIENT'S 11099 07:26:01,001 --> 07:26:03,000 HOME. 11100 07:26:03,001 --> 07:26:07,000 9,000 MEDICARE APPROVED HOME 11101 07:26:07,001 --> 07:26:09,000 HEALTH AGENCIES EXISTED IN 2007. 11102 07:26:09,001 --> 07:26:12,000 I'M VERY PLEASED REPORT TO 11103 07:26:12,001 --> 07:26:17,000 YOU, MR. PRESIDENT, THAT 74 OF 11104 07:26:17,001 --> 07:26:19,000 THOSE ARE IN MY HOME STATE OF 11105 07:26:19,001 --> 07:26:22,000 NEBRASKA. 11106 07:26:22,001 --> 07:26:24,000 NURSES, THERAPISTS, HOME CARE 11107 07:26:24,001 --> 07:26:26,000 AIDS AND OTHERS WHO SERVE 11108 07:26:26,001 --> 07:26:30,000 ELDERLY AND DISABLED PATIENTS IN 11109 07:26:30,001 --> 07:26:32,000 EIR OWN HOMES DRIVE NEARLY 11110 07:26:32,001 --> 07:26:35,000 FIVE BILLION, FIVE BILLION MILES 11111 07:26:35,001 --> 07:26:36,000 A YEAR TO PROVIDE THESE 11112 07:26:36,001 --> 07:26:39,000 MUCH-NEEDED SERVICES. 11113 07:26:39,001 --> 07:26:45,000 THEY CARE FOR ABOUT 12 MILLION 11114 07:26:45,001 --> 07:26:46,000 REAL PEOPLE ANNUALLY WITH 11115 07:26:46,001 --> 07:26:50,000 428 MILLION VISITS. 11116 07:26:50,001 --> 07:26:51,000 EACH ONE PROVIDING THAT PERSONAL 11117 07:26:51,001 --> 07:26:54,000 TOUCH OF CARE. 11118 07:26:54,001 --> 07:26:57,000 THE SERVICES THAT ARE PROVIDED 11119 07:26:57,001 --> 07:27:00,000 TO THIS VERY, VERY ESSENTIAL 11120 07:27:00,001 --> 07:27:02,000 PROGRAM INCLUDE REHABILITATION 11121 07:27:02,001 --> 07:27:03,000 THERAPIES, TELEMEDICINE, WOUND 11122 07:27:03,001 --> 07:27:06,000 CARE, PAIN MANAGEMENT, AND 11123 07:27:06,001 --> 07:27:07,000 SKILLED NURSING. 11124 07:27:07,001 --> 07:27:10,000 WHO IS ELIGIBLE TO RECEIVE 11125 07:27:10,001 --> 07:27:12,000 MEDICARE HOME HEALTH SERVICES? 11126 07:27:12,001 --> 07:27:14,000 WE CAN ANSWER THAT QUESTION BY 11127 07:27:14,001 --> 07:27:17,000 GOING TO C.M. 11128 07:27:17,001 --> 07:27:19,000 ACCORDING TO C.M.S., TO QUALIFY 11129 07:27:19,001 --> 07:27:20,000 FOR MEDICARE HOME HEALTH 11130 07:27:20,001 --> 07:27:24,000 BENEFITS, A MEDICARE BENEFICIARY 11131 07:27:24,001 --> 07:27:26,000 MUST MEET ONE OF THE FOLLOWING 11132 07:27:26,001 --> 07:27:27,000 REQUIREMENTS -- THEY MUST BE 11133 07:27:27,001 --> 07:27:30,000 CONFINED TO HOME. 11134 07:27:30,001 --> 07:27:32,000 THEY MUST BE UNDER A DOCTOR'S CARE. 11135 07:27:32,001 --> 07:27:35,000 THEY MUST NEED SKILLED NURSING 11136 07:27:35,001 --> 07:27:37,000 ON A PERIODIC BASIS. 11137 07:27:37,001 --> 07:27:41,000 AND THEY MUST HAVE A CONTINUING 11138 07:27:41,001 --> 07:27:45,000 NEED FOR OCCUPATIONAL THERAPY. 11139 07:27:45,001 --> 07:27:47,000 THESERE TRULY SOME OF THE MOST 11140 07:27:47,001 --> 07:27:50,000 VULNERABLE AMERICANS, YET IN 11141 07:27:50,001 --> 07:27:51,000 ORDER TO FINANCE THIS NEW 11142 07:27:51,001 --> 07:27:54,000 ENTITLEMENT, THIS BILL TAKES 11143 07:27:54,001 --> 07:27:57,000 MONEY OUT OF THAT MUCH-NEED 11144 07:27:57,001 --> 07:28:01,000 PROGRA 11145 07:28:01,001 --> 07:28:04,000 ON THE BACKS OF THESE AMERICANS. 11146 07:28:04,001 --> 07:28:08,000 OUR MOST VULNERABLE 11147 07:28:08,001 --> 07:28:09,000 YET THESE CUTS RISK LEAVING THEM 11148 07:28:09,001 --> 07:28:10,000 WITHOUT CARE. 11149 07:28:10,001 --> 07:28:13,000 AND WHAT KIND OF CONDITIONS DO 11150 07:28:13,001 --> 07:28:15,000 PEOPLE WHO UTILIZE HOME HEALTH 11151 07:28:15,001 --> 07:28:17,000 AGENCIES SUFFER FROM? 11152 07:28:17,001 --> 07:28:20,000 WELL, I'LL TURN TO MY OWN STATE 11153 07:28:20,001 --> 07:28:22,000 TO 11154 07:28:22,001 --> 07:28:25,000 IN NEBRASKA, ONE OF OUR AGENCIES 11155 07:28:25,001 --> 07:28:28,000 IS IN RURAL CHERRY COUNTY. 11156 07:28:28,001 --> 07:28:29,000 CHERRY COUNTY IS A VERY LARGE 11157 07:28:29,001 --> 07:28:32,000 COUNTY IN WESTERN NEBRASKA. 11158 07:28:32,001 --> 07:28:34,000 IN FACT, LARGER THAN SOME 11159 07:28:34,001 --> 07:28:37,000 WHO GETS SERVED IN THAT COUNTY? 11160 07:28:37,001 --> 07:28:40,000 A GENTLEMAN WITH CLASS THREE 11161 07:28:40,001 --> 07:28:42,000 CONGESTIVE HEART FAILURE. 11162 07:28:42,001 --> 07:28:45,000 HE'S AWAITING A HEART TRANSPLANT. 11163 07:28:45,001 --> 07:28:48,000 A GENTLEMAN WHO JUST LOST A LEG 11164 07:28:48,001 --> 07:28:49,000 FROM COME PLAY OCCASIONS -- FROM 11165 07:28:49,001 --> 07:28:51,000 COMPLICATIONS FROM DIABETES. 11166 07:28:51,001 --> 07:28:56,000 THEY GET HOME HEALTH CARE SERVICES. 11167 07:28:56,001 --> 07:28:57,000 THESE FOLKS ARE NOT STRIVING TO 11168 07:28:57,001 --> 07:28:58,000 BILLEING THE SYSTEM. 11169 07:28:58,001 --> 07:29:01,000 THE PAYMENTS THAT ALLOW US TO 11170 07:29:01,001 --> 07:29:04,000 PROVIDE THIS MUCH-NEED SERVICE 11171 07:29:04,001 --> 07:29:07,000 TO THEM ARE NOT EXCESS PAYMENTS. 11172 07:29:07,001 --> 07:29:10,000 THESE A JUST AVERAGE FOLKS WHO 11173 07:29:10,001 --> 07:29:12,000 ARE STRIVING TO DO THEIR BEST TO 11174 07:29:12,001 --> 07:29:15,000 RECOVER FROM THEIR CONDITION AND 11175 07:29:15,001 --> 07:29:17,000 MANAGE THE BEST THEY CAN. 11176 07:29:17,001 --> 07:29:19,000 KEEPING THESE FOLKS OUT OF THE 11177 07:29:19,001 --> 07:29:22,000 EMERGENCY ROOM OR THE NURSING 11178 07:29:22,001 --> 07:29:24,000 HOME IS A BENEFIT TO EVERYBODY, 11179 07:29:24,001 --> 07:29:27,000 AND I DON'T SEE HOW ANYBODY 11180 07:29:27,001 --> 07:29:29,000 COULD ARGUE THAT THIS DOESN'T 11181 07:29:29,001 --> 07:29:31,000 SAVE TAX DOLLARS. 11182 07:29:31,001 --> 07:29:33,000 WELL, IN FACT, THERE ARE 11183 07:29:33,001 --> 07:29:34,000 STATISTICS THAT PROVE THAT STATEMENT. 11184 07:29:34,001 --> 07:29:37,000 ACCORDING TO THE NATIONAL 11185 07:29:37,001 --> 07:29:40,000 ASSOCIATION OF HOME HEALTH CARE 11186 07:29:40,001 --> 07:29:42,000 AND HOSPICE, AN AVERAGE 11187 07:29:42,001 --> 07:29:46,000 PER-VISIT MEDICARE CHARGE FOR 11188 07:29:46,001 --> 07:29:48,000 HOME HEALTH IS $132. 11189 07:29:48,001 --> 07:29:51,000 LET ME 11190 07:29:51,001 --> 07:29:55,000 COMPARE THAT CHARGE OF $132 TO 11191 07:29:55,001 --> 07:29:59,000 ONE DAY AT A HOSPITAL THAT WOULD 11192 07:29:59,001 --> 07:30:04,000 COST 43 TIMES AS MUCH, 11193 07:30:04,001 --> 07:30:05,000 LITERALLY. 11194 07:30:05,001 --> 07:30:08,000 $5,0766 PER DAY. 11195 07:30:08,001 --> 07:30:09,000 ACCORDING TO TO A STUDY, AND I'M 11196 07:30:09,001 --> 07:30:11,000 QUOTING, EARLY USE OF HOME 11197 07:30:11,001 --> 07:30:13,000 HEALTH CARE SERVICES FOLLOWING A 11198 07:30:13,001 --> 07:30:17,000 HOSPITAL STAY BY PATIENTS WITH 11199 07:30:17,001 --> 07:30:20,000 AT LEAST ONE CHRONIC DISEASE 11200 07:30:20,001 --> 07:30:25,000 SAVED MEDICARE $1.71 BILLION IN 11201 07:30:25,001 --> 07:30:27,000 THE TWO-YEAR PERIOD OF 2005 TO 11202 07:30:27,001 --> 07:30:30,000 2006. UNQUOTE. SAVED MEDICARE. 11203 07:30:30,001 --> 07:30:32,000 DOESN'T 11204 07:30:32,001 --> 07:30:34,000 STEP BACKWARDS WHEN WE TALK 11205 07:30:34,001 --> 07:30:37,000 ABOUT REFORM, WHEN REALLY WHAT 11206 07:30:37,001 --> 07:30:39,000 WE'RE DOING IS CUTTING A PROGRAM 11207 07:30:39,001 --> 07:30:43,000 THAT SERVES PEOPLE SO MUCH I 11208 07:30:43,001 --> 07:30:44,000 NEED AND YET SAVES MONEY IN OUR 11209 07:30:44,001 --> 07:30:46,000 MEDICARE PROGRAM. 11210 07:30:46,001 --> 07:30:48,000 HOME HEALTH AGENCIES IN NEBRASKA 11211 07:30:48,001 --> 07:30:51,000 HAVE BEEN VERY SUCCESSFUL IN 11212 07:30:51,001 --> 07:30:52,000 DOING EXACTLY WHAT WE WANT, 11213 07:30:52,001 --> 07:30:55,000 KEEPING PEOPLE AT HOME AND OUT 11214 07:30:55,001 --> 07:30:56,000 OF THE HOSPITAL AND NURSING 11215 07:30:56,001 --> 07:30:59,000 HOME. 11216 07:30:59,001 --> 07:31:02,000 OF SPECIAL INTEREST ARE PATIENTS 11217 07:31:02,001 --> 07:31:03,000 WITH CONGESTIVE HEART FAILURE. 11218 07:31:03,001 --> 07:31:05,000 ONE NEBRASKA WOMAN TURNED TO 11219 07:31:05,001 --> 07:31:08,000 HOME HEALTH AFTER FACING A BIG 11220 07:31:08,001 --> 07:31:10,000 STACK OF HOSPITAL BILLS FOR REHAB. 11221 07:31:10,001 --> 07:31:12,000 SINCE THEN, SHE HAS BEEN ABLE TO 11222 07:31:12,001 --> 07:31:14,000 REMAIN AT HOME SAFELY AT A 11223 07:31:14,001 --> 07:31:16,000 FRACTION OF THE COST. 11224 07:31:16,001 --> 07:31:19,000 THIS HOME HEALTH AGENCY CAN SEE 11225 07:31:19,001 --> 07:31:22,000 A PERSON FOR 60 DAYS AT A COST 11226 07:31:22,001 --> 07:31:23,000 OF ABOUT $2,500. 11227 07:31:23,001 --> 07:31:26,000 60 DAYS. 11228 07:31:26,001 --> 07:31:28,000 ONE HOSPITAL ADMISSION, BY 11229 07:31:28,001 --> 07:31:30,000 COMPARISON, WOULD COST MEDICARE 11230 07:31:30,001 --> 07:31:34,000 CONSERVATIVELY $20,000 TO TREAT 11231 07:31:34,001 --> 07:31:36,000 A PATIENT WITH CHRONIC HEALTH 11232 07:31:36,001 --> 07:31:37,000 FAILURE -- OR CHRONIC HEART 11233 07:31:37,001 --> 07:31:39,000 FAILURE. 11234 07:31:39,001 --> 07:31:41,000 SO, 11235 07:31:41,001 --> 07:31:43,000 COSTS A FRACTION OF HOSPITAL 11236 07:31:43,001 --> 07:31:46,000 CARE, ABOUT TEN TIMES LESS. 11237 07:31:46,001 --> 07:31:48,000 THERE ARE SO MANY STORIES FROM 11238 07:31:48,001 --> 07:31:50,000 PATIENTS WHO ARE ALIVE TODAY WHO 11239 07:31:50,001 --> 07:31:54,000 LOVE HOME HEALTH CARE. 11240 07:31:54,001 --> 07:31:56,000 AND THIS BILL THREATENS THEM. 11241 07:31:56,001 --> 07:31:57,000 SOMEWHERE IN THE NEXT HOURS, 11242 07:31:57,001 --> 07:31:58,000 MR. PRESIDENT, I'M GOING TO SEND 11243 07:31:58,001 --> 07:32:01,000 TO EVERY MEMBER OF THE UNITED 11244 07:32:01,001 --> 07:32:03,000 STATES SENATE ALL OF MY 11245 07:32:03,001 --> 07:32:05,000 COLLEAGUES, A 11246 07:32:05,001 --> 07:32:08,000 ANALYSIS OF WHAT THESE CUTS WILL 11247 07:32:08,001 --> 07:32:10,000 DO IN THEIR STATE, BECAUSE THEY 11248 07:32:10,001 --> 07:32:12,000 ED TO KNOW THE IMPACT. 11249 07:32:12,001 --> 07:32:14,000 THIS BILL THREATENS TO TAKE THAT 11250 07:32:14,001 --> 07:32:18,000 ALL AWAY. 11251 07:32:18,001 --> 07:32:20,000 YO CAN'T CUT $42 BILLION AND 11252 07:32:20,001 --> 07:32:23,000 JUST DESCRIBE IT AS EXCESS PAYMENTS. 11253 07:32:23,001 --> 07:32:25,000 YOU CAN'T CUT $42 BILLION AND 11254 07:32:25,001 --> 07:32:27,000 SAY, WELL, THAT'S JUST FIXING 11255 07:32:27,001 --> 07:32:30,000 THOSE WHO ARE BILKING THE SYSTEM. 11256 07:32:30,001 --> 07:32:32,000 WHEN YOU CUT $42 BILLION OUT OF 11257 07:32:32,001 --> 07:32:35,000 A PROGRAM LIKE HOME HEALTH CARE, 11258 07:32:35,001 --> 07:32:37,000 IT HAS REAL 11259 07:32:37,001 --> 07:32:39,000 EARLIER THIS WEEK, 11260 07:32:39,001 --> 07:32:40,000 MR. PRESIDENT, I DID A VIDEO 11261 07:32:40,001 --> 07:32:42,000 CONFERENCE WITH MEDICARE 11262 07:32:42,001 --> 07:32:44,000 PROVIDERS IN NEBRASKA. 11263 07:32:44,001 --> 07:32:47,000 THESE NEBRASKA HOME HEALTH 11264 07:32:47,001 --> 07:32:51,000 PROVIDERS REPORTED THIS 11265 07:32:51,001 --> 07:32:54,000 LEGISLATION WILL COST THEM $120 11266 07:32:54,001 --> 07:32:58,000 MILLION IN MY STATE. 11267 07:32:58,001 --> 07:33:01,000 WHAT DOES THAT MEAN? 11268 07:33:01,001 --> 07:33:04,000 $120 MILLION MAY NOT SOUND MUCH 11269 07:33:04,001 --> 07:33:06,000 AROUND HERE WHERE WE TALK ABOUT 11270 07:33:06,001 --> 07:33:09,000 TRILLION-DOLLAR PROGRAMS. 11271 07:33:09,001 --> 07:33:13,000 $120 MILLION TO THE PEOPLE OF 11272 07:33:13,001 --> 07:33:16,000 NEBRASKA IN HOME HEALTH CARE, 11273 07:33:16,001 --> 07:33:21,000 68% OF HOME HEALTH AGENCIES IN 11274 07:33:21,001 --> 07:33:22,000 NEBRASKA WILL BE IN THE RED BY 11275 07:33:22,001 --> 07:33:26,000 2016. 68%. 11276 07:33:26,001 --> 07:33:29,000 IN RURAL AREAS, AS HIGH AS 80% 11277 07:33:29,001 --> 07:33:32,000 WILL HAVE NEGATIVE MARGINS. 11278 07:33:32,001 --> 07:33:34,000 YOU LOSE THOSE SERVICES IN RURAL 11279 07:33:34,001 --> 07:33:35,000 AREAS, THEY ARE LOST. 11280 07:33:35,001 --> 07:33:38,000 THERE'S NOTHING THAT WILL STEP 11281 07:33:38,001 --> 07:33:39,000 IN FOR THOSE PEOPLE. 11282 07:33:39,001 --> 07:33:42,000 HOME HEALTH PROVIDERS ALREADY 11283 07:33:42,001 --> 07:33:45,000 HAVE TO WATCH THEIR BOTTOM LINE, 11284 07:33:45,001 --> 07:33:48,000 AND THEY'RE ALREADY MAKING VERY 11285 07:33:48,001 --> 07:33:51,000 HARD, PAINFUL DECISIONS. 11286 07:33:51,001 --> 07:33:52,000 DURING THIS VIDEO CONFERENCE, A 11287 07:33:52,001 --> 07:33:55,000 NURSE IN RURAL NEBRASKA 11288 07:33:55,001 --> 07:33:57,000 EXPLAINED THE REALITY TO ME THIS 11289 07:33:57,001 --> 07:33:59,000 WAY -- AND I'M QUOTING -- "I CAN 11290 07:33:59,001 --> 07:34:01,000 GIVE YOU A HUMAN STORY THAT JUST 11291 07:34:01,001 --> 07:34:02,000 HAPPENED YESTERDAY IN OUR 11292 07:34:02,001 --> 07:34:04,000 AGENCY. 11293 07:34:04,001 --> 07:34:07,000 WE HAD A REFERRAL FROM A PATIENT 11294 07:34:07,001 --> 07:34:09,000 THAT LIVES 90 MILES AWAY. 11295 07:34:09,001 --> 07:34:14,000 THE DRIVE TIME IS THREE HOURS. 11296 07:34:14,001 --> 07:34:15,000 TO DO THE ADMISSION TAKES ONE 11297 07:34:15,001 --> 07:34:18,000 AND A HALF TO TWO HOURS. 11298 07:34:18,001 --> 07:34:19,000 AND THEN YOU COME BACK TO THE 11299 07:34:19,001 --> 07:34:20,000 OFFICE, AND YOU DO AT LEAST 11300 07:34:20,001 --> 07:34:22,000 ANOTHER HOUR OF PAPERWORK. 11301 07:34:22,001 --> 07:34:27,000 IT WOULD TAKE ONE PERSON'S 11302 07:34:27,001 --> 07:34:29,000 ENTIRE DAY TO SERVE ONE PATIENT. 11303 07:34:29,001 --> 07:34:30,000 AND REGRETFULLY, WE HAD TO SAY 11304 07:34:30,001 --> 07:34:32,000 NO. 11305 07:34:32,001 --> 07:34:34,000 WE JUST COULD NOT SEE HER. 11306 07:34:34,001 --> 07:34:37,000 AND THERE IS NO OTHER AGENCY 11307 07:34:37,001 --> 07:34:41,000 CLOSE ENOUGH TO HELP THIS WOMAN." UNQUOTE. 11308 07:34:41,001 --> 07:34:43,000 CAN YOU IMAGINE, MR. PRESIDENT? 11309 07:34:43,001 --> 07:34:46,000 WE HAVE A PERSON WHO DESPERATELY 11310 07:34:46,001 --> 07:34:49,000 NEEDED THESE SERVICES, AND WE'RE 11311 07:34:49,001 --> 07:34:51,000 DEBATING WHETHER WE SHOULD CUT 11312 07:34:51,001 --> 07:34:52,000 $42 BILLION OUT OF THIS PROGRAM, 11313 07:34:52,001 --> 07:34:55,000 IMPACT A STATE LIKE MINE TO THE 11314 07:34:55,001 --> 07:34:58,000 TUNE OF $120 MILLION? 11315 07:34:58,001 --> 07:35:00,000 THESE AGENCIES AND THE SERVICES 11316 07:35:00,001 --> 07:35:02,000 THEY PROVIDE ABSOLUTELY ARE 11317 07:35:02,001 --> 07:35:04,000 RELIAN ON MEDICARE. 11318 07:35:04,001 --> 07:35:06,000 ACCORDING TO THE NATIONAL 11319 07:35:06,001 --> 07:35:09,000 ASSOCIATION OF HOME CARE AND 11320 07:35:09,001 --> 07:35:10,000 HOSPICE -- AND AGAIN I'M 11321 07:35:10,001 --> 07:35:11,000 QUOTING -- "MEDICARE IS THE 11322 07:35:11,001 --> 07:35:14,000 LARGEST SINGLE-PAYER OF HOME 11323 07:35:14,001 --> 07:35:15,000 HEALTH CARE SERVICES." UNQUOTE. 11324 07:35:15,001 --> 07:35:18,000 WHEN WE CUT THE PAYMENTS IN A 11325 07:35:18,001 --> 07:35:21,000 PROGRAM LIKE THIS, WE CUT ACCESS 11326 07:35:21,001 --> 07:35:22,000 CARE. 11327 07:35:22,001 --> 07:35:26,000 THESE ACCESS CONCERNS ARE ROOTED 11328 07:35:26,001 --> 07:35:29,000 IN REAL-LIFE EXPERIENCES. 11329 07:35:29,001 --> 07:35:31,000 BETWEEN 1998 AND 2000, MEDICARE 11330 07:35:31,001 --> 07:35:35,000 HOME HEALTH SPENDING FELL FROM 11331 07:35:35,001 --> 07:35:39,000 $14 BILLION TO $9.2 BILLION, OR 11332 07:35:39,001 --> 07:35:41,000 NEGATIVE 34% AS A RESULT OF 11333 07:35:41,001 --> 07:35:42,000 CONGRESSIONAL ACTION BETWEEN 11334 07:35:42,001 --> 07:35:45,000 1998 AND 2000. 11335 07:35:45,001 --> 07:35:47,000 THOSE ACTIONS TRIGGERED THE 11336 07:35:47,001 --> 07:35:50,000 CLOSURE OF 40% OF HOME HEALTH 11337 07:35:50,001 --> 07:35:54,000 AGENCIES ANDEAP DUED ACCESS 11338 07:35:54,001 --> 07:35:57,000 FOR -- REDUCED ACCESS FOR 1.5 11339 07:35:57,001 --> 07:35:59,000 MILLION MEDICARE BENEFICIARIES. 11340 07:35:59,001 --> 07:36:02,000 ACCESS BECOMES 11341 07:36:02,001 --> 07:36:04,000 IF THERE'S NO HOME HEALTH 11342 07:36:04,001 --> 07:36:08,000 AGENCY, HOMEBOUND PATIENTS END 11343 07:36:08,001 --> 07:36:10,000 UP WITH MORE EXPENSIVE CARE IN 11344 07:36:10,001 --> 07:36:12,000 HOSPITALS AND NURSING HOMES, AND 11345 07:36:12,001 --> 07:36:14,000 THAT COSTS MEDICARE MONEY. 11346 07:36:14,001 --> 07:36:16,000 BUT, YOU SEE, WE'RE ALSO CUTTING 11347 07:36:16,001 --> 07:36:17,000 HOSPITALS AND NURSING HOMES IN 11348 07:36:17,001 --> 07:36:22,000 THIS BILL. 11349 07:36:22,001 --> 07:36:25,000 IF THERE IS NO HOME HEALTH 11350 07:36:25,001 --> 07:36:26,000 PROVIDER NEAR THE AREA, NOT ONLY 11351 07:36:26,001 --> 07:36:28,000 ARE MEDICARE BENEFICIARIES HURT, 11352 07:36:28,001 --> 07:36:31,000 BUT ALL CITIZENS WHO NEED THE CARE. 11353 07:36:31,001 --> 07:36:33,000 YOU KNOW, MR. PRESIDENT, ANY 11354 07:36:33,001 --> 07:36:34,000 ANALYSIS IS GOING TO COME TO THE 11355 07:36:34,001 --> 07:36:37,000 SAME CONCLUSION. 11356 07:36:37,001 --> 07:36:39,000 AND I'LL QUOTE FROM ONE. 11357 07:36:39,001 --> 07:36:40,000 QUOTE -- "STUDIES FROM MEDPAC 11358 07:36:40,001 --> 07:36:42,000 AND THE GOVERNMENT 11359 07:36:42,001 --> 07:36:44,000 ACCOUNTABILITY OFFICE ALSO 11360 07:36:44,001 --> 07:36:46,000 SUGGEST THAT ACCESS IS A GROWING 11361 07:36:46,001 --> 07:36:48,000 PROBLEM FOR PATIENTS WHO REQUIRE 11362 07:36:48,001 --> 07:36:51,000 INTENSIVE SERVICES. 11363 07:36:51,001 --> 07:36:54,000 IN JUNE 2003, MEDPAC ISSUED A 11364 07:36:54,001 --> 07:36:56,000 REPORT INDICATING THAT SKILLED 11365 07:36:56,001 --> 07:36:58,000 NURSING FACILITIES CARE IS NOW 11366 07:36:58,001 --> 07:37:01,000 SUBSTITUTING FOR HOME HEALTH 11367 07:37:01,001 --> 07:37:02,000 CARE FOR SOME PATIENTS. 11368 07:37:02,001 --> 07:37:05,000 MOST LIKELY AT A MUCH HIGHER 11369 07:37:05,001 --> 07:37:08,000 COST FOR MEDICARE." 11370 07:37:08,001 --> 07:37:13,000 UNQUOTE. 11371 07:37:13,001 --> 07:37:16,000 WELL, I DON'T THINK THESE ARE TRANSFORMATIONAL REFORM. 11372 07:37:16,001 --> 07:37:17,000 THESE CUTS ARE NOT 11373 07:37:17,001 --> 07:37:20,000 TRANSFORMATIONAL REFORM. 11374 07:37:20,001 --> 07:37:25,000 THEY'RE JUST PLAIN CUTS TO START 11375 07:37:25,001 --> 07:37:26,000 A NEW ENTITLEMENT THAT HURT REAL 11376 07:37:26,001 --> 07:37:27,000 PEOPLE: SENIOR CITIZENS WHO 11377 07:37:27,001 --> 07:37:28,000 NEED OUR HELP. 11378 07:37:28,001 --> 07:37:30,000 THAT'S WHY I'M OFFERING THIS 11379 07:37:30,001 --> 07:37:33,000 AMENDMENT TO RECOMMIT THIS 11380 07:37:33,001 --> 07:37:35,000 LEGISLATION BACK TO THE FINANCE 11381 07:37:35,001 --> 07:37:36,000 COMMITTEE, TO STRIKE THESE 11382 07:37:36,001 --> 07:37:39,000 ILL-ADVISED HOME HEALTH CARE 11383 07:37:39,001 --> 07:37:41,000 CUTS FROM IT. 11384 07:37:41,001 --> 07:37:43,000 MR. PRESIDENT, I WILL FOLLOW UP. 11385 07:37:43,001 --> 07:37:45,000 I WILL MAKE SURE THAT EVERY 11386 07:37:45,001 --> 07:37:47,000 MEMBER SEES THE IMPACT OF THESE 11387 07:37:47,001 --> 07:37:52,000 CUTS IN THEIR STATE SO THEY CAN 11388 07:37:52,001 --> 07:37:54,000 MAKE AN 11389 07:37:54,001 --> 07:37:55,000 SHOULD THESE CUTS BE PUT IN 11390 07:37:55,001 --> 07:37:58,000 PLACE AND CAUSE THE KIND OF 11391 07:37:58,001 --> 07:37:59,000 DAMAGE THAT I'VE DESCRIBED THIS AFTERNOON? 11392 07:37:59,001 --> 07:38:06,000 THANK YOU, 11393 07:38:06,001 --> 07:38:07,000 I YIELD THE 11394 07:38:07,001 --> 07:38:10,000 SENATOR FROM MAINE. 11395 07:38:10,001 --> 07:38:11,000 MR. BAUCUS: 11396 07:38:11,001 --> 07:38:12,000 THE PRESIDING OFFICER: THE 11397 07:38:12,001 --> 07:38:15,000 SENATOR FROM MONTANA. 11398 07:38:15,001 --> 07:38:17,000 MR. BAUCUS: I YIELD TO SENATOR KLOBUCHAR TEN MINUTES. 11399 07:38:17,001 --> 07:38:18,000 MS. KLOBUCHAR: THANK YOU VERY MUCH. 11400 07:38:18,001 --> 07:38:19,000 THE PRESIDING OFFICER: THE 11401 07:38:19,001 --> 07:38:20,000 SENATOR FROM MINNESOTA. 11402 07:38:20,001 --> 07:38:22,000 MS. KLOBUCHAR: I ASK UNANIMOUS 11403 07:38:22,001 --> 07:38:23,000 CONSENT TO PEEK FOR UP TO 12 MINUTES. 11404 07:38:23,001 --> 07:38:25,000 THE PRESIDING OFFICER: WITHOUT OBJECTION. 11405 07:38:25,001 --> 07:38:26,000 MS. KLOBUCHAR: I RISE TODAY TO 11406 07:38:26,001 --> 07:38:27,000 SPEAK ABOUT TRUE HEALTH CARE 11407 07:38:27,001 --> 07:38:28,000 REFORM. 11408 07:38:28,001 --> 07:38:31,000 THE WAY I LOOK AT THIS IN MY 11409 07:38:31,001 --> 07:38:33,000 STATE IS IT'S A MATTER OF AFFORDABILITY AND COST. 11410 07:38:33,001 --> 07:38:35,000 WE HAVE ONE OF THE HIGHEST 11411 07:38:35,001 --> 07:38:37,000 PERCENTAGE OF PEOPLE COVERED IN 11412 07:38:37,001 --> 07:38:39,000 THE COUNTRY, MR. PRESIDENT, IN MINNESOTA. 11413 07:38:39,001 --> 07:38:40,000 BUT THE ISSUE IS IT'S BECOMING 11414 07:38:40,001 --> 07:38:42,000 MORE AND MORE EXPENSIVE FOR THE 11415 07:38:42,001 --> 07:38:44,000 PEOPLE OF OUR STATE TO AFFORD HEALTH CARE. 11416 07:38:44,001 --> 07:38:45,000 I TRY TO REMEMBER THREE SIMPLE 11417 07:38:45,001 --> 07:38:47,000 NUMBERS OF ALL THE NUMBERS WE'RE 11418 07:38:47,001 --> 07:38:50,000 GOING TO HEAR IN THE NEXT FEW WEEKS. 11419 07:38:50,001 --> 07:38:54,000 THOSE ARE THE NUMBERS 6, 12 AND 24. 11420 07:38:54,001 --> 07:38:55,000 TEN YEARS OF COLA COSTS 11421 07:38:55,001 --> 07:38:56,000 FOR AN AVERAGE FAMILY TO PAY FOR 11422 07:38:56,001 --> 07:38:58,000 THEIR HEALTH CARE A FAMILY. 11423 07:38:58,001 --> 07:39:00,000 NOW IT'S $12,000 WITH A LOT OF 11424 07:39:00,001 --> 07:39:01,000 PEOPLE PAYING A LOT MORE. 11425 07:39:01,001 --> 07:39:03,000 TEN YEARS FROM NOW IF WE DON'T 11426 07:39:03,001 --> 07:39:07,000 DO ANYTHING, IT'S GOING TO BE 11427 07:39:07,001 --> 07:39:09,000 $36,000 A YEAR, SOMETHING 11428 07:39:09,001 --> 07:39:10,000 REGULAR PEOPLE JUST CAN'T 11429 07:39:10,001 --> 07:39:11,000 AFFORD. 11430 07:39:11,001 --> 07:39:13,000 6, 12 AND 24. 11431 07:39:13,001 --> 07:39:14,000 IT'S NOT GOING IN THE RIGHT 11432 07:39:14,001 --> 07:39:16,000 DIRECTION, MR. PRESIDENT. 11433 07:39:16,001 --> 07:39:17,000 IF WE DON'T ACT, COSTS WILL 11434 07:39:17,001 --> 07:39:20,000 CONTINUE TO SKYROCKET. 11435 07:39:20,001 --> 07:39:23,000 THE COUNTRY SPENT $2.4 TRILLION 11436 07:39:23,001 --> 07:39:26,000 ON HEALTH CARE LAST YEAR ALONE. 11437 07:39:26,001 --> 07:39:27,000 THAT'S ONE OUT OF EVERY $6 SPENT 11438 07:39:27,001 --> 07:39:30,000 IN THE ECONOMY. 11439 07:39:30,001 --> 07:39:32,000 BY 2018 NATIONAL HEALTH CARE 11440 07:39:32,001 --> 07:39:35,000 SPENDING IS EXPECTED TO REACH 11441 07:39:35,001 --> 07:39:36,000 $4.4 TRILLION, OVER 20% OF OUR 11442 07:39:36,001 --> 07:39:38,000 ENTIRE ECONOMY. 11443 07:39:38,001 --> 07:39:39,000 DESPITE SPENDING ONE AND A HALF 11444 07:39:39,001 --> 07:39:42,000 TIMES MORE PER PERSON ON HEALTH 11445 07:39:42,001 --> 07:39:44,000 CARE THAN ANY OTHER COUNTRY, 11446 07:39:44,001 --> 07:39:46,000 MANY OF OUR PEOPLE DON'T EVEN 11447 07:39:46,001 --> 07:39:48,000 HAVE HEALTH CARE COVERAGE. 11448 07:39:48,001 --> 07:39:50,000 AND MANY OF THEM ARE LOSING 11449 07:39:50,001 --> 07:39:53,000 THEIR COVERAGE BECAUSE OF PREEXISTING CONDITIONS OR 11450 07:39:53,001 --> 07:39:54,000 BEUSE IT SIMPLY IS COSTING TOO MUCH. 11451 07:39:54,001 --> 07:39:57,000 THESE COSTS ARE BREAKING THE 11452 07:39:57,001 --> 07:40:00,000 BUSINESSES. 11453 07:40:00,001 --> 07:40:03,000 YOU CAN S 11454 07:40:03,001 --> 07:40:05,000 COVERAGE, 1999, $2,192. 11455 07:40:05,001 --> 07:40:09,000 IN 2008, THE LAST FIGURES WE 11456 07:40:09,001 --> 07:40:10,000 HAVE AVAILABLE, $4,704. 11457 07:40:10,001 --> 07:40:16,000 A 11458 07:40:16,001 --> 07:40:18,000 FAMILY COSTS $19 -- 11459 07:40:18,001 --> 07:40:21,000 TKHR-RBS 5,791. 11460 07:40:21,001 --> 07:40:22,000 NOW WHAT ARE THEY PAYING? 11461 07:40:22,001 --> 07:40:24,000 $12,680. 11462 07:40:24,001 --> 07:40:25,000 NOW LOOK WHAT'S HAPPENING TO 11463 07:40:25,001 --> 07:40:28,000 SMALL BUSINESS, MR. PRESIDENT. 11464 07:40:28,001 --> 07:40:30,000 A STUDY BY THE COUNCIL OF 11465 07:40:30,001 --> 07:40:32,000 ECONOMIC ADVISORS FOUND SMALL 11466 07:40:32,001 --> 07:40:33,000 BUSINESSES PAY UP TO 18% MORE 11467 07:40:33,001 --> 07:40:34,000 THAN LARGE BUSINESSES TO PROVIDE 11468 07:40:34,001 --> 07:40:36,000 HEALTH CARE COVERAGE. 11469 07:40:36,001 --> 07:40:38,000 IN A RECENT NATIONAL SURVEY 11470 07:40:38,001 --> 07:40:40,000 NEARLY THREE-QUARTERS OF SMALL 11471 07:40:40,001 --> 07:40:42,000 BUSINESSES THAT DID NOT OFFER 11472 07:40:42,001 --> 07:40:45,000 BENEFITS CITED HIGH PREMIUMS AS THE REASON. 11473 07:40:45,001 --> 07:40:46,000 NOW LOOK AT IT THIS WAY, 11474 07:40:46,001 --> 07:40:49,000 MR. PRESIDENT, INFLATION USUALLY 11475 07:40:49,001 --> 07:40:52,000 RAISES THE COST OF MOST GOODS 11476 07:40:52,001 --> 07:40:53,000 AND SERVICES BETWE 2% TO 3% 11477 07:40:53,001 --> 07:40:54,000 PER YEAR. 11478 07:40:54,001 --> 07:40:56,000 HEALTH CARE PREMIUM COSTS 11479 07:40:56,001 --> 07:40:58,000 ALREADY HAVE BEEN GOING UP CLOSE 11480 07:40:58,001 --> 07:40:59,000 TO 8% A YEAR. 11481 07:40:59,001 --> 07:41:01,000 THAT'S AN INCREASE AMERICANS 11482 07:41:01,001 --> 07:41:03,000 JUST CAN'T AFFORD. 11483 07:41:03,001 --> 07:41:05,000 WAGES HAVE NOT KEPT PACE WITH AN 11484 07:41:05,001 --> 07:41:06,000 INCREASE IN PREMIUMS. WAGES. 11485 07:41:06,001 --> 07:41:09,000 LOOK AT THIS. 11486 07:41:09,001 --> 07:41:11,000 BETWEEN 1999 AND 2007, THE 11487 07:41:11,001 --> 07:41:14,000 AVERAGE AMERICAN WORKER SAW HIS 11488 07:41:14,001 --> 07:41:15,000 WAGES INCREASE 29%. 11489 07:41:15,001 --> 07:41:17,000 OBVIOUSLY THE LAST FEW YEARS IT 11490 07:41:17,001 --> 07:41:21,000 HAS NOT BEEN THAT ROSY. 11491 07:41:21,001 --> 07:41:22,000 BUT 29% BETWEEN 1999-2007. 11492 07:41:22,001 --> 07:41:25,000 HOW MUCH DID HIS INSURANCE 11493 07:41:25,001 --> 07:41:27,000 PREMIUMS GO UP? 11494 07:41:27,001 --> 07:41:30,000 120% DURING THE SAME TIME PERIOD. 11495 07:41:30,001 --> 07:41:33,000 SO, IN OTHER 11496 07:41:33,001 --> 07:41:35,000 CARE PREMIUMS ARE TAKING ON A 11497 07:41:35,001 --> 07:41:36,000 BIGGER 11498 07:41:36,001 --> 07:41:38,000 AVERAGE WORKER'S PAYCHECK. 11499 07:41:38,001 --> 07:41:41,000 AND THESE COSTS ARE BREAKING THE 11500 07:41:41,001 --> 07:41:42,000 BACKS OF THE AMERICAN 11501 07:41:42,001 --> 07:41:44,000 MY COLLEAGUE ACROSS THE AISLE 11502 07:41:44,001 --> 07:41:46,000 WAS TALKING ABOUT MEDICARE. 11503 07:41:46,001 --> 07:41:48,000 WELL, THE TRUTH IS THIS, 11504 07:41:48,001 --> 07:41:50,000 MEDICARE IS PROJECTED TO GO INTO 11505 07:41:50,001 --> 07:41:52,000 DEFICIT BY 2017 IF WE DON'T DO 11506 07:41:52,001 --> 07:41:53,000 ANYTHING ABOUT IT. 11507 07:41:53,001 --> 07:41:54,000 AND RECENT CONGRESSIONAL BUDGET 11508 07:41:54,001 --> 07:41:57,000 OFFICE ESTIMATES SHOW THAT THE 11509 07:41:57,001 --> 07:41:58,000 MAJORITY OF T PROJECTED $344 11510 07:41:58,001 --> 07:42:00,000 BILLION INCREASE IN FEDERAL 11511 07:42:00,001 --> 07:42:01,000 REVENUES ARE SCHEDULED TO 11512 07:42:01,001 --> 07:42:04,000 AUTOMATICALLY GO TO COVER RISING 11513 07:42:04,001 --> 07:42:05,000 HEALTH CARE COSTS. 11514 07:42:05,001 --> 07:42:08,000 MEDICARE, SOMETHING THAT PEOPLE 11515 07:42:08,001 --> 07:42:09,000 WHO ARE 55 WANT TO GET WHEN 11516 07:42:09,001 --> 07:42:10,000 THEY'RE 65. 11517 07:42:10,001 --> 07:42:12,000 PEOPLE WHO ARE 65 WANT TO KEEP 11518 07:42:12,001 --> 07:42:14,000 THEIR MEDICARE UNTIL THEY LIVE 11519 07:42:14,001 --> 07:42:16,000 TOHE RIPE OLD AGE OF 95. 11520 07:42:16,001 --> 07:42:18,000 BUT IF WE DON'T DO ANYTHING 11521 07:42:18,001 --> 07:42:19,000 ABOUT IT, 11522 07:42:19,001 --> 07:42:20,000 BY 2017. 11523 07:42:20,001 --> 07:42:21,000 HOW DO WE DO THIS? 11524 07:42:21,001 --> 07:42:22,000 HOW DO WE GET TO THE PLACE WE 11525 07:42:22,001 --> 07:42:24,000 WANT TO GO? 11526 07:42:24,001 --> 07:42:26,000 WE MUST GET OUR MONEY'S WORTH 11527 07:42:26,001 --> 07:42:27,000 FROM OUR HEAH CARE DOLLARS. 11528 07:42:27,001 --> 07:42:29,000 THE PROBLEM NOW IS WE'RE PAYING 11529 07:42:29,001 --> 07:42:32,000 TOO MUCH AND WE'RE NOT GETTING A 11530 07:42:32,001 --> 07:42:33,000 GOOD RETURN ON WHAT WE PAY. 11531 07:42:33,001 --> 07:42:35,000 THE SOLUTION MU BE TO GET THE 11532 07:42:35,001 --> 07:42:36,000 BEST VALUE FOR OUR HEALTH CARE 11533 07:42:36,001 --> 07:42:38,000 DOLLARS. 11534 07:42:38,001 --> 07:42:39,000 OTHERWISE, COSTS ARE GOING TO 11535 07:42:39,001 --> 07:42:43,000 CONTINUE TO WREAK MASSIVE SROBG 11536 07:42:43,001 --> 07:42:44,000 ON THE BUDGETS OF -- TO WREAK 11537 07:42:44,001 --> 07:42:46,000 HAVOC ON GOVERNMENTS, BUSINESS 11538 07:42:46,001 --> 07:42:48,000 AND INDIVIDUAL FAMILIES. 11539 07:42:48,001 --> 07:42:49,000 HEALTH CARE IS 57% OF ALL 11540 07:42:49,001 --> 07:42:51,000 FEDERAL HEALTH SPENDING. 11541 07:42:51,001 --> 07:42:52,000 IF WE WANT TO SUSTAIN MEDICARE, 11542 07:42:52,001 --> 07:42:54,000 WHICH WE ALL DO, TO PROVIDE THAT 11543 07:42:54,001 --> 07:42:55,000 KIND OF HIGH-QUALITY HEALTH CARE 11544 07:42:55,001 --> 07:42:58,000 THAT OUR SENIORS DESERVE, WE 11545 07:42:58,001 --> 07:43:00,000 MUST DO SOMETHING TO ADDRESS THE SCAL CHALLENGES. 11546 07:43:00,001 --> 07:43:01,000 THE ROOT OF THE PROBLEM IS THAT 11547 07:43:01,001 --> 07:43:05,000 MOST HEALTH CARE IS PURCHASED O 11548 07:43:05,001 --> 07:43:07,000 A 11549 07:43:07,001 --> 07:43:09,000 TESTS, MORE SURGERY MEANS MORE MONEY. 11550 07:43:09,001 --> 07:43:12,000 QUANTITY, NOT QUALITY PAYS. 11551 07:43:12,001 --> 07:43:14,000 ACCORDING TO RESEARCHERS AT 11552 07:43:14,001 --> 07:43:15,000 DARTHMOUTH MEDICAL 11553 07:43:15,001 --> 07:43:17,000 $700ILLION PER YEAR IS WASTED 11554 07:43:17,001 --> 07:43:18,000 ON UNNECESSARY, INEFFECTIVE 11555 07:43:18,001 --> 07:43:19,000 CARE. 11556 07:43:19,001 --> 07:43:24,000 NOW, MY FAVORITE EXAMPLE WITH 11557 07:43:24,001 --> 07:43:25,000 ALL THIS IS WHAT A CLINIC DID IN PENNSYLVANIA. 11558 07:43:25,001 --> 07:43:26,000 THEY WEREN'T HAPPY WITH HOW 11559 07:43:26,001 --> 07:43:27,000 THEIR DIABETES TREATMENT WAS 11560 07:43:27,001 --> 07:43:28,000 GOING. 11561 07:43:28,001 --> 07:43:30,000 THEY SAID WE'RE GOING TO HAVE 11562 07:43:30,001 --> 07:43:32,000 OUR ROUTINE PATIENTS SEE NURSES. 11563 07:43:32,001 --> 07:43:33,000 AND MORE DIFFICULT CASES WILL 11564 07:43:33,001 --> 07:43:35,000 SEE DOCTORS. 11565 07:43:35,001 --> 07:43:37,000 THEN THOSE EPIDEMIOLOGISTS WILL 11566 07:43:37,001 --> 07:43:39,000 REVIEW THE RECORDS OF THE NURSES 11567 07:43:39,001 --> 07:43:40,000 AND MAKE SURE THAT THE PATIENT 11568 07:43:40,001 --> 07:43:41,000 IS PROGRESSING AS WE WANT. 11569 07:43:41,001 --> 07:43:43,000 GUESS WHAT? 11570 07:43:43,001 --> 07:43:44,000 PATIENT QUALITY GOES WAY UP 11571 07:43:44,001 --> 07:43:46,000 BECAUSE THEY SEE NURSES AND THEY 11572 07:43:46,001 --> 07:43:48,000 SEE THEM MORE REGULARLY. 11573 07:43:48,001 --> 07:43:50,000 RESULTS GO WAY UP BECAUSE THE 11574 07:43:50,001 --> 07:43:51,000 EPIDEMIOLOGISTS ARE SPENDING 11575 07:43:51,001 --> 07:43:53,000 THEIR TIME ON THE MOST DIFFICULT 11576 07:43:53,001 --> 07:43:54,000 CASES AND REVIEWING THE RECORDS 11577 07:43:54,001 --> 07:43:56,000 OF THE OTHER. 11578 07:43:56,001 --> 07:43:58,000 COSTS GO DOWN $200 PER PATIENT 11579 07:43:58,001 --> 07:43:59,000 PER MONTH. 11580 07:43:59,001 --> 07:44:01,000 GUESS WHAT? 11581 07:44:01,001 --> 07:44:03,000 THEY GET PAID LESS, WAY, LESS 11582 07:44:03,001 --> 07:44:05,000 FOR THAT KIND 11583 07:44:05,001 --> 07:44:06,000 THAT'S WHY THE SYSTEM IS MESSED 11584 07:44:06,001 --> 07:44:08,000 UPND WE NEED TO CHANGE IT. 11585 07:44:08,001 --> 07:44:10,000 WE ARE REWARDING BASED ON RESULTS. 11586 07:44:10,001 --> 07:44:12,000 WE PUT THE PATIENT IN THE 11587 07:44:12,001 --> 07:44:14,000 IVERS SEAT SO WHEN THAT 11588 07:44:14,001 --> 07:44:16,000 PATIENT GETS BETTER RESULTS, WE REWARD WITH PAYMENTS. 11589 07:44:16,001 --> 07:44:18,000 IN MINNESOTA, WE HAVE SEVERAL 11590 07:44:18,001 --> 07:44:19,000 GREAT EXAMPLES OF THIS 11591 07:44:19,001 --> 07:44:22,000 COORDINATED OCOME SYSTEM. 11592 07:44:22,001 --> 07:44:26,000 AT A PLACE LIKE THE MAYO CLINIC, 11593 07:44:26,001 --> 07:44:30,000 PARK NICK LET, ST. MARY'S IN 11594 07:44:30,001 --> 07:44:31,000 DULUTH, IT IS VALUE, NOT VOLUME. 11595 07:44:31,001 --> 07:44:33,000 EVERYWHERE IN THE COUNTRY 11596 07:44:33,001 --> 07:44:36,000 MIRRORED THE EFFICIENT LEVEL OF 11597 07:44:36,001 --> 07:44:38,000 SPENDING IN THE MAYO'S CLINIC 11598 07:44:38,001 --> 07:44:42,000 HOME REGION IN MINNESOTA. 11599 07:44:42,001 --> 07:44:44,000 FOR THE LAST FOUR YEARS OF 11600 07:44:44,001 --> 07:44:46,000 CHRONICALLY ILL PATIENTS' LIVES 11601 07:44:46,001 --> 07:44:48,000 IF WE USED THAT SAME SYSTEM ALL 11602 07:44:48,001 --> 07:44:51,000 OVER 11603 07:44:51,001 --> 07:44:56,000 THIS SYSTEM IN TEXAS, FLORIDA, 11604 07:44:56,001 --> 07:45:00,000 WE WOULD SPEND -- SAVE $50 11605 07:45:00,001 --> 07:45:01,000 BILLION EVERY FIVE YEARS AND GET 11606 07:45:01,001 --> 07:45:02,000 HIGHER QUALITY CARE. 11607 07:45:02,001 --> 07:45:06,000 THIS IS NOT LIKE A HOTEL WHERE 11608 07:45:06,001 --> 07:45:07,000 YOU PAY MORE MONEY AND GET A 11609 07:45:07,001 --> 07:45:09,000 BETTER CARE. 11610 07:45:09,001 --> 07:45:11,000 IN THIS SYSTEM WHEN YOU PAY MORE 11611 07:45:11,001 --> 07:45:12,000 MONEY YOU GET LESS QUALITY CARE. 11612 07:45:12,001 --> 07:45:14,000 THAT IS WHE WE NEED TO BRING 11613 07:45:14,001 --> 07:45:15,000 THE COUNTRY, EFFICIENT CARE THAT 11614 07:45:15,001 --> 07:45:19,000 COSTS LESS BUT IS BETTER VALUE. 11615 07:45:19,001 --> 07:45:20,000 THAT'S WHAT WE 11616 07:45:20,001 --> 07:45:24,000 NEED TO DO. 11617 07:45:24,001 --> 07:45:25,000 LINKING REWARDS TO OUTCOMES 11618 07:45:25,001 --> 07:45:27,000 CREATES AN INCENTIVE FOR 11619 07:45:27,001 --> 07:45:29,000 PHYSICIANS AND HOSPITALS TO WORK 11620 07:45:29,001 --> 07:45:30,000 TOGETHER TO IMPROVE QUALITY AND 11621 07:45:30,001 --> 07:45:32,000 EFFICIENCY. 11622 07:45:32,001 --> 07:45:33,000 USING BUNDLING TO BILL FOR 11623 07:45:33,001 --> 07:45:34,000 BUNDLING SO YOU LOOK AT THE 11624 07:45:34,001 --> 07:45:36,000 WHOLE OUTCOME OF EVERYONE 11625 07:45:36,001 --> 07:45:38,000 WORKING TOGETHER, SO YOU RELY ON 11626 07:45:38,001 --> 07:45:39,000 NURSES WHEN YOU WANT TO RELY ON 11627 07:45:39,001 --> 07:45:43,000 NURSES, YOU RELY ON DOCTORS WHEN 11628 07:45:43,001 --> 07:45:45,000 YOU WANT TO RELY ON DOCTORS. 11629 07:45:45,001 --> 07:45:49,000 REDUCING HOSPITAL READMISSIONS 11630 07:45:49,001 --> 07:45:51,000 -- YOU WANTS TO GO BACK IN THE 11631 07:45:51,001 --> 07:45:52,000 HOSPITAL INFECTIONS. 11632 07:45:52,001 --> 07:45:53,000 WHEN THE GO BACK INTO THE 11633 07:45:53,001 --> 07:45:54,000 HOSPITAL, THE HOSPITAL GETS 11634 07:45:54,001 --> 07:45:56,000 REWARDED FOR THAT. 11635 07:45:56,001 --> 07:45:57,000 SO WE WANT TO PUT IN PLACE 11636 07:45:57,001 --> 07:45:59,000 PROTOCOLS THAT MAKE HOSPITALS 11637 07:45:59,001 --> 07:46:01,000 SAFER PLACES TO GET TREATS. 11638 07:46:01,001 --> 07:46:03,000 ONE-YEAR HOSPITAL READMISSIONS 11639 07:46:03,001 --> 07:46:05,000 COST MICARE $17.4 BILLION AND 11640 07:46:05,001 --> 07:46:08,000 IN 2007 REPORT BY MEDPAC FOUND 11641 07:46:08,001 --> 07:46:11,000 THAT MEDICARE PAID AN AVERAGE OF 11642 07:46:11,001 --> 07:46:12,000 $7,200 PER READMISSION THAT WAS 11643 07:46:12,001 --> 07:46:13,000 PREVENTABLE. 11644 07:46:13,001 --> 07:46:15,000 INTEGRATED CARE -- WHERE YOU'VE 11645 07:46:15,001 --> 07:46:16,000 GOT A QUAERBACK THAT'S THE 11646 07:46:16,001 --> 07:46:17,000 PRIMARY CARE PROVIDER WORKING 11647 07:46:17,001 --> 07:46:19,000 WITH A TEAM. 11648 07:46:19,001 --> 07:46:20,000 INSTEAD OF HAVING 15 SPECIALISTS 11649 07:46:20,001 --> 07:46:22,000 RUNNING AROUND THE FIELD RUNNING 11650 07:46:22,001 --> 07:46:25,000 OVER EACH OTHER, YOU HAVE A QUARTERBACK. 11651 07:46:25,001 --> 07:46:26,000 WELL, LET'S JUST SAY LIKE BRETT 11652 07:46:26,001 --> 07:46:29,000 PHASER OF THE MINNESOTA VIKINGS. 11653 07:46:29,001 --> 07:46:32,000 YOU HAVE ONE QUARTERBACK WHO IS 11654 07:46:32,001 --> 07:46:33,000 YOUR 11655 07:46:33,001 --> 07:46:35,000 IN CHARGE WITH A TEAM OF DOCTORS 11656 07:46:35,001 --> 07:46:36,000 WHO LOOK AT ALL THE RECORDS. 11657 07:46:36,001 --> 07:46:44,000 THAT'S INTEGRATED CARE. 11658 07:46:44,001 --> 07:46:46,000 THAT'S WHAT THIS BILL DOES. 11659 07:46:46,001 --> 07:46:49,000 YOU THINK ABOUT THE MONEY WE CAN SAVE. 11660 07:46:49,001 --> 07:46:51,000 MEDICARE FRAUD ALONE COSTE 11661 07:46:51,001 --> 07:46:52,000 TAXPAYERS MORE THAN $60 BILLION 11662 07:46:52,001 --> 07:46:55,000 A YEAR. 11663 07:46:55,001 --> 07:46:57,000 THE MONEY IS GOING TO CONMEN, 11664 07:46:57,001 --> 07:46:58,000 PEOPLE LEACHING OFF THE SYSTEM, 11665 07:46:58,001 --> 07:46:59,000 PEOPLE MAKING UP THAT THEY ARE 11666 07:46:59,001 --> 07:47:01,000 PROVIDING SERVICES WHEN THEY'RE NOT. 11667 07:47:01,001 --> 07:47:03,000 WE HAVE A BILL W WE'RE WORKING 11668 07:47:03,001 --> 07:47:05,000 TOGETHER TO BRING THAT DOWN SO 11669 07:47:05,001 --> 07:47:07,000 THAT MONEY CAN GO TO OUR SENIORS 11670 07:47:07,001 --> 07:47:08,000 INSTEAD OF GOING TO A BURCHL OF 11671 07:47:08,001 --> 07:47:09,000 PEOPLE WHO ARE RIPPING OFF THE 11672 07:47:09,001 --> 07:47:10,000 SYSTEM. 11673 07:47:10,001 --> 07:47:12,000 YOU LOOK AT HOW YOU SAVE MONEY, 11674 07:47:12,001 --> 07:47:14,000 YOU LOOK AT HOW YOU REDUCE 11675 07:47:14,001 --> 07:47:16,000 COVELETS IN MEDICARE. 11676 07:47:16,001 --> 07:47:18,000 WELL, YOU REDUCE COSTS IN 11677 07:47:18,001 --> 07:47:20,000 MEDICARE BY MAKING CHANGES TO 11678 07:47:20,001 --> 07:47:22,000 THE SYSTEM AND MAKING THIS WORK. 11679 07:47:22,001 --> 07:47:23,000 WE MUST LOOK TO THE FUTURE, 11680 07:47:23,001 --> 07:47:24,000 MR. PRESIDENT. 11681 07:47:24,001 --> 07:47:26,000 THAT'S WHY HEALTH CARE REFORM 11682 07:47:26,001 --> 07:47:29,000 THIS YEAR IS SO CRUCIAL. 11683 07:47:29,001 --> 07:47:31,000 THIS BILL IS NOT ABOUT TODAY OR 11684 07:47:31,001 --> 07:47:34,000 EVEN NEXT YEAR; IT'S ABOUT FIVE 11685 07:47:34,001 --> 07:47:36,000 YEARS, IT'S ABOUT TEN YEARS FROM NOW AND BEYOND. 11686 07:47:36,001 --> 07:47:38,000 WE CAN'T AFFORD FOR THE PEOPLE 11687 07:47:38,001 --> 07:47:40,000 OF THIS COUNTRY TO HOLD OFF ANY LONGER. 11688 07:47:40,001 --> 07:47:42,000 WE CAN BRING THESE COSTS DOWN. 11689 07:47:42,001 --> 07:47:43,000 WE CAN BRING THE QUALITY UP. 11690 07:47:43,001 --> 07:47:45,000 AND WE CAN REWARD THE PEOPLE OF 11691 07:47:45,001 --> 07:47:46,000 THIS COUNTRY FOR THE MONEY THAT 11692 07:47:46,001 --> 07:47:47,000 THEY'RE PUTTING INTO HEALTH 11693 07:47:47,001 --> 07:47:48,000 CARE. 11694 07:47:48,001 --> 07:47:49,000 THANK YOU, MR. PRESIDENT. 11695 07:47:49,001 --> 07:47:51,000 AND I YIELD THE FLOOR. 11696 07:47:51,001 --> 07:47:54,000 WE HAVE ONE CORRECTION TO THE 11697 07:47:54,001 --> 07:47:55,000 RECORD, WHICH I WILL SMIVMENT. 11698 07:47:55,001 --> 07:47:56,000 A SENATOR: MR. PRESIDENT? 11699 07:47:56,001 --> 07:47:58,000 THE PRESIDING OFFICER: THE 11700 07:47:58,001 --> 07:47:59,000 SENATOR FROM SOUTH CONTRARILY. MR. DeMINT: ANK YOU, 11701 07:47:59,001 --> 07:48:02,000 MR. PRESIDENT. 11702 07:48:02,001 --> 07:48:05,000 I APPRECIATE THE COMMENTS FROM 11703 07:48:05,001 --> 07:48:06,000 THE SENATOR FROM MINNESOTA. 11704 07:48:06,001 --> 07:48:07,000 IT BROUGHT OUT A LOT OF 11705 07:48:07,001 --> 07:48:09,000 IMPORTANT ISSUES AS FAR AS THE 11706 07:48:09,001 --> 07:48:12,000 RISING COST OF HEALTH INSURANCE, 11707 07:48:12,001 --> 07:48:14,000 AND I CERTAINLY KNEW THAT, AS 11708 07:48:14,001 --> 07:48:15,000 SMALL BUSINESSMAN. 11709 07:48:15,001 --> 07:48:17,000 THERE'S ONLY ONE PROBLEM. 11710 07:48:17,001 --> 07:48:19,000 THE BILL THAT WE'RE GOING TO 11711 07:48:19,001 --> 07:48:20,000 VOTE ON DOESN'T SOLVE THOSE 11712 07:48:20,001 --> 07:48:22,000 PROBLEMS. 11713 07:48:22,001 --> 07:48:24,000 IN FACT, C.B.O. BASICALLY TELLS 11714 07:48:24,001 --> 07:48:25,000 US THAT INSURANCE WILL CONTINUE 11715 07:48:25,001 --> 07:48:26,000 TO INCREASE AT THE SAME RATE IT 11716 07:48:26,001 --> 07:48:28,000 IS NOW AND FOR THOSE WITH 11717 07:48:28,001 --> 07:48:33,000 INDIVIDUAL INSURANCE POLICIES, 11718 07:48:33,001 --> 07:48:34,000 IT'S VERY LIKELY TO GO UP. 11719 07:48:34,001 --> 07:48:37,000 MR. PRESIDENT, WE'RE HERE ON 11720 07:48:37,001 --> 07:48:40,000 FRIDAY EVENING BEING TOLD WE'RE 11721 07:48:40,001 --> 07:48:42,000 GOING TO WORK THROUGH THE 11722 07:48:42,001 --> 07:48:46,000 WEEKEND, MAYBE NEXT 11723 07:48:46,001 --> 07:48:48,000 THE WAY UP TO CHRISTMAS EVE, 11724 07:48:48,001 --> 07:48:52,000 WITH THE INTENT TO RUSH THROUGH 11725 07:48:52,001 --> 07:48:54,000 A BILL THAT MANY HAVE CALLED -- 11726 07:48:54,001 --> 07:48:57,000 PIECES OF LEGISLATION AND ONE OF 11727 07:48:57,001 --> 07:49:00,000 THE BIGGEST 11728 07:49:00,001 --> 07:49:01,000 CARE THAT WE'VE EVER SEEN HERE 11729 07:49:01,001 --> 07:49:02,000 IN THIS COUNTRY. 11730 07:49:02,001 --> 07:49:05,000 AND APPARENTLY THE MAJORITY 11731 07:49:05,001 --> 07:49:08,000 WANTS TO RUSH THIS 11732 07:49:08,001 --> 07:49:10,000 HOPEFULLY I THINK INTIMIDATE THE 11733 07:49:10,001 --> 07:49:12,000 MINORITY INTO ALLOWING IT TO GO 11734 07:49:12,001 --> 07:49:15,000 THROUGH BY KEEPING US HERE ON 11735 07:49:15,001 --> 07:49:16,000 WEEKENDS OVER THE HOLIDAYS. 11736 07:49:16,001 --> 07:49:18,000 BUT I'M PROUD THAT REPUBLICANS 11737 07:49:18,001 --> 07:49:21,000 ARE STANDING TOGETHER AGAINST 11738 07:49:21,001 --> 07:49:23,000 THIS BILL AND STANDING WITH THE 11739 07:49:23,001 --> 07:49:24,000 AMERICAN PEOPLE TO STOP THE 11740 07:49:24,001 --> 07:49:27,000 DEMOCRAT GOVERNMENT TAKEOVER OF 11741 07:49:27,001 --> 07:49:30,000 HEALTH CARE IN A 11742 07:49:30,001 --> 07:49:33,000 STOP THEM FROM PAYING FOR IT BY 11743 07:49:33,001 --> 07:49:36,000 CUTTING NEARLY $500 BILLION FROM 11744 07:49:36,001 --> 07:49:38,000 MEDICARE AND RAISING TAXES ON 11745 07:49:38,001 --> 07:49:42,000 MILLIONS OF AMERICANS. 11746 07:49:42,001 --> 07:49:43,000 I HEARD FROM ONE OF OUR 11747 07:49:43,001 --> 07:49:45,000 CONSTITUENTS THAT WAS TALKING 11748 07:49:45,001 --> 07:49:46,000 ABOUT MEDICARE D THE CUTS IN 11749 07:49:46,001 --> 07:49:49,000 MEDICARE EXPLAING VERY SIMPLY 11750 07:49:49,001 --> 07:49:51,000 THAT MEDICARE IS SOMETHING HE 11751 07:49:51,001 --> 07:49:54,000 HAD PAID FOR HIS ENTIRE 40 YEARS 11752 07:49:54,001 --> 07:49:56,000 OF WORKING OUT OF HIS 11753 07:49:56,001 --> 07:49:58,000 TAXES, AND NOW HE COULD NOT 11754 07:49:58,001 --> 07:49:59,000 BELIEVE THAT WE WERE CONSIDERING 11755 07:49:59,001 --> 07:50:02,000 TANG ANY MONEY OUT OF MEDICARE 11756 07:50:02,001 --> 07:50:04,000 IN ORDER TO PAY FOR A NEW 11757 07:50:04,001 --> 07:50:06,000 GOVERNMENT PROGRAM. 11758 07:50:06,001 --> 07:50:09,000 AMERICANS WORK AND PAY FOR 11759 07:50:09,001 --> 07:50:12,000 MEDICARE SO THAT WHEN THE 11760 07:50:12,001 --> 07:50:13,000 RETIRE, THEY WILL HAVE 11761 07:50:13,001 --> 07:50:14,000 THAT GIVES THEM THE COVERAGE 11762 07:50:14,001 --> 07:50:15,000 THEY NEED. 11763 07:50:15,001 --> 07:50:16,000 I THINK THE MAJORITY MUST THINK 11764 07:50:16,001 --> 07:50:17,000 AMERICANS ARE NOT PAYING 11765 07:50:17,001 --> 07:50:19,000 ATTENTION OR MAYBE EVEN THEY'RE 11766 07:50:19,001 --> 07:50:21,000 NOT REAL SMART, THAT YOU CAN 11767 07:50:21,001 --> 07:50:23,000 TAKE $500 BILLION OUT OF A 11768 07:50:23,001 --> 07:50:26,000 PROGRAM THAT'S ALREADY BANKRUPT 11769 07:50:26,001 --> 07:50:28,000 AND EXPECT THE BENEFITS TO STAY 11770 07:50:28,001 --> 07:50:29,000 THE SAME WHEN ALREADY WE KNOW 11771 07:50:29,001 --> 07:50:32,000 WE'RE NOT PAYING DOCTORS ENOUGH 11772 07:50:32,001 --> 07:50:34,000 TO SEE OUR SENIORS AND MORE AND 11773 07:50:34,001 --> 07:50:35,000 MORE PHYSICIANS ARE NOT EVEN 11774 07:50:35,001 --> 07:50:36,000 WILLING TO SEE MEDICARE 11775 07:50:36,001 --> 07:50:38,000 PATIENTS. 11776 07:50:38,001 --> 07:50:40,000 IF THERE REALLY IS WASTE AND 11777 07:50:40,001 --> 07:50:42,000 FRAUD IN MEDICARE -- AND WE KNOW 11778 07:50:42,001 --> 07:50:43,000 THERE'S SOME -- WE SHOULD 11779 07:50:43,001 --> 07:50:46,000 IT AND PUT THAT MONEY BACK INTO 11780 07:50:46,001 --> 07:50:48,000 THE MEDICARE SYSTEM SO THAT WE 11781 07:50:48,001 --> 07:50:50,000 CAN KEEP OUR PROMISES TO 11782 07:50:50,001 --> 07:50:52,000 SENIORS. 11783 07:50:52,001 --> 07:50:55,000 EVERY DEMOCRAT HERE IN THE 11784 07:50:55,001 --> 07:50:57,000 SENATE HAS ALREADY VOTED FOR A 11785 07:50:57,001 --> 07:50:58,000 GOVERNMENT TAKEOVER OF HEALTH 11786 07:50:58,001 --> 07:51:00,000 CARE, TO CUT MEDICARE TO PAY FOR 11787 07:51:00,001 --> 07:51:02,000 IT, AND TO RAISE TAXES. 11788 07:51:02,001 --> 07:51:04,000 SOME OF THEM SAID THEY WERE JUST 11789 07:51:04,001 --> 07:51:06,000 MOVING THE DEBATE FORWARD. 11790 07:51:06,001 --> 07:51:09,000 BUT I ASK YOU, WHAT DEBATE? 11791 07:51:09,001 --> 07:51:10,000 WILL THERE BE ANY SERIOUS 11792 07:51:10,001 --> 07:51:12,000 CONSIDERATION TO TAKE THIS 11793 07:51:12,001 --> 07:51:13,000 GOVERNMENT-RUN PLAN OUT OF THIS 11794 07:51:13,001 --> 07:51:14,000 BILL? 11795 07:51:14,001 --> 07:51:16,000 THERE WON'T BE. 11796 07:51:16,001 --> 07:51:18,000 WE'VE ALREADY SEEN THAT THERE'S 11797 07:51:18,001 --> 07:51:19,000 NO SERIOUS CONSIDERATION TO STOP 11798 07:51:19,001 --> 07:51:21,000 TAKING MONEY OUT OF MEDICARE TO 11799 07:51:21,001 --> 07:51:22,000 PAY FOR IT. 11800 07:51:22,001 --> 07:51:24,000 IN FACT, WE'VE HAD A LOT OF 11801 07:51:24,001 --> 07:51:27,000 DEBATE ABOUT WHAT THIS IS GOING 11802 07:51:27,001 --> 07:51:29,000 TO DO, TO CUT FROM MEDICARE, 11803 07:51:29,001 --> 07:51:31,000 WHAT IT'S EVENTUALLY GOING TO DO 11804 07:51:31,001 --> 07:51:32,000 TO BENEFITS, CUT MEDICARE ADVANTAGE. 11805 07:51:32,001 --> 07:51:34,000 NOW WE'RE TALKING ABOUT CUTTING 11806 07:51:34,001 --> 07:51:36,000 HOME HEALTH, WHICH IS SO 11807 07:51:36,001 --> 07:51:38,000 IMPORTANT, PARTICULARLY IN RURAL 11808 07:51:38,001 --> 07:51:40,000 COMMUNITIES AND FOR THE MORE 11809 07:51:40,001 --> 07:51:41,000 ELDERLY CONSTITUENTS THAT WE 11810 07:51:41,001 --> 07:51:42,000 SERVE. 11811 07:51:42,001 --> 07:51:45,000 THERE'S NO WAY YOU COULD TAKE 11812 07:51:45,001 --> 07:51:47,000 THIS MONEY OUT OF MEDICARE 11813 07:51:47,001 --> 07:51:48,000 WITHOUT HURTING THE PROGRAMS. 11814 07:51:48,001 --> 07:51:51,000 INSTEAD, AS WE LOOK 11815 07:51:51,001 --> 07:51:54,000 MORE PEOPLE RETIRING THAN EVER 11816 07:51:54,001 --> 07:51:57,000 IN HISTORY AND MEDICARE BEING BANKRUPT, WE NEED TO BE LOOKING 11817 07:51:57,001 --> 07:51:59,000 AT WAYS THAT WE CAN SHORE UP IN 11818 07:51:59,001 --> 07:52:03,000 PROGRAM SO THAT IT WILL BE THERE 11819 07:52:03,001 --> 07:52:06,000 FOR GENERATIONS TO COME. 11820 07:52:06,001 --> 07:52:07,000 EVERY REPUBLICAN VOTED "NO." 11821 07:52:07,001 --> 07:52:09,000 EVERY REPUBLICAN IN THIS SENATE 11822 07:52:09,001 --> 07:52:11,000 HAS STOOD WITH THE AMERICAN 11823 07:52:11,001 --> 07:52:13,000 PEOPLE AND STAYED "NO" TO A 11824 07:52:13,001 --> 07:52:15,000 HEALTH CARE BILL THAT TAS OVER 11825 07:52:15,001 --> 07:52:17,000 THE MOST PERSONAL AND PRIVATE 11826 07:52:17,001 --> 07:52:21,000 PART OF OUR LIVES. 11827 07:52:21,001 --> 07:52:23,000 I'M PROUD OF OUR LEADERSH 11828 07:52:23,001 --> 07:52:25,000 AND AMERICANS HAVE BEEN ASKING 11829 07:52:25,001 --> 07:52:27,000 TO SEE THE DIFFERENCES BETWEEN 11830 07:52:27,001 --> 07:52:30,000 THE REPUBLICAN AND THE DEMOCRAT 11831 07:52:30,001 --> 07:52:32,000 PARTY, AND I THINK NOW MORE THAN 11832 07:52:32,001 --> 07:52:34,000 EVER ON THIS ISSUE THEY'RE GOING 11833 07:52:34,001 --> 07:52:36,000 TO SEE THE DEMOCRATSTANDING 11834 07:52:36,001 --> 07:52:39,000 WITH GOVERNMENT-CONTROLLED 11835 07:52:39,001 --> 07:52:41,000 HEALTH CARE, CUTS IN MEDICARE, 11836 07:52:41,001 --> 07:52:43,000 INCREASED TAXES, AND ON THE 11837 07:52:43,001 --> 07:52:44,000 OTHER SIDE REPUBLICANS WHO ARE 11838 07:52:44,001 --> 07:52:45,000 GOING TO STAY HERE THROUGH 11839 07:52:45,001 --> 07:52:47,000 CHRISTMAS OR NEW YEAR'S OR 11840 07:52:47,001 --> 07:52:50,000 WHATEVER IT TAKES TO STOP TS 11841 07:52:50,001 --> 07:52:51,000 BILL AND TO SIT DOWN AND REALLY 11842 07:52:51,001 --> 07:52:53,000 REFORM THE SYSTEM IN A WAY THAT 11843 07:52:53,001 --> 07:52:55,000 WILL LOWER COST AND IMPROVE CARE 11844 07:52:55,001 --> 07:52:57,000 TO ALL AMERICANS. 11845 07:52:57,001 --> 07:52:58,000 WE NEED TO CONTINUE TO TALK 11846 07:52:58,001 --> 07:52:59,000 ABOUT THESE BIGGER ISSUES, 11847 07:52:59,001 --> 07:53:00,000 PARTICULARLY H IT AFFECTS 11848 07:53:00,001 --> 07:53:01,000 MEDICARE. 11849 07:53:01,001 --> 07:53:04,000 AND WE'LL BE DOING THAT OVER THE WEEKEND. 11850 07:53:04,001 --> 07:53:05,000 BUT I THINK WE OWE IT TO THE 11851 07:53:05,001 --> 07:53:07,000 AMERICAN PEOPLE TO BEGIN TO OPEN 11852 07:53:07,001 --> 07:53:09,000 THIS BILL UP AND EXPLAIN WHAT'S 11853 07:53:09,001 --> 07:53:10,000 IN IT. 11854 07:53:10,001 --> 07:53:12,000 I CAN ALMOST GUARANTEE YOU THAT 11855 07:53:12,001 --> 07:53:15,000 THERE'S NOT ONE MEMBER OF THE 11856 07:53:15,001 --> 07:53:17,000 SENATE WHO'S READ IT YET. 11857 07:53:17,001 --> 07:53:22,000 WE'RE GOING TO TRY TO FIT THIS 11858 07:53:22,001 --> 07:53:23,000 IN SANTA'S SLAY TH SANTA'S SLEIGH THIS YEAR SO 11859 07:53:23,001 --> 07:53:27,000 IT'LL BE DELIVERED TO EVER AMERICAN. 11860 07:53:27,001 --> 07:53:29,000 I'VE GOT THE FIRST PART 11861 07:53:29,001 --> 07:53:30,000 1,000 PAGES, SMALL PRINT, FRONT 11862 07:53:30,001 --> 07:53:31,000 AND BACK. 11863 07:53:31,001 --> 07:53:33,000 STARTED GOING THROUGH IT PUTTING 11864 07:53:33,001 --> 07:53:34,000 TABS ON DIFFERENT PAGES SO WE 11865 07:53:34,001 --> 07:53:36,000 CAN TALK ABOUT THE DIFFERENT THINGS BECAUSE SOMETIMES THEY 11866 07:53:36,001 --> 07:53:37,000 SOUND SO EXTRAORDINARILY PEOPLE 11867 07:53:37,001 --> 07:53:38,000 DON'T REALLY BELIEVE THEY'RE IN 11868 07:53:38,001 --> 07:53:39,000 THERE. 11869 07:53:39,001 --> 07:53:41,000 I'M NOT SURE WE'LL EVER GET 11870 07:53:41,001 --> 07:53:43,000 THROUGH THE WHOLE THING, BUT I 11871 07:53:43,001 --> 07:53:45,000 JUST WANTED TO TAKE A COUPLE 11872 07:53:45,001 --> 07:53:47,000 PARTS TONIGHT AND JUST START 11873 07:53:47,001 --> 07:53:49,000 TALKING ABOUT WHAT IS REALLY IN 11874 07:53:49,001 --> 07:53:56,000 THIS BILL. 11875 07:53:56,001 --> 07:53:57,000 ON PAGE 17 IN SECTION 2713, IT 11876 07:53:57,001 --> 07:53:58,000 IS INTIELTDED "COVERAGE OF 11877 07:53:58,001 --> 07:54:03,000 PREVENTIVE HEALTH SFERTIONS" 11878 07:54:03,001 --> 07:54:05,000 WHICH IS REALLY OUR JARGON FOR 11879 07:54:05,001 --> 07:54:07,000 RATIONING IF SAYS A GROUP HEALTH 11880 07:54:07,001 --> 07:54:09,000 PLAN AND HEALTH INSURANCE ISSUER 11881 07:54:09,001 --> 07:54:11,000 OFFERING GROUP OR INDIVIDUAL 11882 07:54:11,001 --> 07:54:13,000 HEALTH INSURANCE COVERAGEERN 11883 07:54:13,001 --> 07:54:14,000 PROVIDE COVERAGE FROR 11884 07:54:14,001 --> 07:54:19,000 EVIDENCE-BASED ITEMS OR SERVICES 11885 07:54:19,001 --> 07:54:22,000 THAT HAVE IN EFFECT AN "A" OR 11886 07:54:22,001 --> 07:54:23,000 "B" RATING IN THE CURRENT 11887 07:54:23,001 --> 07:54:25,000 RECOMMENDATIONS OF THE UNITED 11888 07:54:25,001 --> 07:54:27,000 STATES PREVENTIVE SERVICES TASK 11889 07:54:27,001 --> 07:54:28,000 FORCE. 11890 07:54:28,001 --> 07:54:30,000 AND WE HEARD FROM THIS TASK 11891 07:54:30,001 --> 07:54:31,000 FORCE A FEW WEEKS AGO. 11892 07:54:31,001 --> 07:54:34,000 BUT THIS MAY SOUND HARMLESS 11893 07:54:34,001 --> 07:54:37,000 ENOUGH, AS YOU LOOK AT 11894 07:54:37,001 --> 07:54:40,000 BUT LET'S SEE WHAT THIS REALLY MEANS. 11895 07:54:40,001 --> 07:54:45,000 EVIDENCE-BASED. 11896 07:54:45,001 --> 07:54:47,000 "A" OR "B" WHAT'S NOT "A" OR "B"? 11897 07:54:47,001 --> 07:54:51,000 WELL, WE JUST FOUND OUT 11898 07:54:51,001 --> 07:54:53,000 SOMETHING THAT WAS NOT "A" OR 11899 07:54:53,001 --> 07:54:55,000 "B." 11900 07:54:55,001 --> 07:54:56,000 THE TASK FORCE CAME OUT AND SAI 11901 07:54:56,001 --> 07:54:57,000 IT SHOULD NOT BE COVERED ON 11902 07:54:57,001 --> 07:54:59,000 ANYONE UNDER 50 YEARS OLD. 11903 07:54:59,001 --> 07:55:01,000 NOW, THAT'S IN THE BILL THAT IT 11904 07:55:01,001 --> 07:55:04,000 WOULD NOT COVER MAMMOGRAMS FOR 11905 07:55:04,001 --> 07:55:07,000 FOLKS UNDER 50 YEARS OLD. 11906 07:55:07,001 --> 07:55:09,000 BECAUSE IT'S NOT "A" OR "B" 11907 07:55:09,001 --> 07:55:10,000 BECAUSE OF THE OUTCRY, WE HAD AN 11908 07:55:10,001 --> 07:55:12,000 AMENDMENT FROM THE OTHER SIDE TO 11909 07:55:12,001 --> 07:55:15,000 GIVE THEMSELVES A LITTLE BIT OF 11910 07:55:15,001 --> 07:55:17,000 COVER ON THAT ONE MEDICAL 11911 07:55:17,001 --> 07:55:18,000 PROCEDURE, MAMMOGRAMS. 11912 07:55:18,001 --> 07:55:21,000 AND WE PASSED IT WITH SOME 11913 07:55:21,001 --> 07:55:23,000 FANFARE YESTERDAY, BUT THE FACT 11914 07:55:23,001 --> 07:55:25,000 IS, THERE ARE GOING TO BE MANY 11915 07:55:25,001 --> 07:55:27,000 "C" RATINGS THAT AREN'T COVERED. 11916 07:55:27,001 --> 07:55:28,000 WHAT ARE WE GOING TO DO HERE IN 11917 07:55:28,001 --> 07:55:30,000 CONGRESS OVER THE NEXT SEVERAL 11918 07:55:30,001 --> 07:55:32,000 YEARS WHEN WE FIND CONSTITUENTS 11919 07:55:32,001 --> 07:55:35,000 ARE NOT COVERED FOR THINGS THAT 11920 07:55:35,001 --> 07:55:36,000 THEY NEED IN RETIREMENT FROM 11921 07:55:36,001 --> 07:55:37,000 MEDICARE? 11922 07:55:37,001 --> 07:55:39,000 ARE WE GOING TO PASS BILLS TO 11923 07:55:39,001 --> 07:55:40,000 TRY COVER THOSE INDIVIDUAL 11924 07:55:40,001 --> 07:55:42,000 THINGS? 11925 07:55:42,001 --> 07:55:43,000 WHAT WE SHOULD REALLY DO IS 11926 07:55:43,001 --> 07:55:45,000 THROW OUT THE BILL THAT'S 11927 07:55:45,001 --> 07:55:48,000 CAUSING THE PROBLEM. 11928 07:55:48,001 --> 07:55:49,000 WE SHOULD NOT BE RATIONING CARE 11929 07:55:49,001 --> 07:55:51,000 TO OUR SENIORS. 11930 07:55:51,001 --> 07:55:53,000 LET'S LOOK AT ANOTHER PAGE. 11931 07:55:53,001 --> 07:55:55,000 AND I KNOW THIS IS NOT AS 11932 07:55:55,001 --> 07:55:56,000 INTEREING AS TALKING ABOUT 11933 07:55:56,001 --> 07:56:01,000 THEORETICAL STUFF. 11934 07:56:01,001 --> 07:56:04,000 BU 11935 07:56:04,001 --> 07:56:06,000 CALLED "THE AAPPEALS PROCESS," A 11936 07:56:06,001 --> 07:56:08,000 GROUP HEALTH PLAN AND A HEALTH 11937 07:56:08,001 --> 07:56:10,000 ISSUANCE 11938 07:56:10,001 --> 07:56:12,000 OR INDIVIDUAL HEALTH INSURANCE 11939 07:56:12,001 --> 07:56:15,000 COVERAGE SHALL IMPLEMENT AN 11940 07:56:15,001 --> 07:56:19,000 EFFECTIVE APPEALS PROCESS TO 11941 07:56:19,001 --> 07:56:22,000 PROVIDE NOTICE TO ENROLLEES IN A 11942 07:56:22,001 --> 07:56:23,000 CULTURALLY AND 11943 07:56:23,001 --> 07:56:26,000 APPROPRIATE MANNER." 11944 07:56:26,001 --> 07:56:29,000 NOW, WHAT DO WE THINK THAT 11945 07:56:29,001 --> 07:56:31,000 MEANS? 11946 07:56:31,001 --> 07:56:33,000 WELL, IN FACT IN 2001, THIS TERM 11947 07:56:33,001 --> 07:56:36,000 HAS BEEN USED BEFORE IN THE 11948 07:56:36,001 --> 07:56:39,000 DEPARTMENT OF HEALTH AND HUMAN 11949 07:56:39,001 --> 07:56:41,000 SERVICES SPENT $10 MILLION TO 11950 07:56:41,001 --> 07:56:42,000 FIGURE OUT WHAT THAT PHRASE 11951 07:56:42,001 --> 07:56:43,000 MEANT -- MEANS. 11952 07:56:43,001 --> 07:56:46,000 AND WE STILL DON'T KNOW. 11953 07:56:46,001 --> 07:56:47,000 I MEAN, IT SAYS "HEALTH SERVICES 11954 07:56:47,001 --> 07:56:49,000 THAT ARE RESPECTFUL AND 11955 07:56:49,001 --> 07:56:50,000 RESPONSIVE TO CULTURAL AND 11956 07:56:50,001 --> 07:56:52,000 LINGUISTIC NEEDS." 11957 07:56:52,001 --> 07:56:54,000 BUT WHAT IT REALLY MEANS TO US 11958 07:56:54,001 --> 07:56:56,000 IN THE 2000 CENSUS IS THERE ARE 11959 07:56:56,001 --> 07:56:59,000 AT LEAST 20 LANGUAGES SPOKEN BY 11960 07:56:59,001 --> 07:57:01,000 AT LEAST 200,000 AMERICANS IN 11961 07:57:01,001 --> 07:57:03,000 THIS COUNTRY, AND WHAT WE'RE 11962 07:57:03,001 --> 07:57:04,000 PUTTING OUT THERE IS A LIABILITY 11963 07:57:04,001 --> 07:57:06,000 FOR EVERY INSURANCE COMPANY WHO 11964 07:57:06,001 --> 07:57:08,000 DOESN'T HAVE EVERY ASPECT OF 11965 07:57:08,001 --> 07:57:10,000 THEIR PLAN IN THOSE 20 LANGUAGES. 11966 07:57:10,001 --> 07:57:12,000 IT MAY SOUND LIKE A SIMPLE 11967 07:57:12,001 --> 07:57:14,000 THING, BUT EVERY PAGE OF THIS 11968 07:57:14,001 --> 07:57:16,000 BILL ALMOST AS YOU READ IT, YOU 11969 07:57:16,001 --> 07:57:17,000 REALIZE IT'S INCREASING 11970 07:57:17,001 --> 07:57:19,000 COMPLEXITY AND COST OF THE 11971 07:57:19,001 --> 07:57:21,000 SYSTEM HERE IN AMERICA. 11972 07:57:21,001 --> 07:57:24,000 I'LL JUST COVER ONE OF -- ONE 11973 07:57:24,001 --> 07:57:26,000 MORE OF THESE, AS I HEAR MY 11974 07:57:26,001 --> 07:57:28,000 COLLEAGUES URGING ME TO FINISH HERE IN THE BACKGROUND. 11975 07:57:28,001 --> 07:57:31,000 BUT I DO THINK WE OWE IT TO THE 11976 07:57:31,001 --> 07:57:32,000 AMERICAN PEOPLE TO GRIN TO TALK 11977 07:57:32,001 --> 07:57:34,000 ABOUT -- TO BEGIN TO TALK ABOUT 11978 07:57:34,001 --> 07:57:39,000 WHAT'S REALLY IN THIS BILL. 11979 07:57:39,001 --> 07:57:41,000 ON PAGE 39 11980 07:57:41,001 --> 07:57:43,000 "FUNDING CATEGORY" -- "OUT OF 11981 07:57:43,001 --> 07:57:45,000 ALL FUNDS IN THE TREASURY NOT 11982 07:57:45,001 --> 07:57:47,000 OTHERWISE APPROPRIATED, THEY'RE 11983 07:57:47,001 --> 07:57:50,000 APPROPRIATE TO THE SECRETARY 11984 07:57:50,001 --> 07:57:52,000 $250 MILLION TO BE AVAILABLE FOR 11985 07:57:52,001 --> 07:57:54,000 EXPENDITURES FOR GRANTS UNDER 11986 07:57:54,001 --> 07:57:57,000 PARAGRAPH 1 AND SUBPARAGRAPH 1." 11987 07:57:57,001 --> 07:57:59,000 AND WHAT THOSE SUBPARAGRAPHS ARE 11988 07:57:59,001 --> 07:58:01,000 ARE TO TRACK THE TRENDS IN 11989 07:58:01,001 --> 07:58:03,000 PREMIUM INCREASES OF HEALTH 11990 07:58:03,001 --> 07:58:05,000 INSURANCE ONCE THIS BILL GOES 11991 07:58:05,001 --> 07:58:07,000 INTO EFFECT. 11992 07:58:07,001 --> 07:58:09,000 $250 MILLION TO DO WHAT THE 11993 07:58:09,001 --> 07:58:11,000 CONGRESSIONAL BUDGET OFFICE HAS 11994 07:58:11,001 --> 07:58:13,000 ALREADY TOLD US IS GOING TO BE INCREASES. 11995 07:58:13,001 --> 07:58:15,000 BUT THIS KIND OF SPENDING AND 11996 07:58:15,001 --> 07:58:17,000 THIS TYPE OF BUREAUCRACY AND 11997 07:58:17,001 --> 07:58:19,000 COMPLEXITY THAT WE'RE CREATING 11998 07:58:19,001 --> 07:58:21,000 IS NOT GOING TO MAKE HEALTH CARE 11999 07:58:21,001 --> 07:58:22,000 MORE ACCESSIBLE AND MORE 12000 07:58:22,001 --> 07:58:24,000 AFFORDABLE FOR AMERICANS. 12001 07:58:24,001 --> 07:58:25,000 IT IS CREATING A COMPLEX 12002 07:58:25,001 --> 07:58:28,000 BUREAUCRACY WITH TENS OF 12003 07:58:28,001 --> 07:58:29,000 THOUSANDS OF WORKERS 12004 07:58:29,001 --> 07:58:31,000 BUREAUCRATS TO 12005 07:58:31,001 --> 07:58:33,000 DO -- TELL DOC 12006 07:58:33,001 --> 07:58:34,000 AND 12007 07:58:34,001 --> 07:58:36,000 US HOW TO MANAGE OUR HEALTH 12008 07:58:36,001 --> 07:58:37,000 CARE. 12009 07:58:37,001 --> 07:58:38,000 THE CONGRESSIONAL BUDGET OFFICE 12010 07:58:38,001 --> 07:58:40,000 HAS ALREADY RELEASE ADD REPORT 12011 07:58:40,001 --> 07:58:41,000 FINDING THAT THE PURCHASING 12012 07:58:41,001 --> 07:58:45,000 HEALTH INSURANCE EXCHANGES THAT 12013 07:58:45,001 --> 07:58:47,000 ARE IN THIS BILL COULD PAY UP TO 12014 07:58:47,001 --> 07:58:49,000 16% MORE FOR HEALTH CARE THAN WE 12015 07:58:49,001 --> 07:58:50,000 DO TODAY. 12016 07:58:50,001 --> 07:58:52,000 YET WE'RE MOVING AHEAD WITH THIS 12017 07:58:52,001 --> 07:58:53,000 BILL. 12018 07:58:53,001 --> 07:58:54,000 I'LL CONTINUE THROUGHOUT THIS 12019 07:58:54,001 --> 07:58:57,000 WEEKEND AND EVERY TIME I GET A 12020 07:58:57,001 --> 07:58:58,000 CHANCE TO SPEAK TO TALK ABOUT 12021 07:58:58,001 --> 07:59:00,000 MORE OF THESE THINGS THAT ARE IN 12022 07:59:00,001 --> 07:59:01,000 THIS BILL. 12023 07:59:01,001 --> 07:59:03,000 FOLKS, THIS IS NOT A BILL WE 12024 07:59:03,001 --> 07:59:04,000 SHOULD DELIVER TO THE ARICAN 12025 07:59:04,001 --> 07:59:07,000 PEOPLE FOR CHRISTMAS THIS YEAR. 12026 07:59:07,001 --> 07:59:08,000 TH IS A BILL THAT WE SHOULD 12027 07:59:08,001 --> 07:59:11,000 THROW OUT SO THAT WE CAN START 12028 07:59:11,001 --> 07:59:12,000 OVER AND HAVE A STEP-BY-STEP 12029 07:59:12,001 --> 07:59:14,000 APPROACH TO MAKE HEALTH 12030 07:59:14,001 --> 07:59:15,000 INSURANCE MORE AFFORDABLE AND 12031 07:59:15,001 --> 07:59:16,000 AVAILABLE TO EVERY A 12032 07:59:16,001 --> 07:59:27,000 WITH 12033 07:59:27,001 --> 07:59:28,000 YIELD BACK. 12034 07:59:28,001 --> 07:59:30,000 A SENATOR: MR. PREDENT? 12035 07:59:30,001 --> 07:59:32,000 A SENATOR: MR. PRESIDENT, I 12036 07:59:32,001 --> 07:59:34,000 THINK WE'RE GOING BAC BACK AND FORTH 12037 07:59:34,001 --> 07:59:36,000 HERE. 12038 07:59:36,001 --> 07:59:37,000 A SENATO 12039 07:59:37,001 --> 07:59:42,000 MR. BAUCUS: SORRY? 12040 07:59:42,001 --> 07:59:44,000 A SENATOR: THERE'S NO FORTH. 12041 07:59:44,001 --> 07:59:46,000 WE CAN GO BACK AND BACK AND THEN 12042 07:59:46,001 --> 07:59:48,000 FORTH AND 12043 07:59:48,001 --> 07:59:54,000 MR. BAUCUS: FORTH ANDORTH AND 12044 07:59:54,001 --> 07:59:56,000 TO AND FRO, AND THIS AND THAT. 12045 07:59:56,001 --> 08:00:00,000 THAT'S FINE WITH ME. 12046 08:00:00,001 --> 08:00:01,000 A SENATOR: MR. CHAIRMAN, 12047 08:00:01,001 --> 08:00:13,000 WASTING. 12048 08:00:13,001 --> 08:00:17,000 I 12049 08:00:17,001 --> 08:00:18,000 A SENATOR: MADAM PRESIDENT? 12050 08:00:18,001 --> 08:00:20,000 THE PRESIDING OFFICER: THE 12051 08:00:20,001 --> 08:00:21,000 SENATOR FROM DELAWARE'S 12052 08:00:21,001 --> 08:00:22,000 RECOGNIZED. 12053 08:00:22,001 --> 08:00:24,000 MR. KAUFMAN: MR. PRESIDENT, I 12054 08:00:24,001 --> 08:00:27,000 ASK TO SPEAK IN MORNING BUSINESS 12055 08:00:27,001 --> 08:00:29,000 FOR UP TO FIVE MINUTES. THE PRESIDING OFFICER: WITHOUT 12056 08:00:29,001 --> 08:00:31,000 OBJECTION, SO ORDERED. 12057 08:00:31,001 --> 08:00:35,000 MR. KAUFMAN: MADAM PRESIDENT, I 12058 08:00:35,001 --> 08:00:37,000 GREAT FEDERAL EMPLOYEE. 12059 08:00:37,001 --> 08:00:38,000 HUMAN INGENUITY IS BOUNDLESS. 12060 08:00:38,001 --> 08:00:40,000 THIS IS ESPECIALLY TRUE IN 12061 08:00:40,001 --> 08:00:43,000 AMERICA, WHICH HAS ALWAYS BEEN 12062 08:00:43,001 --> 08:00:44,000 DRIVEN BY AN ENTREPRENEURIAL 12063 08:00:44,001 --> 08:00:46,000 SPIRIT AND BELIEF THAT NOTHING 12064 08:00:46,001 --> 08:00:48,000 IS IP POSSIBLE. 12065 08:00:48,001 --> 08:00:51,000 -- IMPOSSIBLE. 12066 08:00:51,001 --> 08:00:55,000 FROM THE ELECTRIC TELEGRAPH TO 12067 08:00:55,001 --> 08:00:57,000 THE REFRIDGE RATED RAILCAR, OUR 12068 08:00:57,001 --> 08:00:59,000 FOREBEARERS HELPED TO BUILD A NATION. 12069 08:00:59,001 --> 08:01:01,000 SUCH INVENTION CLOSED THE 12070 08:01:01,001 --> 08:01:02,000 WESTERN FRONTIER IN THE 19th CENTURY. 12071 08:01:02,001 --> 08:01:04,000 IN THE CENTURY THAT FOLLOWED 12072 08:01:04,001 --> 08:01:06,000 AMERICANS CONTINUED TO BE 12073 08:01:06,001 --> 08:01:09,000 PIONEERS ON THAT FRONTIER WHICH 12074 08:01:09,001 --> 08:01:10,000 HAS NO END, THE FRONTIER OF 12075 08:01:10,001 --> 08:01:12,000 SPBS. 12076 08:01:12,001 --> 08:01:14,000 -- SCIENCE. 12077 08:01:14,001 --> 08:01:18,000 67 YEARS AGO THIS WEEK, A TEAM 12078 08:01:18,001 --> 08:01:22,000 OF 12079 08:01:22,001 --> 08:01:25,000 FREDERICKO FERNI, THEY HUDDLED 12080 08:01:25,001 --> 08:01:27,000 UNDER THE STANDS OF A FOOTBALL 12081 08:01:27,001 --> 08:01:28,000 STADIUM IN THE UNIVERSITY OF 12082 08:01:28,001 --> 08:01:30,000 CHICAGO, THEY INITIATED THE 12083 08:01:30,001 --> 08:01:32,000 FIRST EVER CONTROLLED NUCLEAR 12084 08:01:32,001 --> 08:01:34,000 REACTION. 12085 08:01:34,001 --> 08:01:35,000 THAT EXPERIMENT CALLED THE 12086 08:01:35,001 --> 08:01:38,000 CHICAGO PILE ONE, MARKED THE 12087 08:01:38,001 --> 08:01:39,000 BEGINNING OF THE NUCLEAR AGE. 12088 08:01:39,001 --> 08:01:41,000 MADAM PRESIDENT, TODAY ALL 12089 08:01:41,001 --> 08:01:44,000 AMERICANS KNOW 12090 08:01:44,001 --> 08:01:45,000 DISCOVERY OF NUCLEAR POWER WAS A 12091 08:01:45,001 --> 08:01:47,000 MIXED BLESSING. 12092 08:01:47,001 --> 08:01:49,000 WITH IT CAME THE POTENTIAL FOR A 12093 08:01:49,001 --> 08:01:51,000 NEW FORM OF ENERGY TO POWER OUR 12094 08:01:51,001 --> 08:01:53,000 HOMES AN BUSINESSES. 12095 08:01:53,001 --> 08:01:55,000 FOR THE FIRST TIME OUR NAVAL 12096 08:01:55,001 --> 08:01:57,000 SHIPS COULD REMAIN AT SEA AND ON 12097 08:01:57,001 --> 08:01:58,000 GUARD FOR EXTENDED PERIODS 12098 08:01:58,001 --> 08:02:01,000 WITHOUT REFUELING. 12099 08:02:01,001 --> 08:02:02,000 WITH THE NUCLEAR ENERGY CAME 12100 08:02:02,001 --> 08:02:04,000 NUCLEAR WEAPONS, THIS LED TO THE 12101 08:02:04,001 --> 08:02:05,000 MASS DESTRUCTION OF HUNDREDS OF 12102 08:02:05,001 --> 08:02:07,000 CITIES WITHIN WEEKENDS. 12103 08:02:07,001 --> 08:02:10,000 THEY BROUGHT US THE GENERATION 12104 08:02:10,001 --> 08:02:12,000 OF DUCK AND COVER AND BACK YARD 12105 08:02:12,001 --> 08:02:13,000 FALLOUT 12106 08:02:13,001 --> 08:02:15,000 THANKFULLY, THOU OUR NATION 12107 08:02:15,001 --> 08:02:16,000 AND OTHERS CONTINUE 12108 08:02:16,001 --> 08:02:17,000 THESE WEAPONS IN OUR TIME, THE 12109 08:02:17,001 --> 08:02:21,000 COLD WAR IS OVER. 12110 08:02:21,001 --> 08:02:23,000 NO LONGER ARE WE MINUTES FROM 12111 08:02:23,001 --> 08:02:24,000 DESTRUCTION THE WAY WE ONCE 12112 08:02:24,001 --> 08:02:26,000 WERE. 12113 08:02:26,001 --> 08:02:28,000 TODAY PEACEFUL NUCLEAR ENERGY 12114 08:02:28,001 --> 08:02:30,000 PROVIDES ONE-FIFTH OF OUR 12115 08:02:30,001 --> 08:02:32,000 NUCLEAR ENERGY AND THERE ARE 104 12116 08:02:32,001 --> 08:02:33,000 NUCLEAR REACTORS ACROSS THE 12117 08:02:33,001 --> 08:02:35,000 COUNTRY. 12118 08:02:35,001 --> 08:02:37,000 DEVELOPING AND ENFORCING THE 12119 08:02:37,001 --> 08:02:38,000 REGULATION THAT'S KEEP THESE 12120 08:02:38,001 --> 08:02:41,000 REACTORS SAFE ARE THE MEN AND 12121 08:02:41,001 --> 08:02:42,000 WOMEN OF THE UNITED STATES 12122 08:02:42,001 --> 08:02:45,000 NUCLEAR REGULATORY COMMISSION. 12123 08:02:45,001 --> 08:02:49,000 I WANT TO RECOGNIZE THE 12124 08:02:49,001 --> 08:02:50,000 CONTRIBUTION OF DR. GARRITH 12125 08:02:50,001 --> 08:02:52,000 PERRY. 12126 08:02:52,001 --> 08:02:54,000 HE HAS A DISTINGUISHED CAREER AT 12127 08:02:54,001 --> 08:02:55,000 THE NUCLEAR REGULATORY 12128 08:02:55,001 --> 08:02:57,000 COMMISSION. 12129 08:02:57,001 --> 08:03:01,000 HE IS ALSO A 2004 RECIPIENT OF 12130 08:03:01,001 --> 08:03:03,000 THE DISTINGUISHED ARTHUR S. 12131 08:03:03,001 --> 08:03:06,000 FLEMING AWARD FOR PUBLIC SERVICE. 12132 08:03:06,001 --> 08:03:09,000 HE IMMIGRATED TO THIS COUNTRY 12133 08:03:09,001 --> 08:03:12,000 FROM THE UNITED KINGD HAS 30 12134 08:03:12,001 --> 08:03:14,000 YEARS OF EXPERIENCE FOR 12135 08:03:14,001 --> 08:03:20,000 DEVELOPING MODELS FOR 12136 08:03:20,001 --> 08:03:21,000 PROBLEMISTIC RISK ANALYSIS OR 12137 08:03:21,001 --> 08:03:23,000 N.P.R.A. 12138 08:03:23,001 --> 08:03:25,000 -- WITH THE OFFICE OF NUCLEAR 12139 08:03:25,001 --> 08:03:27,000 REACTOR REGULATION, HE WAS ONE 12140 08:03:27,001 --> 08:03:29,000 OF THE LEADING EXPERTS ON 12141 08:03:29,001 --> 08:03:31,000 ANALYZING COMMON CAUSE FAILURE 12142 08:03:31,001 --> 08:03:32,000 AND HUMAN RELIABILITY. 12143 08:03:32,001 --> 08:03:34,000 HIS WORK LED TO THE DEVELOPMENT 12144 08:03:34,001 --> 08:03:38,000 OF P.R.I. STANDARDS AND THE USE 12145 08:03:38,001 --> 08:03:40,000 OF P.R.A. TO PERFORM RISK 12146 08:03:40,001 --> 08:03:42,000 INFORMED MAKING WITH REGARD TO 12147 08:03:42,001 --> 08:03:44,000 NUCLEAR SAFETY. 12148 08:03:44,001 --> 08:03:46,000 GARRETH WORKED HARD TO ENSURE 12149 08:03:46,001 --> 08:03:48,000 THE SAFETY OF AMERICANS, 12150 08:03:48,001 --> 08:03:50,000 CIVILIAN NUCLEAR FITS. 12151 08:03:50,001 --> 08:03:52,000 THE KIND OF WORK HE PERFORMED IS 12152 08:03:52,001 --> 08:03:54,000 HIGHLY MATHEMATICAL AND COMPLEX. 12153 08:03:54,001 --> 08:03:56,000 AND IT MAY NOT SOUND GLAMOROUS 12154 08:03:56,001 --> 08:03:58,000 TO THE AVERAGE AMERICAN, BUT IT 12155 08:03:58,001 --> 08:04:00,000 IS CRITICAL AND CONTINUES 12156 08:04:00,001 --> 08:04:01,000 ENORMOUSLY TO THE SECURITY AND 12157 08:04:01,001 --> 08:04:04,000 ECONOMIC WELL-BEING OF OUR 12158 08:04:04,001 --> 08:04:09,000 NATION. 12159 08:04:09,001 --> 08:04:11,000 67 YEARS AGO, THERE WAS THE 12160 08:04:11,001 --> 08:04:13,000 POWER OF THE ATOM. 12161 08:04:13,001 --> 08:04:15,000 TODAY MEN AND WOMEN OF THE 12162 08:04:15,001 --> 08:04:17,000 NUCLEAR REGULATORY COMMISSION 12163 08:04:17,001 --> 08:04:18,000 THAT OUR MODERN NUCLEAR REACTORS 12164 08:04:18,001 --> 08:04:20,000 CONTINUE TO DO SO SAFELY. 12165 08:04:20,001 --> 08:04:24,000 I HOPE MY COLLEAGUES WILL JOIN 12166 08:04:24,001 --> 08:04:25,000 ME IN HONORING THE SERVICE OF 12167 08:04:25,001 --> 08:04:27,000 DR. GARRETH PERRY AND ALL WHO 12168 08:04:27,001 --> 08:04:29,000 HAVE WORKED AND CONTINUE TO WORK 12169 08:04:29,001 --> 08:04:40,000 AT THE NUCLEAR COMMISSION. 12170 08:04:40,001 --> 08:04:41,000 I YIELD 12171 08:04:41,001 --> 08:04:43,000 A SENATOR: MADAM PRESIDENT? THE PRESIDING OFFICER: THE 12172 08:04:43,001 --> 08:04:45,000 SENATOR FROM KANSAS IS RECOGNIZED. 12173 08:04:45,001 --> 08:04:46,000 A SENATOR: I TRULY APPRECIATE 12174 08:04:46,001 --> 08:04:48,000 IT, MADAM PRESIDENT. 12175 08:04:48,001 --> 08:04:51,000 MR. ROBERTS: I RISE TODAY IN 12176 08:04:51,001 --> 08:04:53,000 SUPPORT OF MY GOOD FRIEND FROM 12177 08:04:53,001 --> 08:04:55,000 NEBRASKA, MY COLLEAGUE FROM 12178 08:04:55,001 --> 08:04:58,000 NEBRASKA, SENATOR JOHANNS. 12179 08:04:58,001 --> 08:05:01,000 WITH HIS MOTION TO THE OFFICIAL 12180 08:05:01,001 --> 08:05:06,000 WORDS TO COMMIT THE BILL BACK TO THE SENATE FINANCE COMMITTEE 12181 08:05:06,001 --> 08:05:08,000 WITH THE INSTRUCTIONS TO CUT THE 12182 08:05:08,001 --> 08:05:10,000 HOME HEALTH CARE BENEFITS. 12183 08:05:10,001 --> 08:05:12,000 WHAT THE DISTINGUISHED SENATOR 12184 08:05:12,001 --> 08:05:16,000 IS TRYING TO BRING COMMONSENSE 12185 08:05:16,001 --> 08:05:19,000 CUTS TO BRING CARE TO NOT ONLY 12186 08:05:19,001 --> 08:05:20,000 RURAL AREAS, BUT ALL OVER THE COUNTRY. 12187 08:05:20,001 --> 08:05:24,000 THE BILL THAT WE'RE CONSIDERING 12188 08:05:24,001 --> 08:05:27,000 WOULD CUT HOME HEALTH -- THE 12189 08:05:27,001 --> 08:05:28,000 BILL SOMETIMES CALLED THE BEHIND 12190 08:05:28,001 --> 08:05:31,000 THE CLOSED DOOR BILL. 12191 08:05:31,001 --> 08:05:32,000 IT WOULD CUT HEALTH 12192 08:05:32,001 --> 08:05:33,000 CARE $32 BILLION. 12193 08:05:33,001 --> 08:05:35,000 NOW THE SENATOR FROM NEBRASKA 12194 08:05:35,001 --> 08:05:36,000 SAID THAT'S A HEAD SCRATCHER. 12195 08:05:36,001 --> 08:05:37,000 AND THAT CERTAINLY IS. 12196 08:05:37,001 --> 08:05:41,000 IT IS MORE THAN A HEAD 12197 08:05:41,001 --> 08:05:43,000 SCRATCHER, IT IS A LIZZIE BORDEN 12198 08:05:43,001 --> 08:05:45,000 AMPUTATION IN REGARDS TO A 12199 08:05:45,001 --> 08:05:48,000 VITAL, VITAL PROGRAM. 12200 08:05:48,001 --> 08:05:50,000 HOME HEALTH CARE IS CERTIFIED -- 12201 08:05:50,001 --> 08:05:51,000 PARDON ME -- IS CRITICAL FOR OUR 12202 08:05:51,001 --> 08:05:54,000 SENIORS, OBVIOUSLY THAT'S THE 12203 08:05:54,001 --> 08:05:57,000 TRUE AND AS CO- CHAIR OF THE 12204 08:05:57,001 --> 08:05:59,000 RURAL HEALTH CARE CAUCUS, I CERTAINLY UNDERSTAND THAT. 12205 08:05:59,001 --> 08:06:01,000 SO DOES THE SENATOR FROM NEBRASKA. 12206 08:06:01,001 --> 08:06:04,000 HE WAS SAYING YESTERDAY HOW MANY 12207 08:06:04,001 --> 08:06:06,000 TIMES HE VISITS HIS RURAL 12208 08:06:06,001 --> 08:06:08,000 HOSPITALS, RURAL CLINICS, RURAL 12209 08:06:08,001 --> 08:06:10,000 HOSPICES, AND YOU DO THAT A LOT 12210 08:06:10,001 --> 08:06:12,000 IF YOU'RE FROM NEBRASKA, IOWA, 12211 08:06:12,001 --> 08:06:14,000 OR TEXAS OR KANSAS. 12212 08:06:14,001 --> 08:06:16,000 AND SO AT ANY RATE IN MY HOME 12213 08:06:16,001 --> 08:06:18,000 STATE OF KANSAS AND IN OTHER 12214 08:06:18,001 --> 08:06:20,000 RURAL AREAS, MANY SENIORS LIVE 12215 08:06:20,001 --> 08:06:26,000 ALONE OUT IN THE COUNTRY, MILES 12216 08:06:26,001 --> 08:06:27,000 AWAY FROM A LOCAL HOSPITAL OR 12217 08:06:27,001 --> 08:06:29,000 DOCTOR'S OFFICE AND EVEN IF THEY 12218 08:06:29,001 --> 08:06:30,000 HAVE A VERY GOOD DOCTOR, THEY 12219 08:06:30,001 --> 08:06:32,000 COULDN'T GET THERE FROM HERE 12220 08:06:32,001 --> 08:06:33,000 BECAUSE OF 12221 08:06:33,001 --> 08:06:35,000 CONDITION. 12222 08:06:35,001 --> 08:06:37,000 SO HOME HEALTH CARE ALLOWS THAT 12223 08:06:37,001 --> 08:06:38,000 SENIOR THE FREEDOM AND 12224 08:06:38,001 --> 08:06:40,000 INDEPENDENCE, MR. PRESIDENT, TO 12225 08:06:40,001 --> 08:06:43,000 STAY IN THEIR HOME AND THE 12226 08:06:43,001 --> 08:06:44,000 COMFORT OF KNOWING SOMEBODY IS THERE ASSISTING THEIR HEALTH 12227 08:06:44,001 --> 08:06:46,000 CARE NEEDS. 12228 08:06:46,001 --> 08:06:49,000 MORE IMPORTANTLY HOME HEALTH 12229 08:06:49,001 --> 08:06:51,000 CARE IS -- IS THE COST EFFECTIVE 12230 08:06:51,001 --> 08:06:53,000 CARE, AS THE SENATOR FROM 12231 08:06:53,001 --> 08:06:54,000 NEBRASKA HAS POINTED OUT, THAT 12232 08:06:54,001 --> 08:06:56,000 KEEPS THE SENIOR OUT OF A 12233 08:06:56,001 --> 08:07:00,000 NURSING HOME OR HOSPITAL. 12234 08:07:00,001 --> 08:07:02,000 AND QUESTION GUESS WHAT? 12235 08:07:02,001 --> 08:07:03,000 SAVES THE GOVERNMENT MONEY. 12236 08:07:03,001 --> 08:07:05,000 OVER THE LONG TERM OF HEALTH 12237 08:07:05,001 --> 08:07:07,000 CARE, YOU WILL INCREASE THE COST 12238 08:07:07,001 --> 08:07:08,000 IN REGARDS TO NURSING HOMES. 12239 08:07:08,001 --> 08:07:10,000 NO QUESTION ABOUT IT. 12240 08:07:10,001 --> 08:07:11,000 IN MY STATE I'VE HAD THE 12241 08:07:11,001 --> 08:07:12,000 PLEASURE BEING ABLE TO SEE 12242 08:07:12,001 --> 08:07:15,000 FIRSTHAND, JUST LIKE THE SENATOR 12243 08:07:15,001 --> 08:07:18,000 FROM NEBRASKA, THE GREAT WORK 12244 08:07:18,001 --> 08:07:19,000 THAT OUR HOME HEALTH CARE 12245 08:07:19,001 --> 08:07:22,000 ASSOCIATION DOES EVERY DAY. 12246 08:07:22,001 --> 08:07:26,000 I WAS INVITED INTO THE HOME OF A 12247 08:07:26,001 --> 08:07:29,000 LOVELY COUPLE IN 12248 08:07:29,001 --> 08:07:31,000 CONCORDEGENTLEMAN, AND DESPITE 12249 08:07:31,001 --> 08:07:32,000 HAVING MULTIPLE HEALTH ISSUES 12250 08:07:32,001 --> 08:07:34,000 DUANE AND PHYLLIS WERE ABLE TO 12251 08:07:34,001 --> 08:07:39,000 STAY IN THEIR HOME WITH THEIR 12252 08:07:39,001 --> 08:07:41,000 LITTLE DOG JOSEY THANK TO A HOME 12253 08:07:41,001 --> 08:07:43,000 HEALTH CARE AIDE AND A NURSE. 12254 08:07:43,001 --> 08:07:47,000 WHAT'S GOING TO HAPPEN TO 12255 08:07:47,001 --> 08:07:49,000 SENIORS LIKE DUANE AND PHYLLIS 12256 08:07:49,001 --> 08:07:53,000 IF WE SLASH $32 BILLION FROM 12257 08:07:53,001 --> 08:07:55,000 HOME HEALTH CARE PARTICIPATES? 12258 08:07:55,001 --> 08:07:59,000 IT IS ONE OF THE LARGEST CUTS IN 12259 08:07:59,001 --> 08:08:01,000 THE WHOLE BILL NEXT TO MEDICARE ADVANTAGE. 12260 08:08:01,001 --> 08:08:03,000 THE SENATOR FROM NEBRASKA HAD 12261 08:08:03,001 --> 08:08:05,000 THAT CHART WITH ALL OF THE CUTS 12262 08:08:05,001 --> 08:08:07,000 TO ALL OF THE PROVIDERS. 12263 08:08:07,001 --> 08:08:08,000 DON'T FORGET THIS COMES ON THE 12264 08:08:08,001 --> 08:08:10,000 HEELS OF SEVERAL YEARS OF 12265 08:08:10,001 --> 08:08:12,000 ADDITIONAL CUTS TO HOME HEALTH CARE. 12266 08:08:12,001 --> 08:08:13,000 AROUND THE $35 BILLION ALL TOLD 12267 08:08:13,001 --> 08:08:15,000 THAT ALREA HAVE A LARGE 12268 08:08:15,001 --> 08:08:17,000 PERCENTAGE OF KANSAS HOME HEALTH 12269 08:08:17,001 --> 08:08:19,000 CARE AGENCIES OPERATING AT VERY 12270 08:08:19,001 --> 08:08:20,000 SLIM OR NEGATIVE MEDICARE 12271 08:08:20,001 --> 08:08:21,000 MARGINS. 12272 08:08:21,001 --> 08:08:23,000 I KNOW THE SAME IS IN IOWA. 12273 08:08:23,001 --> 08:08:25,000 I KNOW THE SAME IS IN MONDAY. 12274 08:08:25,001 --> 08:08:26,000 THE SAME IS IN TEXAS. 12275 08:08:26,001 --> 08:08:28,000 THE SAME IS IN NEBSKA. 12276 08:08:28,001 --> 08:08:31,000 ALL OVER THE COUNTRY. 12277 08:08:31,001 --> 08:08:32,000 I KEEP HEARING MY COLLEAGUES, 12278 08:08:32,001 --> 08:08:35,000 HOWEVER, ON THE OTHER SIDE OF 12279 08:08:35,001 --> 08:08:38,000 THE AISLE INSISTING THAT THEY'RE 12280 08:08:38,001 --> 08:08:42,000 HALF TRILLION DOLLAR CUT TO ALL 12281 08:08:42,001 --> 08:08:44,000 MEDICARE -- HERE'S THE QUOTE -- 12282 08:08:44,001 --> 08:08:46,000 "WON'T AFFECT THE BENEFITS 12283 08:08:46,001 --> 08:08:49,000 GUARANTEED TO SENIORS." PLEASE STOP THAT. 12284 08:08:49,001 --> 08:08:51,000 THAT IS THE MOST DISINGENUOUS 12285 08:08:51,001 --> 08:08:52,000 SMOKE SCREEN IN THIS WHOLE DEBATE. 12286 08:08:52,001 --> 08:08:54,000 IT MAY BE TRUE. 12287 08:08:54,001 --> 08:08:56,000 IT MAY BE TRUE THAT THIS BILL 12288 08:08:56,001 --> 08:08:58,000 DOES NOT EXPLICITLY CUT 12289 08:08:58,001 --> 08:09:01,000 BENEFITS. 12290 08:09:01,001 --> 08:09:02,000 MY FRIENDS, HOWEVER, ACROSS THE 12291 08:09:02,001 --> 08:09:04,000 AISLE CANNOT DENY THAT THEIR 12292 08:09:04,001 --> 08:09:06,000 CUTS IN REIMBURSEMENT TO 12293 08:09:06,001 --> 08:09:08,000 PROVIDERS WILL AFFECT THOSE BENEFITS. 12294 08:09:08,001 --> 08:09:09,000 BECAUSE WHEN YOU CUT THE 12295 08:09:09,001 --> 08:09:11,000 REIMBURSEMENTS TO PROVIDERS, 12296 08:09:11,001 --> 08:09:13,000 GUESS WHO PACE THE PRICE? 12297 08:09:13,001 --> 08:09:16,000 THE PATIENT. 12298 08:09:16,001 --> 08:09:19,000 DAVID. 12299 08:09:19,001 --> 08:09:21,000 OR PARDON ME AND DUANE AND 12300 08:09:21,001 --> 08:09:23,000 PHYLLIS AND THEIR DOG JOSIE. 12301 08:09:23,001 --> 08:09:24,000 YOU COME TO THEIR HOUSE AND MAKE 12302 08:09:24,001 --> 08:09:26,000 THAT ARGUMENT THAT IF YOU CLOSE 12303 08:09:26,001 --> 08:09:29,000 DOWN OR MAKE CUTS TO HOME HEALTH 12304 08:09:29,001 --> 08:09:31,000 CARE, DUANE'S NOT GOING TO LIKE 12305 08:09:31,001 --> 08:09:34,000 IT, PHYLLIS' NOT GOING TO LIKE 12306 08:09:34,001 --> 08:09:36,000 IT AND JOSIE WILL BITE YOU ON 12307 08:09:36,001 --> 08:09:37,000 YOUR LEG. 12308 08:09:37,001 --> 08:09:41,000 MANY OF MY KANSAS HOME HEALTH 12309 08:09:41,001 --> 08:09:44,000 CARE AGENCIES ARE WORKING AT 12310 08:09:44,001 --> 08:09:45,000 NEGATIVE MARGINS. 12311 08:09:45,001 --> 08:09:48,000 THE CUTS AS PROVIDED BY THE 12312 08:09:48,001 --> 08:09:49,000 DISTINGUISHED SENATOR FROM 12313 08:09:49,001 --> 08:09:52,000 BRASKA, $240 MILLION. 12314 08:09:52,001 --> 08:09:53,000 THE GENTLEMAN FROM MONTANA, THE 12315 08:09:53,001 --> 08:09:55,000 DISTINGUISHED CHAIRMAN OF THE -- 12316 08:09:55,001 --> 08:09:58,000 OF THE FINANCE COMMITTEE, MY 12317 08:09:58,001 --> 08:10:03,000 DEAR FRIEND, THAT'S $60 MILLION 12318 08:10:03,001 --> 08:10:04,000 IN MONTANA, IN NEVADA, WHERE THE 12319 08:10:04,001 --> 08:10:06,000 DISTINGUISHED MAJORITY LEADER 12320 08:10:06,001 --> 08:10:09,000 LIVES, THE CHART THAT'S JUST 12321 08:10:09,001 --> 08:10:10,000 BEEN PROVIDED TO ME BY THE 12322 08:10:10,001 --> 08:10:12,000 SENATOR, $263 MILLION. 12323 08:10:12,001 --> 08:10:15,000 TEXAS -- TEXAS WE HAVE SENATOR 12324 08:10:15,001 --> 08:10:16,000 CORNYN SITTING RIGHT BEHIND ME 12325 08:10:16,001 --> 08:10:19,000 HERE. 12326 08:10:19,001 --> 08:10:20,000 SENATOR CORNYN, YOU'RE IN TH 12327 08:10:20,001 --> 08:10:23,000 THE $6.8 BILLION CATEGORY. 12328 08:10:23,001 --> 08:10:26,000 WHAT WILL HAPPEN IF YOU GET CU 12329 08:10:26,001 --> 08:10:27,000 CUT $6.8 BILLION IN REGARDS TO 12330 08:10:27,001 --> 08:10:29,000 HOME HEALTH CARE, SIR? 12331 08:10:29,001 --> 08:10:33,000 MR. CORNYN: IF THE SENATOR WILL 12332 08:10:33,001 --> 08:10:34,000 YI 12333 08:10:34,001 --> 08:10:36,000 $6.8 BILLION WILL CUT NOT JUST 12334 08:10:36,001 --> 08:10:38,000 INTO THE MUSCLE, BUT INTO THE 12335 08:10:38,001 --> 08:10:41,000 BONE AND DENY A LOT OF PEOPLE -- 12336 08:10:41,001 --> 08:10:43,000 A LOT OF 12337 08:10:43,001 --> 08:10:46,000 PARTICULARLY IN RURAL AREAS, 12338 08:10:46,001 --> 08:10:47,000 ACCESS TO CARE ENTIRELY. 12339 08:10:47,001 --> 08:10:49,000 MR. ROBERTS: I THANK THE SENATOR. 12340 08:10:49,001 --> 08:10:50,000 THE SENATOR FROM NEBRASKA HAS ALREADY POINTED OUT WHAT HAPPENS 12341 08:10:50,001 --> 08:10:53,000 IN NEBRASKA. 12342 08:10:53,001 --> 08:10:55,000 AND I KNOW WHAT WILL HAPPEN IN KANSAS. 12343 08:10:55,001 --> 08:10:57,000 NEARLY TWO-THIRDS OF KANSAS HOME 12344 08:10:57,001 --> 08:10:59,000 HEALTH CARE AGENCIES WILL HAVE 12345 08:10:59,001 --> 08:11:01,000 NEGATIVE MARGINS ONE FIVE YEARS, 12346 08:11:01,001 --> 08:11:02,000 PROBABLY TWO OR THREE, IF THESE 12347 08:11:02,001 --> 08:11:04,000 CUTS ARE ALLOWED TO OCCUR. 12348 08:11:04,001 --> 08:11:06,000 MR. PRESIDENT, HOW ARE THESE 12349 08:11:06,001 --> 08:11:08,000 AGENCIES SUPPOSED TO STAY IN 12350 08:11:08,001 --> 08:11:10,000 BUSINESS WITH THESE KINDS OF CUTS? 12351 08:11:10,001 --> 08:11:13,000 THE HOME HEALTH CARE BENEFIT 12352 08:11:13,001 --> 08:11:14,000 WILL BE WORTHLESS TO A KANSAS 12353 08:11:14,001 --> 08:11:16,000 MEDICARE PATIENT WHOSE HOME 12354 08:11:16,001 --> 08:11:17,000 HEALTH CARE AGENCIES WILL GO OUT 12355 08:11:17,001 --> 08:11:20,000 OF BUSINESS. 12356 08:11:20,001 --> 08:11:22,000 SO, YES, IN FACT, THIS BILL WILL 12357 08:11:22,001 --> 08:11:23,000 EFFECTIVELY CUT BENEFITS. 12358 08:11:23,001 --> 08:11:24,000 AGAIN, GET RID OF THE SMOKE 12359 08:11:24,001 --> 08:11:25,000 SCREEN. 12360 08:11:25,001 --> 08:11:27,000 AND THIS JUST DOESN'T APPLY TO 12361 08:11:27,001 --> 08:11:28,000 THE HOME HEALTH CARE BENEFIT. 12362 08:11:28,001 --> 08:11:29,000 THE SAME CAN BE SAID FOR THE 12363 08:11:29,001 --> 08:11:31,000 EFFECTS OF THE CUTS AS 12364 08:11:31,001 --> 08:11:34,000 DEMONSTRATED BY THE SENATOR FROM 12365 08:11:34,001 --> 08:11:36,000 NEBRASKA, TO REIMBURSEMENT FOR 12366 08:11:36,001 --> 08:11:38,000 HOSPITALS. 12367 08:11:38,001 --> 08:11:39,000 $1.5 BILLION, THIS BILL IS GOING 12368 08:11:39,001 --> 08:11:41,000 TO COST THE KANSAS HOSPITAL 12369 08:11:41,001 --> 08:11:43,000 ASSOCIATION. 12370 08:11:43,001 --> 08:11:45,000 BECAUSE SOME OUTSIDE EXPERTS CAME IN. 12371 08:11:45,001 --> 08:11:46,000 I ASKED THEM WHAT WILL BE THE 12372 08:11:46,001 --> 08:11:48,000 EFFECT OF THE CUTS. 12373 08:11:48,001 --> 08:11:51,000 THEY ALREADY HAVE CUTS. 12374 08:11:51,001 --> 08:11:54,000 THEY ONLY GET REIMBURSED 70% 12375 08:11:54,001 --> 08:11:55,000 NOW, AND $1.5 BILLION ON TOP OF THAT. 12376 08:11:55,001 --> 08:11:57,000 WE OUGHT TO HAVE A CHART, I'M 12377 08:11:57,001 --> 08:11:59,000 SURE THAT WE WILL HAVE A CHART 12378 08:11:59,001 --> 08:12:01,000 TO SAY TO IOWA, NEBRASKA OR ANY 12379 08:12:01,001 --> 08:12:02,000 STATE HERE, AND TEXAS 12380 08:12:02,001 --> 08:12:04,000 ESPECIALLY, BECAUSE OF THE 12381 08:12:04,001 --> 08:12:08,000 NUMBER OF FOLKS THAT WE HAVE. 12382 08:12:08,001 --> 08:12:09,000 SO HOSPITALS, HOSPICES, SKILLED NURSING FACILITIES AND ALL OF 12383 08:12:09,001 --> 08:12:11,000 THE REST. 12384 08:12:11,001 --> 08:12:14,000 I WANT EVERY SENIOR TO KNOW THAT 12385 08:12:14,001 --> 08:12:15,000 WHILE MAYBE IT IS TECHNICALLY 12386 08:12:15,001 --> 08:12:17,000 ACCURATE AGAIN FOR MY FRIENDS 12387 08:12:17,001 --> 08:12:19,000 ACROSS THE AISLE TO CLAIM THAT 12388 08:12:19,001 --> 08:12:21,000 THIS BILL DOESN'T CUT MEDICARE 12389 08:12:21,001 --> 08:12:24,000 BENEFITS THERE IS NO WAY -- NO 12390 08:12:24,001 --> 08:12:26,000 WAY THAT YOU CAN SLASH A HALF A 12391 08:12:26,001 --> 08:12:27,000 TRILLION DOLLARS FROM PAYMENTS 12392 08:12:27,001 --> 08:12:30,000 TO PROVIDERS WITHOUT AFFECTING 12393 08:12:30,001 --> 08:12:33,000 THEIR ABILITY TO KEEP THEIR DOOR OPEN. 12394 08:12:33,001 --> 08:12:35,000 ESPECIALLY IN RURAL AND 12395 08:12:35,001 --> 08:12:36,000 SMALL-TOWN AMERICA. 12396 08:12:36,001 --> 08:12:39,000 SENIORS SHOULD KNOW THEY WILL BE 12397 08:12:39,001 --> 08:12:40,000 LEFT WITH A WORTHLESS BENEFIT TO 12398 08:12:40,001 --> 08:12:42,000 PARAPHRASE MY FRIEND, SENATOR 12399 08:12:42,001 --> 08:12:43,000 ALEXANDER FROM TENNESSEE, IT 12400 08:12:43,001 --> 08:12:44,000 WILL BE LIKE HAVING A BUS TICKET 12401 08:12:44,001 --> 08:12:46,000 WITHOUT A BUS. 12402 08:12:46,001 --> 08:12:47,000 THANK YOU, SENATOR JOHANNS. 12403 08:12:47,001 --> 08:12:48,000 THANK YOU FOR THE WORK THAT YOU 12404 08:12:48,001 --> 08:12:49,000 ARE DOING. 12405 08:12:49,001 --> 08:12:51,000 THANK YOU FOR THIS MOTION. 12406 08:12:51,001 --> 08:12:55,000 I HOPE WE ARE SUCCESSFUL. 12407 08:12:55,001 --> 08:12:56,000 I HOPE PEOPLE WILL WAKE UP AND 12408 08:12:56,001 --> 08:12:58,000 UNDERSTAND THE SEVERITY OF WHAT 12409 08:12:58,001 --> 08:13:00,000 THESE CS WILL DO. 12410 08:13:00,001 --> 08:13:01,000 AND I URGE EVERY MEMBER OF THIS 12411 08:13:01,001 --> 08:13:03,000 SENATE TO SUPPORT SENATOR 12412 08:13:03,001 --> 08:13:04,000 JOHANNS WHEN WE COME TO A VOTE 12413 08:13:04,001 --> 08:13:05,000 ON THIS 12414 08:13:05,001 --> 08:13:11,000 THANK YOU, MR. PRESIDENT. 12415 08:13:11,001 --> 08:13:12,000 I YIELD THE FLOOR. 12416 08:13:12,001 --> 08:13:13,000 MR. BAUCUS: MR. PRESIDENT? 12417 08:13:13,001 --> 08:13:15,000 THE PRESIDING OFFICER: T 12418 08:13:15,001 --> 08:13:18,000 SENATOR FROM 12419 08:13:18,001 --> 08:13:23,000 MR. BAUCUS: I HEARD THAT THIS IS 12420 08:13:23,001 --> 08:13:27,000 GOING TO HEAR FROM SENATORS THAT 12421 08:13:27,001 --> 08:13:28,000 THIS WILL HURT SENIORS, WORDS 12422 08:13:28,001 --> 08:13:30,000 LIKE SMOKE SCREEN AND ALL OF THAT. 12423 08:13:30,001 --> 08:13:32,000 THIS IS A WELL THOUGHTOUT 12424 08:13:32,001 --> 08:13:34,000 CONSIDERED POLICY THAT I THINK 12425 08:13:34,001 --> 08:13:36,000 STRIKES A VERY GOOD BALANCE 12426 08:13:36,001 --> 08:13:38,000 BETWEEN GETTING CARE TO -- 12427 08:13:38,001 --> 08:13:40,000 ESPECIALLY TO SENIORS AT HOME, 12428 08:13:40,001 --> 08:13:42,000 WHICH IS SO IMPORTANT, ON THE 12429 08:13:42,001 --> 08:13:44,000 ONE HAND AND MAKING SURE THAT 12430 08:13:44,001 --> 08:13:46,000 THERE'S NOT WASTE ON THE OTHER HAND. 12431 08:13:46,001 --> 08:13:47,000 I MEAN, THAT IS OUR 12432 08:13:47,001 --> 08:13:48,000 RESPONSIBILITY HERE IS TO MAKE 12433 08:13:48,001 --> 08:13:51,000 SURE THAT THE PROGRAM WORKS AN 12434 08:13:51,001 --> 08:13:52,000 WORKS WELL. 12435 08:13:52,001 --> 08:13:53,000 I HAVE SORT AFTER SPECIAL 12436 08:13:53,001 --> 08:13:56,000 INTEREST IN THIS. 12437 08:13:56,001 --> 08:13:58,000 MY MOTHER'S IN THE HOSPITAL, 12438 08:13:58,001 --> 08:13:59,000 ABOUT TWO WEEKSGO, AND SHE 12439 08:13:59,001 --> 08:14:00,000 FORTUNATELY IS DOING MUCH 12440 08:14:00,001 --> 08:14:01,000 BETTER. 12441 08:14:01,001 --> 08:14:03,000 SHE'S IN THE HOSPITAL. 12442 08:14:03,001 --> 08:14:05,000 I SPENT SOME TIME WITH HOME 12443 08:14:05,001 --> 08:14:08,000 HEALTH CAREGIVER, WHO IS DOING 12444 08:14:08,001 --> 08:14:09,000 -- WITH WHOM I WAS VERY, IMPRESSED. 12445 08:14:09,001 --> 08:14:12,000 THISOME HEALTH PERSON WAS JUST 12446 08:14:12,001 --> 08:14:14,000 DOING A GREAT JOB WITH MY MOTHER 12447 08:14:14,001 --> 08:14:15,000 AND -- AND I'VE SEEN OTHER 12448 08:14:15,001 --> 08:14:17,000 INSTANCES TOO. 12449 08:14:17,001 --> 08:14:19,000 BUT, PERSONALLY, I WAS VERY 12450 08:14:19,001 --> 08:14:21,000 HAPPY TO SEE MY MOTHER IN VERY, 12451 08:14:21,001 --> 08:14:22,000 VERY GOOD CARE FROM A HOME 12452 08:14:22,001 --> 08:14:24,000 HEALTH CARE NURSE. 12453 08:14:24,001 --> 08:14:25,000 I THINK IT IS ALSO IMPORTANT TO 12454 08:14:25,001 --> 08:14:27,000 JUST REMIND MY COLLEAGUES THAT 12455 08:14:27,001 --> 08:14:28,000 THIS AMENDMENT IS REALLY A 12456 08:14:28,001 --> 08:14:30,000 RETREAD ON THE McCAIN 12457 08:14:30,001 --> 08:14:31,000 AMENDMENT THAT WE DEBATED OVER 12458 08:14:31,001 --> 08:14:33,000 THE LAST FEW DAYS, GENERALLY. 12459 08:14:33,001 --> 08:14:35,000 THAT IS, ONCE AGAIN THE 12460 08:14:35,001 --> 08:14:37,000 OPPONENTS OF THIS BILL ARE 12461 08:14:37,001 --> 08:14:39,000 ENDORSING THE STATUS QUO OF 12462 08:14:39,001 --> 08:14:41,000 MEDICARE GOING ON THE BRINK OF 12463 08:14:41,001 --> 08:14:45,000 GOING BANKRUPT AND SENIORS 12464 08:14:45,001 --> 08:14:47,000 FACING 12465 08:14:47,001 --> 08:14:49,000 I REMIND MY COLLEAGUES AGAIN 12466 08:14:49,001 --> 08:14:51,000 WHAT WILL HAPPEN IF WE STICK TO 12467 08:14:51,001 --> 08:14:52,000 THE STATUS QUO, THAT IS NO BILL 12468 08:14:52,001 --> 08:14:53,000 WHICH THE OTHER SIDE IS 12469 08:14:53,001 --> 08:14:54,000 ADVOCATING. 12470 08:14:54,001 --> 08:14:55,000 IT MEANS MEDICARE WILL GO BROKE 12471 08:14:55,001 --> 08:14:59,000 IN EIGHT YEARS. 12472 08:14:59,001 --> 08:15:02,000 THAT'S THE STUS QUO. IN OUR LEGISLATION THAT IS 12473 08:15:02,001 --> 08:15:04,000 POSTPONED FOR AT LEAST FIVE MORE YEARS. 12474 08:15:04,001 --> 08:15:05,000 THE STATUS QUO, WITH NO BILL 12475 08:15:05,001 --> 08:15:06,000 WITH THE OTHER SIDES ADVOCATING, 12476 08:15:06,001 --> 08:15:08,000 MEANS SENIORS WILL CONTINUE 12477 08:15:08,001 --> 08:15:09,000 PAYING HIGHER AND HIGHER 12478 08:15:09,001 --> 08:15:11,000 PREMIUMS AND COST SHARING DUE TO 12479 08:15:11,001 --> 08:15:13,000 WASTEFUL OVERPAYMENTS TO A GOOD 12480 08:15:13,001 --> 08:15:14,000 NEWSROOM OF -- NUMBER OF HEALTH 12481 08:15:14,001 --> 08:15:15,000 CARE PROVIDERS. 12482 08:15:15,001 --> 08:15:16,000 THERE IS SO MUCH WASTE IN OUR 12483 08:15:16,001 --> 08:15:18,000 SYST 12484 08:15:18,001 --> 08:15:21,000 KNOW THERE IS A LOT OF WASTE IN 12485 08:15:21,001 --> 08:15:23,000 OUR SYSTEM, AND FRANKLY I'M 12486 08:15:23,001 --> 08:15:24,000 QUITE SURPRISED THAT NOT ALL OF 12487 08:15:24,001 --> 08:15:27,000 OUR COLLEAGUES WANT TO CUT OUT THE WASTE. 12488 08:15:27,001 --> 08:15:29,000 IN EFFECT, THEY WANT TO KEEP THE 12489 08:15:29,001 --> 08:15:30,000 WASTE. 12490 08:15:30,001 --> 08:15:31,000 THAT'S UNFORTUNATELY IN OUR SYSTEM. 12491 08:15:31,001 --> 08:15:33,000 THE STATUS QUO ALSO MEANS TT 12492 08:15:33,001 --> 08:15:34,000 EACH YEAR BILLIONS OF MEDICARE 12493 08:15:34,001 --> 08:15:37,000 DOLLARS WILL CONTINUE TO BE 12494 08:15:37,001 --> 08:15:38,000 WASTED ON LINING THE POCKETS OF 12495 08:15:38,001 --> 08:15:40,000 PRIVATE INSURANCE COMPANIES, AND 12496 08:15:40,001 --> 08:15:44,000 THAT MIGHT BE A BIT 12497 08:15:44,001 --> 08:15:46,000 STATEMENT, BUT THE FACT IS THAT 12498 08:15:46,001 --> 08:15:47,000 THAT -- IS THAT SOME CHIEF 12499 08:15:47,001 --> 08:15:49,000 EXECUTIVES OF PRIVATE INSURANCE 12500 08:15:49,001 --> 08:15:53,000 COMPANIES ARE PAID MILLIONS -- 12501 08:15:53,001 --> 08:15:55,000 TENS OF MILLIONS OF DOLLARS TO 12502 08:15:55,001 --> 08:15:56,000 MANAGE MEDICARE PROGRAMS, 12503 08:15:56,001 --> 08:15:57,000 ESPECIALLY MEDICARE ADVANTAGE, 12504 08:15:57,001 --> 08:15:58,000 AND THAT THE STATUS QUO MEANS 12505 08:15:58,001 --> 08:16:00,000 THAT WILL CONTINUE. 12506 08:16:00,001 --> 08:16:02,000 THE STATUS QUO ALSO MEANS THAT 12507 08:16:02,001 --> 08:16:04,000 SENIORS WILL CONTINUE STRUGGLING 12508 08:16:04,001 --> 08:16:07,000 TO PAY FOR PRESCRIPTION DRUGS. 12509 08:16:07,001 --> 08:16:08,000 MR. PRESIDENT, THE STAKES OF 12510 08:16:08,001 --> 08:16:09,000 SENIORS IN THE MEDICARE PROGRAM 12511 08:16:09,001 --> 08:16:11,000 HAVE NEVER BEEN HIGHER. 12512 08:16:11,001 --> 08:16:12,000 WE HAVE A CHOICE HERE, 12513 08:16:12,001 --> 08:16:15,000 MR. PRESIDENT. 12514 08:16:15,001 --> 08:16:18,000 IT'S A VERY SIMPLE CHOICE. 12515 08:16:18,001 --> 08:16:19,000 EITHER ENDORSE THE STATUS QUO OR 12516 08:16:19,001 --> 08:16:21,000 STRENGTHEN MEDICARE. 12517 08:16:21,001 --> 08:16:24,000 LET'S TALK A LITTLE BIT ABOUT 12518 08:16:24,001 --> 08:16:25,000 HOME HEALTH CARE. 12519 08:16:25,001 --> 08:16:27,000 REGARDING MEDICARE CHANGES FOR 12520 08:16:27,001 --> 08:16:28,000 HOME HEALTH PROVIDERS LET ME 12521 08:16:28,001 --> 08:16:30,000 DESCRIBE WHAT IS IN THE SENATE BILL. 12522 08:16:30,001 --> 08:16:31,000 I DON'T THINK OUR COLLEAGUES 12523 08:16:31,001 --> 08:16:32,000 REALLY KNOW SPECIFICALLY WHAT'S 12524 08:16:32,001 --> 08:16:33,000 IN THE SENATE BILL. 12525 08:16:33,001 --> 08:16:35,000 THAT MAY BE A STRONG STATEMENT 12526 08:16:35,001 --> 08:16:38,000 TO MAKE, BUT I THINK IF THEY 12527 08:16:38,001 --> 08:16:39,000 KNEW WHAT WAS IN THE BILL, THAT 12528 08:16:39,001 --> 08:16:41,000 SOME OF THE STATEMENTS MADE 12529 08:16:41,001 --> 08:16:44,000 TONIGHT MIGHT BE A LITTLE BIT DIFFERENT. 12530 08:16:44,001 --> 08:16:47,000 AS MOST OF MY COLLEAGUES WOULD 12531 08:16:47,001 --> 08:16:48,000 AGREE, HOME HEALTH CARE IS 12532 08:16:48,001 --> 08:16:50,000 EXTREMELY IMPORTANT. 12533 08:16:50,001 --> 08:16:51,000 IT'S A VY IMPORTANT BENEFIT IN 12534 08:16:51,001 --> 08:16:53,000 THE MEDICARE PROGRAM. 12535 08:16:53,001 --> 08:16:54,000 WE ARE ALL VERY STRONG ADVOCATES 12536 08:16:54,001 --> 08:16:56,000 OF HOME HEALTH. 12537 08:16:56,001 --> 08:16:58,000 ACROSS THE COUNTRY, THERE ARE 12538 08:16:58,001 --> 08:17:01,000 MORE THAN 9,800 HOME HEALTH 12539 08:17:01,001 --> 08:17:02,000 AGENCIES THAT PROVIDE CARE 12540 08:17:02,001 --> 08:17:04,000 SENIORS IN THEIR HOMES. 12541 08:17:04,001 --> 08:17:07,000 THIS CARE HELPS SENIORS GET 12542 08:17:07,001 --> 08:17:08,000 BETTER, IT HELPS THEM AVOID 12543 08:17:08,001 --> 08:17:10,000 EXPENSIVE REHOSPITALIZATIONS. 12544 08:17:10,001 --> 08:17:11,000 WE'RE ALL CHAMPIONS OF HOME 12545 08:17:11,001 --> 08:17:15,000 HEALTH. 12546 08:17:15,001 --> 08:17:18,000 WE LIKE PEOPLEOT TO B INSTITUTIONALIZED. 12547 08:17:18,001 --> 08:17:19,000 IT'S MUCH BETTER WHERE 12548 08:17:19,001 --> 08:17:20,000 APPROPRIATE TO HAVE CARE IN THE 12549 08:17:20,001 --> 08:17:22,000 HOME AND HOME HEALTH CARE 12550 08:17:22,001 --> 08:17:24,000 AGENCIES HAVE PROVIDED THAT. 12551 08:17:24,001 --> 08:17:27,000 IT'S SO, SO IMPORTANT. 12552 08:17:27,001 --> 08:17:28,000 IN MY STATE OF MONTANA, HOME 12553 08:17:28,001 --> 08:17:30,000 HEALTH CARE PROVIDERS GO THE 12554 08:17:30,001 --> 08:17:31,000 EXTRA MILE, LITERALLY, TO 12555 08:17:31,001 --> 08:17:32,000 PROVIDE CARE TO PATIENTS ACROSS 12556 08:17:32,001 --> 08:17:34,000 VAST DISTANCES. 12557 08:17:34,001 --> 08:17:36,000 IN SOME CASES,OME HEALTH 12558 08:17:36,001 --> 08:17:38,000 PROVIDERS IN RURAL AREAS HAVE TO 12559 08:17:38,001 --> 08:17:40,000 DRIVE 100 MILES JUST TO SEE ONE PATIENT. 12560 08:17:40,001 --> 08:17:42,000 THEY'RE DEDICATED PEOPLE. 12561 08:17:42,001 --> 08:17:44,000 THEY GO GREAT DISTANCES AND 12562 08:17:44,001 --> 08:17:46,000 TRAVEL A LONG WAY TO SEE VERY 12563 08:17:46,001 --> 08:17:47,000 FEW PATIENTS. 12564 08:17:47,001 --> 08:17:50,000 HOME HEALTH PROVIDERS MAKE A 12565 08:17:50,001 --> 08:17:51,000 REAL DIFFERENCE IN IMPROVING 12566 08:17:51,001 --> 08:17:52,000 SENIORS' HEALTH AND WE SHOULD 12567 08:17:52,001 --> 08:17:53,000 SUPPORT THEIR EFFORTS, AND WE 12568 08:17:53,001 --> 08:17:55,000 ALL DO. 12569 08:17:55,001 --> 08:17:56,000 WE ALL VERY MUCH SUPPORT THEIR 12570 08:17:56,001 --> 08:17:57,000 EFRTS. 12571 08:17:57,001 --> 08:18:00,000 WE'LL HAVE GREAT RESPECT FOR THE 12572 08:18:00,001 --> 08:18:01,000 SERVICES OF HOME HEALTH -- THAT 12573 08:18:01,001 --> 08:18:02,000 HOME HEALTH PROVIDERS GIVE. 12574 08:18:02,001 --> 08:18:04,000 WE ALSO HAVE THE RESPONSIBILITY 12575 08:18:04,001 --> 08:18:06,000 TO PROTECT THE MEDICARE PROGRAM. 12576 08:18:06,001 --> 08:18:08,000 WE HAVE TO ROOT OUT WASTE. 12577 08:18:08,001 --> 08:18:09,000 AND UNFORTUNATELY, THERE IS 12578 08:18:09,001 --> 08:18:11,000 ALMOST ALWAYS SOME WASTE SOMEWHERE. 12579 08:18:11,001 --> 08:18:13,000 IT'S A MATTER OF JUDGMENT AS TO 12580 08:18:13,001 --> 08:18:14,000 HOW MUCH IS WASTE AND HOW MUCH 12581 08:18:14,001 --> 08:18:18,000 IS NOT. 12582 08:18:18,001 --> 08:18:19,000 WE MUST MAKE SURE MEDICARE IS 12583 08:18:19,001 --> 08:18:22,000 PAYING APPROPRIATELY. 12584 08:18:22,001 --> 08:18:24,000 THAT IS, MEDICARE IS NOT OVER 12585 08:18:24,001 --> 08:18:26,000 PAYING FOR MEDICARE SERVICES. 12586 08:18:26,001 --> 08:18:28,000 WE ALSO MUST TAKE ACTION TO ROOT 12587 08:18:28,001 --> 08:18:30,000 OUT FRAUD AND ABUSE GENERALLY 12588 08:18:30,001 --> 08:18:31,000 WHERE IT MAY OCCUR IN THE HOME 12589 08:18:31,001 --> 08:18:33,000 HEALTH INDUSTRY AS WELL. 12590 08:18:33,001 --> 08:18:34,000 THE POLICIES IN THIS SENATE BILL 12591 08:18:34,001 --> 08:18:36,000 I THINK ACHIEVE BOTH GOALS. 12592 08:18:36,001 --> 08:18:39,000 SO WHAT DO WE DO IN THE BILL? 12593 08:18:39,001 --> 08:18:40,000 FIRST, THE SENATE BILL WOULD 12594 08:18:40,001 --> 08:18:42,000 REBASE HOME HEALTH PAYMENTS TO 12595 08:18:42,001 --> 08:18:44,000 ENSURE PAYMENTS REFLECT ACTUAL 12596 08:18:44,001 --> 08:18:46,000 COSTS OF PROVIDING CARE. 12597 08:18:46,001 --> 08:18:48,000 THESE CHANGES ARE BASED ON 12598 08:18:48,001 --> 08:18:51,000 RECOMMENDATIONS BY MEDPAC, THE 12599 08:18:51,001 --> 08:18:53,000 INDEPENDENT ADVISORY COMMISSION 12600 08:18:53,001 --> 08:18:56,000 WHICH ADVISES CONGRESS ON MEDICARE REIMBURSEMENT. 12601 08:18:56,001 --> 08:19:01,000 IT'S A NONPARTISAN GROUP. 12602 08:19:01,001 --> 08:19:02,000 MEDPAC ADVISES REBASE HOME 12603 08:19:02,001 --> 08:19:04,000 HEALTH PAYMENTS. 12604 08:19:04,001 --> 08:19:05,000 WHAT DO WE MEAN BY THAT? 12605 08:19:05,001 --> 08:19:06,000 WHEN THE CURRENT HOME HEALTH 12606 08:19:06,001 --> 08:19:08,000 PAYMENTS WERE SET, SENIORS 12607 08:19:08,001 --> 08:19:09,000 RECEIVED AN AVERAGE OF 31 VISITS 12608 08:19:09,001 --> 08:19:12,000 PER EPISODE. 12609 08:19:12,001 --> 08:19:17,000 TODAY THEY RECEIVE 21, 22 VISITS 12610 08:19:17,001 --> 08:19:18,000 AS THEY GET PAID FOR 12611 08:19:18,001 --> 08:19:21,000 FRANKLY -- ACTUALLY GET PAID 12612 08:19:21,001 --> 08:19:22,000 ABOUT THE SAME FOR DOING LESS. 12613 08:19:22,001 --> 08:19:24,000 WE'RE TRYING TO MAKE SURE THE 12614 08:19:24,001 --> 08:19:25,000 PAYMENT REFLECTS THE ACTUAL 12615 08:19:25,001 --> 08:19:28,000 SERVICES PROVIDED. 12616 08:19:28,001 --> 08:19:30,000 SO THE SENATE BILL DIRECTS THE 12617 08:19:30,001 --> 08:19:31,000 C.M.S. TO REBASE PAYMENTS TO 12618 08:19:31,001 --> 08:19:32,000 REFLECT THIS CHANGE. 12619 08:19:32,001 --> 08:19:34,000 IT'S COMMON SENSE. 12620 08:19:34,001 --> 08:19:35,000 MEDPAC RECOMMENDED 12621 08:19:35,001 --> 08:19:37,000 MEDPAC THINKS IT'S GOT TO KEEP 12622 08:19:37,001 --> 08:19:39,000 UP WITH THE TIMES BECAUSE TIMES 12623 08:19:39,001 --> 08:19:44,000 HAVE CHANGED OVER THE YEARS AND 12624 08:19:44,001 --> 08:19:45,000 THAT THE PAYMENT SYSTEMS REFLECT 12625 08:19:45,001 --> 08:19:47,000 THAT CHANGE. 12626 08:19:47,001 --> 08:19:48,000 SOMETHING ELSE I THINK IS VERY 12627 08:19:48,001 --> 08:19:50,000 IMPORTANT AS MOS OF MY COLLEAGUES AGREE WITH. 12628 08:19:50,001 --> 08:19:51,000 THAT IS THE SENATE BILL ROOTS 12629 08:19:51,001 --> 08:19:54,000 OUT FRAUD THAT UNFORTUNATELY 12630 08:19:54,001 --> 08:19:57,000 EXISTS IN HOME HEALTH CARE AS 12631 08:19:57,001 --> 08:19:59,000 WELL AS SOME AREAS OF MEDICARE SPENDING. 12632 08:19:59,001 --> 08:20:04,000 IT ROOTS OUT THE 12633 08:20:04,001 --> 08:20:07,000 TRIES TO ROOT OUT THE FRAUD AND 12634 08:20:07,001 --> 08:20:08,000 MEDICARE PAYMENTS FOR OUTLI 12635 08:20:08,001 --> 08:20:10,000 CASES. 12636 08:20:10,001 --> 08:20:12,000 MEDICARE PROVIDES AN EXTRA 12637 08:20:12,001 --> 08:20:14,000 PAYMENT TODAY TO 12638 08:20:14,001 --> 08:20:18,000 HEALTH FOLKS WHO TREAT SICKER 12639 08:20:18,001 --> 08:20:21,000 PEOPLE OR OTHERWISE KNOWN AS 12640 08:20:21,001 --> 08:20:23,000 OUTLIER PATIENTS, REALLY SICK. 12641 08:20:23,001 --> 08:20:24,000 FORTUNATELY, THE -- UNFORTUNATELY, THE GENERAL 12642 08:20:24,001 --> 08:20:25,000 ACCOUNTING OFFICE FOUND THAT 12643 08:20:25,001 --> 08:20:28,000 SOME PROVIDERS WERE GAMING THE 12644 08:20:28,001 --> 08:20:30,000 SYSTEM AND GETTING MUCH MORE 12645 08:20:30,001 --> 08:20:31,000 OUTLIER PAYMENTS THAN THEY DESERVED. 12646 08:20:31,001 --> 08:20:32,000 FOR EXAMPLE, THE GENERAL 12647 08:20:32,001 --> 08:20:34,000 ACCOUNTING OFFICE FOUND IN ONE 12648 08:20:34,001 --> 08:20:35,000 FLORIDA COUNTY ALONE, HOME 12649 08:20:35,001 --> 08:20:39,000 HEALTH PROVIDERS WERE RECEIVING 12650 08:20:39,001 --> 08:20:41,000 60% OF ALL TOTAL OUTLIER PAYMENTS. 12651 08:20:41,001 --> 08:20:42,000 THAT'S NATIONWIDE, ONE COUNTY 12652 08:20:42,001 --> 08:20:45,000 GETTING 60%, EVEN THOUGH THE 12653 08:20:45,001 --> 08:20:46,000 COUNTY HAD LESS THAN 1% OF A 12654 08:20:46,001 --> 08:20:49,000 TOTAL MEDICARE POPULATION. 12655 08:20:49,001 --> 08:20:50,000 I DON'T WANT TO JUST SINGLE 12656 08:20:50,001 --> 08:20:51,000 FLORIDA, BUT THERE ARE SOME 12657 08:20:51,001 --> 08:20:52,000 OTHER COUNTIES, THEY TEND TO BE 12658 08:20:52,001 --> 08:20:55,000 IN THE SOUTHERN PART OF THE 12659 08:20:55,001 --> 08:20:57,000 COUNTRY WHICH CLEARLY HAVE 12660 08:20:57,001 --> 08:20:59,000 GROSSLY, GROSSLY 12661 08:20:59,001 --> 08:21:00,000 DISPROPORTIONATE AMOUNT OF 12662 08:21:00,001 --> 08:21:01,000 OUTLIER PAYMENTS, THEY ARE 12663 08:21:01,001 --> 08:21:04,000 GAMING T SYSTEM. 12664 08:21:04,001 --> 08:21:08,000 WE ADDRESSED THI PROBLEM 12665 08:21:08,001 --> 08:21:09,000 PLACING A CAP ON THE AMOUNT 12666 08:21:09,001 --> 08:21:13,000 PROVIDED BY THE PAYMENTS. 12667 08:21:13,001 --> 08:21:15,000 THE SENATE BILL ALSO MAKES 12668 08:21:15,001 --> 08:21:17,000 CHANGES IN 2007 AND 2012 12669 08:21:17,001 --> 08:21:18,000 RECOMMENDED BY MEDPAC. 12670 08:21:18,001 --> 08:21:20,000 WHY IS THAT IMPORTANT? 12671 08:21:20,001 --> 08:21:22,000 MEDPAC WAS ACTUALLY MUCH TOUGHER. 12672 08:21:22,001 --> 08:21:24,000 THEY WANTED TO START RIGHT AWAY IN 2010. 12673 08:21:24,001 --> 08:21:26,000 NO, WE'LL HOLD OFF A LITTLE BIT. 12674 08:21:26,001 --> 08:21:27,000 WE WANTED TO BE FAIR TO THE HOME 12675 08:21:27,001 --> 08:21:30,000 HEALTH PROVIDERS. 12676 08:21:30,001 --> 08:21:31,000 IN ADDITION, THE BILL 12677 08:21:31,001 --> 08:21:32,000 ESTABLISHES A PRODUCTIVITY 12678 08:21:32,001 --> 08:21:33,000 ADJUSTMENT FOR HOME HEALTH 12679 08:21:33,001 --> 08:21:35,000 PROVIDERS BEGINNING NOT RIGHT 12680 08:21:35,001 --> 08:21:36,000 AWAY, NOT NEXT YEAR, NOT THE 12681 08:21:36,001 --> 08:21:38,000 FOLLOWING YEAR. 12682 08:21:38,001 --> 08:21:39,000 IT DOESN'T BEGIN UNTIL THE YEAR 12683 08:21:39,001 --> 08:21:41,000 2015. 12684 08:21:41,001 --> 08:21:44,000 THESE CHANGES AS HOME HEALTH 12685 08:21:44,001 --> 08:21:46,000 MORE EFFICIENT AND HIGHER 12686 08:21:46,001 --> 08:21:49,000 QUALITY CARE OVER TIME. 12687 08:21:49,001 --> 08:21:51,000 BEING VERY FAIR ABOUT IT. 12688 08:21:51,001 --> 08:21:52,000 VERY IMPORTANTLY, IN MING 12689 08:21:52,001 --> 08:21:54,000 THESE CHANGES, WE WORKED VERY 12690 08:21:54,001 --> 08:21:56,000 CLOSELY WITH THE HOME HEALTH 12691 08:21:56,001 --> 08:21:57,000 INDUSTRY 12692 08:21:57,001 --> 08:21:58,000 CHANGES WERE REASONABLE AND THEY 12693 08:21:58,001 --> 08:22:00,000 WERE FAIR. 12694 08:22:00,001 --> 08:22:02,000 LET'S TAKE EACH OF THE POLICIES 12695 08:22:02,001 --> 08:22:04,000 AND WHAT THEY DO WITH RESPECT TO 12696 08:22:04,001 --> 08:22:05,000 THE AGENCIES TO MAKE SURE WE'RE 12697 08:22:05,001 --> 08:22:07,000 FAIR. 12698 08:22:07,001 --> 08:22:10,000 REBASING, MEDPAC RECOMMENDED 12699 08:22:10,001 --> 08:22:12,000 WE FULLY IMPLEMENT THESE CHANGES 12700 08:22:12,001 --> 08:22:15,000 IN THE YEAR 2011. 12701 08:22:15,001 --> 08:22:16,000 TO ENSURE THAT PROVIDERS COULD 12702 08:22:16,001 --> 08:22:18,000 ADAPT TO THE NEW PAYMENT RATES, 12703 08:22:18,001 --> 08:22:19,000 WE IN THE SENATE DECIDED WE 12704 08:22:19,001 --> 08:22:21,000 WOULD PHASE IN THESE CHANGES 12705 08:22:21,001 --> 08:22:22,000 OVER FOUR YEARS. 12706 08:22:22,001 --> 08:22:23,000 HO HEALTH PROVIDERS SUPPORT 12707 08:22:23,001 --> 08:22:25,000 THIS PHASE-IN. 12708 08:22:25,001 --> 08:22:28,000 THEY THINK IT'S A GOOD IDEA. 12709 08:22:28,001 --> 08:22:30,000 ON THE OUTLIER POLICY AND THE 12710 08:22:30,001 --> 08:22:32,000 FRAUD CHANGES, THESE POLICIES 12711 08:22:32,001 --> 08:22:33,000 WERE ACTUALLY SUGGESTED TO US BY 12712 08:22:33,001 --> 08:22:34,000 GUESS WHO? 12713 08:22:34,001 --> 08:22:36,000 BY THE HOME HEALTH INDUSTRY. 12714 08:22:36,001 --> 08:22:37,000 THEY CAME TO US AND SAID WE 12715 08:22:37,001 --> 08:22:40,000 SUGGEST THAT YOU MAKE SOME 12716 08:22:40,001 --> 08:22:41,000 CHANGES IN THE OUTLIERS BECAUSE 12717 08:22:41,001 --> 08:22:43,000 TOO MANY AGENCIES AND HOME 12718 08:22:43,001 --> 08:22:46,000 HEALTH PROVIDERS ARE GAMING THE SYSTEM. 12719 08:22:46,001 --> 08:22:48,000 MAKE SOME 12720 08:22:48,001 --> 08:22:50,000 STOP THAT GAMING. 12721 08:22:50,001 --> 08:22:51,000 MAKE SOME CHANGES TO STOP THE 12722 08:22:51,001 --> 08:22:52,000 FRAUD, SO THEY CAME TO US AND 12723 08:22:52,001 --> 08:22:54,000 THEY GAVE US SOME 12724 08:22:54,001 --> 08:22:55,000 OBVIOUSLY, THE HOME HEALTH 12725 08:22:55,001 --> 08:22:57,000 INDUSTRY FULLY SUPPORTS THE 12726 08:22:57,001 --> 08:22:59,000 CHANGES THATHEY RECOMMENDED TO US. 12727 08:22:59,001 --> 08:23:01,000 AND THEY'RE IN THIS BILL. 12728 08:23:01,001 --> 08:23:02,000 ON THE MARKET BASKET AND 12729 08:23:02,001 --> 08:23:05,000 PRODUCTIVITY CHANGES, THE SENATE 12730 08:23:05,001 --> 08:23:07,000 BILL 12731 08:23:07,001 --> 08:23:09,000 REDUCTIONS AS WE DELAY THESE 12732 08:23:09,001 --> 08:23:10,000 REDUCTIONS WHILE THE REBASING 12733 08:23:10,001 --> 08:23:11,000 POLICY IS TAKING EFFECT. 12734 08:23:11,001 --> 08:23:13,000 AGAIN, WE WANT TO BE FAIR. 12735 08:23:13,001 --> 08:23:15,000 THIS BILL GIVES HOME HEALTH 12736 08:23:15,001 --> 08:23:17,000 AGENCIES EXTRA TIME, MUCH MORE 12737 08:23:17,001 --> 08:23:22,000 TIME THAN IS RECOMMENDED BY VERY 12738 08:23:22,001 --> 08:23:24,000 AGGRESSIVE PROPOSED CHANGES, 12739 08:23:24,001 --> 08:23:25,000 PROPOSED BY MEDPAC, VERY 12740 08:23:25,001 --> 08:23:28,000 AGGRESSIVE CHANGES PROPOSED IN 12741 08:23:28,001 --> 08:23:30,000 THE HOUSE BILL AND BY THE ADMINISTRATION. 12742 08:23:30,001 --> 08:23:32,000 HE IS SAYING NO, THOSE ARE TOO 12743 08:23:32,001 --> 08:23:33,000 AGGRESSIVE, SO WE IN THE SENATE 12744 08:23:33,001 --> 08:23:35,000 DECIDE TO GIVE AGENCIES EXTRA 12745 08:23:35,001 --> 08:23:37,000 TIME TO ADAPT THESE PAYMENT 12746 08:23:37,001 --> 08:23:38,000 CHANGES AND THIS -- RATHER THAN 12747 08:23:38,001 --> 08:23:40,000 HAVING ALL THESE IMPLEMENTED AT 12748 08:23:40,001 --> 08:23:41,000 THE SAME TIME AS MEDPAC AND THE 12749 08:23:41,001 --> 08:23:44,000 HOUSE AND ADMINISTRATION ALL 12750 08:23:44,001 --> 08:23:45,000 WOULD -- WOULD RECOMMEND. 12751 08:23:45,001 --> 08:23:47,000 AND FINALLY, WITH RESPECT TO 12752 08:23:47,001 --> 08:23:49,000 RURAL HOME HEALTH PROVIDERS, 12753 08:23:49,001 --> 08:23:50,000 WE'RE ALL VERY SENSITIVE TO THE 12754 08:23:50,001 --> 08:23:52,000 RURAL -- THE SPECIAL NEEDS OF 12755 08:23:52,001 --> 08:23:54,000 RURAL AMERICA. 12756 08:23:54,001 --> 08:23:57,000 SO WHAT DO WE DO ABOUT THAT? 12757 08:23:57,001 --> 08:24:01,000 WELL, FROM THE 12758 08:24:01,001 --> 08:24:02,000 RURAL PROVIDERS RECEIVE 3% EXTRA 12759 08:24:02,001 --> 08:24:04,000 PAYMENT EACH YEAR. 12760 08:24:04,001 --> 08:24:06,000 THIS IS A PAYMENT THAT WILL 12761 08:24:06,001 --> 08:24:08,000 ENSURE THAT RURAL PROVIDERS ARE 12762 08:24:08,001 --> 08:24:09,000 PROTECTED AS WE REFORM THE 12763 08:24:09,001 --> 08:24:12,000 BROADER HOME HEALTH SYSTEM. 12764 08:24:12,001 --> 08:24:16,000 SO AN EXTRA 3% FROM THE PERIOD 12765 08:24:16,001 --> 08:24:19,000 2010-2015 FOR RURAL PROVIDERS. 12766 08:24:19,001 --> 08:24:21,000 SO IN TOTAL, THE HOME HEAH 12767 08:24:21,001 --> 08:24:22,000 BELIEVE, STRIKE A FAIR BALANCE 12768 08:24:22,001 --> 08:24:25,000 BETWEEN ENSURING SENIORS HAVE 12769 08:24:25,001 --> 08:24:27,000 ACCESS TO HOME CARE AND ALSO 12770 08:24:27,001 --> 08:24:29,000 ROOTINGUT INAPPROPRIATE 12771 08:24:29,001 --> 08:24:30,000 PAYMENTS FROM THIS SYSTEM. 12772 08:24:30,001 --> 08:24:32,000 NOW, I PREVIOUSLY HEARD MY GOOD 12773 08:24:32,001 --> 08:24:34,000 FRIEND SAY, WELL, GEE, THESE 12774 08:24:34,001 --> 08:24:36,000 CHANGES ARE REALLY GOING TO HURT SENIORS. 12775 08:24:36,001 --> 08:24:37,000 THEY'RE NOT GOING TO HURT SENIORS. 12776 08:24:37,001 --> 08:24:38,000 IN FACT, MOST OF THESE CHANGES 12777 08:24:38,001 --> 08:24:39,000 ARE CHANGES SUGGESTED BY THE 12778 08:24:39,001 --> 08:24:42,000 HOME HEALTH CARE INDUSTRY. 12779 08:24:42,001 --> 08:24:46,000 I THINK THAT ALL OF US WANT TO 12780 08:24:46,001 --> 08:24:47,000 ROOT OUT FRAUD AND WASTE. 12781 08:24:47,001 --> 08:24:50,000 OPPONENTS ALSO SOMETIMES CLAIM 12782 08:24:50,001 --> 08:24:52,000 THAT THE MEDICARE BENEFICIARIES 12783 08:24:52,001 --> 08:24:53,000 WILL BE HARMED IN LOTS OF WAYS BY THIS BILL. 12784 08:24:53,001 --> 08:24:54,000 THAT'S A SCARE TACTIC, 12785 08:24:54,001 --> 08:24:56,000 MR. PRESIDENT. 12786 08:24:56,001 --> 08:24:57,000 LET ME SAY WHAT THE AMERICAN 12787 08:24:57,001 --> 08:24:59,000 ASSOCIATION OF RETIRED PERSONS 12788 08:24:59,001 --> 08:25:01,000 SAYS ABOUT THESE KIND OF CLAIMS, 12789 08:25:01,001 --> 08:25:02,000 THAT IS THE CLAIM THAT THESE 12790 08:25:02,001 --> 08:25:04,000 CHANGES IN MEDICARE 12791 08:25:04,001 --> 08:25:09,000 REIMBURSEMENT ARE GOING TO HARM SENIORS. 12792 08:25:09,001 --> 08:25:10,000 THE AARP SAYS, AND I QUOTE -- 12793 08:25:10,001 --> 08:25:11,000 "OPPONENTS OF HEALTH REFORM 12794 08:25:11,001 --> 08:25:13,000 WON'T REST. 12795 08:25:13,001 --> 08:25:14,000 THEY ARE USING MYTHS AND 12796 08:25:14,001 --> 08:25:15,000 MISINFORMATION TO DISTRUTH THE 12797 08:25:15,001 --> 08:25:16,000 TRUTH THAT MEDICARE WILL BE 12798 08:25:16,001 --> 08:25:18,000 HARMED. 12799 08:25:18,001 --> 08:25:19,000 AFTER A LIFETIME OF HARD WORK, 12800 08:25:19,001 --> 08:25:21,000 DON'T SENIO 12801 08:25:21,001 --> 08:25:22,000 THAT'S A STATEMENT BY THE AARP. 12802 08:25:22,001 --> 08:25:24,000 I DON'T SUGGEST HERE TONIGHT 12803 08:25:24,001 --> 08:25:25,000 THAT ANY OF OUR COLLEAGUES ARE 12804 08:25:25,001 --> 08:25:27,000 USING MYTHS AND MISINFORMATION 12805 08:25:27,001 --> 08:25:29,000 TO DISTORT THE TRUTH, BUT 12806 08:25:29,001 --> 08:25:30,000 MAIN POINT HERE IS AARP WHEN IT 12807 08:25:30,001 --> 08:25:32,000 HEARS CLAIMS THAT SENIORS ARE 12808 08:25:32,001 --> 08:25:33,000 ING TO BE HURT SAYS THAT'S NOT 12809 08:25:33,001 --> 08:25:35,000 TRUE, AND THEY SUPPORT THIS 12810 08:25:35,001 --> 08:25:37,000 BILL, THEY STRONGLY SUPPORT THIS LL, I MIGHT ADD. 12811 08:25:37,001 --> 08:25:38,000 SO LET ME REMIND MY COLLEAGUES 12812 08:25:38,001 --> 08:25:40,000 OF SOME OF THE POSITIVE CHANGES 12813 08:25:40,001 --> 08:25:42,000 IN THIS LEGISLATION. 12814 08:25:42,001 --> 08:25:43,000 THIS LEGISLATION APPROVES THE 12815 08:25:43,001 --> 08:25:45,000 SOLVENCY OF THE MEDICARE PROGRAM 12816 08:25:45,001 --> 08:25:48,000 BY FIVE YEARS. 12817 08:25:48,001 --> 08:25:50,000 IT PUTS $30 BILLION BACK INTO 12818 08:25:50,001 --> 08:25:53,000 THE POCKETS OF SENIORS IN THE 12819 08:25:53,001 --> 08:25:55,000 FORM OF LOWER MEDICARE PREMIUMS. 12820 08:25:55,001 --> 08:25:58,000 IT MAKES PRESCRIPTION DRUGS MORE AFFORDABLE. 12821 08:25:58,001 --> 08:25:59,000 THAT'S AN ADDED BILL THAT WOULD 12822 08:25:59,001 --> 08:26:00,000 NOT BE AVAILABLE IF THIS 12823 08:26:00,001 --> 08:26:01,000 LEGISLATION WAS NOT PASSED. 12824 08:26:01,001 --> 08:26:02,000 THE BILL GUARANTEES SENIORS CAN 12825 08:26:02,001 --> 08:26:03,000 CONTINUE TO SEE THE DOCTOR OF 12826 08:26:03,001 --> 08:26:04,000 THEIR CHOOSING. 12827 08:26:04,001 --> 08:26:06,000 THE BILL PROVIDES FREE WELLNESS 12828 08:26:06,001 --> 08:26:07,000 AND PREVENTION 12829 08:26:07,001 --> 08:26:09,000 THOSE ARE NEW BENEFITS THAT 12830 08:26:09,001 --> 08:26:10,000 DON'T CURRENTLY EXIST. 12831 08:26:10,001 --> 08:26:12,000 IT ALSO INCLUDES FAIR TO 12832 08:26:12,001 --> 08:26:13,000 APPROPRIATE CHANGES TO HOME 12833 08:26:13,001 --> 08:26:14,000 HEALTH AS I SUGGESTED 12834 08:26:14,001 --> 08:26:15,000 PROTECT ACCESS TO CARE. 12835 08:26:15,001 --> 08:26:16,000 I DON'T QUESTION THE MOTIVES OF 12836 08:26:16,001 --> 08:26:17,000 MY COLLEAGUES. 12837 08:26:17,001 --> 08:26:20,000 THEY BELIEVE THEY ARE STANDING 12838 08:26:20,001 --> 08:26:21,000 UP FOR SENIORS IN OPPOSING 12839 08:26:21,001 --> 08:26:22,000 HOME HEALTH CHANGES, BUTN 12840 08:26:22,001 --> 08:26:23,000 TRUTH THEY ARE REALLY GOING TO 12841 08:26:23,001 --> 08:26:25,000 HARM SENIORS BECAUSE THEY ARE 12842 08:26:25,001 --> 08:26:26,000 HURTING THE MEDICARE PROGRAM, 12843 08:26:26,001 --> 08:26:28,000 AND I DON'T THINK WE WANT TO 12844 08:26:28,001 --> 08:26:29,000 HURT THE MEDICARE PROGRAM. 12845 08:26:29,001 --> 08:26:32,000 RATHER, WE'RE 12846 08:26:32,001 --> 08:26:35,000 MEDICARE PROAM BY MAKING THESE CHANGES. 12847 08:26:35,001 --> 08:26:37,000 ONE OTHER POINT I WANT TO MAKE 12848 08:26:37,001 --> 08:26:39,000 THAT'S JUST KIND OF INTERESTING, 12849 08:26:39,001 --> 08:26:44,000 I THOUGHT, WHEN I 12850 08:26:44,001 --> 08:26:48,000 STILL HAVE IT. 12851 08:26:48,001 --> 08:26:51,000 IT'S KIND OF INTERESTING, THE 12852 08:26:51,001 --> 08:26:53,000 GROWTH RATE IN HOME HEALTH CARE 12853 08:26:53,001 --> 08:26:57,000 SPENDING WILL CONTINUE TO BE 12854 08:26:57,001 --> 08:27:06,000 VERY HIGH AFTER THIS LEGISLATION PASSED. 12855 08:27:06,001 --> 08:27:09,000 IT WILL 12856 08:27:09,001 --> 08:27:12,000 THE GROWTH RATE PER YEAR UNDER 12857 08:27:12,001 --> 08:27:14,000 THIS BILL 12858 08:27:14,001 --> 08:27:15,000 CURRENTLY, EXCUSE ME, CURRENTLY 12859 08:27:15,001 --> 08:27:16,000 THE GROWTH RATE OF HOME HEALTH 12860 08:27:16,001 --> 08:27:17,000 CARE INDUSTRIES IS ALMOST 11% 12861 08:27:17,001 --> 08:27:19,000 PER YEAR. 12862 08:27:19,001 --> 08:27:21,000 AFTER THIS LEGISLATION, IT WILL 12863 08:27:21,001 --> 08:27:23,000 BE ALMOST 8%. 12864 08:27:23,001 --> 08:27:26,000 8% ANNUAL GROWTH IN THE HOME 12865 08:27:26,001 --> 08:27:28,000 HEALTH CARE INDUSTRY, AND THAT'S 12866 08:27:28,001 --> 08:27:29,000 MUCH FASTER THAN NATIONAL HEALTH 12867 08:27:29,001 --> 08:27:31,000 EXPENDITURES. 12868 08:27:31,001 --> 08:27:33,000 SO I THINK -- MOST THINGS IN 12869 08:27:33,001 --> 08:27:38,000 LIFE ARE A JUDGMENT CALL. 12870 08:27:38,001 --> 08:27:39,000 I THINK WE WILL FAIRLY DECIDE 12871 08:27:39,001 --> 08:27:41,000 THE CHANGES WE MAKE IN THIS BILL 12872 08:27:41,001 --> 08:27:44,000 ARE GOOD FOR SENIORS, THEY ARE 12873 08:27:44,001 --> 08:27:45,000 GOOD FOR HOME HEALTH, BECAUSE 12874 08:27:45,001 --> 08:27:48,000 THEY ARE SENSITIVE TO THE NEEDS 12875 08:27:48,001 --> 08:27:50,000 OF THE INDUSTRY, SENSITIVE TO 12876 08:27:50,001 --> 08:27:51,000 PATIENTS, FRANKLY, BUT ALSO 12877 08:27:51,001 --> 08:27:52,000 RESPONSIBLE TO THE AMERICAN 12878 08:27:52,001 --> 08:28:02,000 TAXPAYERS BY MAKING SURE WE'RE 12879 08:28:02,001 --> 08:28:03,000 ROOTING OUT A LOT 12880 08:28:03,001 --> 08:28:04,000 MR. CORNYN: MR. PRESIDENT? 12881 08:28:04,001 --> 08:28:06,000 THE PRESIDING OFFICER: THE 12882 08:28:06,001 --> 08:28:08,000 SENATOR FROM TEXAS. 12883 08:28:08,001 --> 08:28:10,000 MR. CORNYN: THANK YOU, 12884 08:28:10,001 --> 08:28:12,000 MR. PRESIDENT. 12885 08:28:12,001 --> 08:28:13,000 MR. PRESIDENT, I THINK AS THE 12886 08:28:13,001 --> 08:28:18,000 AMERICAN PEOPLE ARE LISTENING TO 12887 08:28:18,001 --> 08:28:19,000 THE DEBATE WE'RE HAVING ON -- ON 12888 08:28:19,001 --> 08:28:21,000 HEALTH CARE REFORM, THEY ARE 12889 08:28:21,001 --> 08:28:26,000 BE 12890 08:28:26,001 --> 08:28:29,000 PRETTY IMPLAUSIBLE CLAIMS 12891 08:28:29,001 --> 08:28:30,000 ONE CLAIM THAT YOU CAN TAKE HALF 12892 08:28:30,001 --> 08:28:32,000 A TRILLION DOLLARS OUT OF 12893 08:28:32,001 --> 08:28:35,000 MEDICARE AND IT WON'T HAVE ANY 12894 08:28:35,001 --> 08:28:36,000 IMPACT ON THE DELIVERY OF 12895 08:28:36,001 --> 08:28:38,000 SERVICES TO MEDICARE 12896 08:28:38,001 --> 08:28:39,000 BENEFICIARIES. 12897 08:28:39,001 --> 08:28:41,000 HALF A TRILLION DOLLARS. 12898 08:28:41,001 --> 08:28:43,000 AND THE BIGGEST MISTAKE, I 12899 08:28:43,001 --> 08:28:47,000 THINK, ABOUT THE WAY THIS BILL 12900 08:28:47,001 --> 08:28:50,000 IS PAID FOR WITH THE HUGE TAX 12901 08:28:50,001 --> 08:28:52,000 INCREASES AND WITH HUGE CUTS IN 12902 08:28:52,001 --> 08:28:54,000 MEDICARE IS THAT THE PROPOSAL IS 12903 08:28:54,001 --> 08:28:57,000 TO LET'S TAKE HALF A TRILLION 12904 08:28:57,001 --> 08:29:01,000 DOLLARS OUT OF 12905 08:29:01,001 --> 08:29:02,000 INCLUDING $40 BILLION OUT OF 12906 08:29:02,001 --> 08:29:06,000 HOME HEALTH CARE, IN ORDER TO 12907 08:29:06,001 --> 08:29:07,000 PA 12908 08:29:07,001 --> 08:29:12,000 PROGRAM WHEN WE ALREADY KNOW 12909 08:29:12,001 --> 08:29:15,000 THAT MEDICARE ITSELF IS ON A 12910 08:29:15,001 --> 08:29:18,000 FISCALLY UNSUSTAINABLE PATH. 12911 08:29:18,001 --> 08:29:21,000 WELL, I WANT TO TALK PRIMARILY 12912 08:29:21,001 --> 08:29:23,000 ABOUT ANOTHER ASPECT OF -- OF 12913 08:29:23,001 --> 08:29:26,000 THIS -- OF THESE CUTS, AND THAT 12914 08:29:26,001 --> 08:29:29,000 IS THE 11 MILLION SENIORS, 12915 08:29:29,001 --> 08:29:32,000 INCLUDING 532,000 TEXANS WHO 12916 08:29:32,001 --> 08:29:36,000 WILL LOSE BENEFITS UNDER THEIR MEDICARE ADVANTAGE PROGRAM 12917 08:29:36,001 --> 08:29:37,000 BECAUSE THESE ARE NOT 12918 08:29:37,001 --> 08:29:38,000 INCONSEQUENTIAL CUTS IN THEIR 12919 08:29:38,001 --> 08:29:40,000 BENEFITS. 12920 08:29:40,001 --> 08:29:44,000 THEY'RE SERIOUS, AND I WANT TO 12921 08:29:44,001 --> 08:29:48,000 TALK ABOUT SOME REAL HUMAN 12922 08:29:48,001 --> 08:29:52,000 BEINGS, SOME REAL TEXANS WHO ARE 12923 08:29:52,001 --> 08:29:54,000 GOING TO BE AFFECTED IN THE 12924 08:29:54,001 --> 08:29:56,000 NEGATIVE -- NEGATIVELY BY THESE 12925 08:29:56,001 --> 08:29:58,000 CUTS. 12926 08:29:58,001 --> 08:29:59,000 FIRST OF ALL, I THINK IT'S 12927 08:29:59,001 --> 08:30:01,000 ABSOLUTELY CRITICAL FOR THE 12928 08:30:01,001 --> 08:30:04,000 AMERICAN PEOPLE TO UNDERSTAND 12929 08:30:04,001 --> 08:30:07,000 THAT PHER ITSELF DOES NOT 12930 08:30:07,001 --> 08:30:12,000 PROVIDE COMPLETE -- THAT 12931 08:30:12,001 --> 08:30:16,000 MEDICARE ITSELF DOES NOT PROVIDE COMPLETE COVERAGE. 12932 08:30:16,001 --> 08:30:18,000 THAT IS WHY SOME SENIORS BUY 12933 08:30:18,001 --> 08:30:20,000 MEDIGAP IN ORDER TO GET THEIR 12934 08:30:20,001 --> 08:30:23,000 BILLS PAID FOR BECAUSE MEDICARE 12935 08:30:23,001 --> 08:30:26,000 PAYS ON AVERAGE ABOUT 80% TO 12936 08:30:26,001 --> 08:30:27,000 PROVIDERS WHAT PVATE HEALTH 12937 08:30:27,001 --> 08:30:29,000 CARE INSURANCE DOES. 12938 08:30:29,001 --> 08:30:31,000 THAT'S THE REASON WHY WITHOUT 12939 08:30:31,001 --> 08:30:33,000 ADDITIONAL COMPENSATION MANY 12940 08:30:33,001 --> 08:30:34,000 DOCTORS WON'T SEE A MEDICARE 12941 08:30:34,001 --> 08:30:35,000 PATIENT BECAUSE THEY SIMPLY 12942 08:30:35,001 --> 08:30:37,000 CANNOT DO IT AND KP THEIR 12943 08:30:37,001 --> 08:30:39,000 DOORS OPEN TO THEIR OTHER PATIENTS. 12944 08:30:39,001 --> 08:30:41,000 THE TRUTH IS MEDICARE ADVANTAGE 12945 08:30:41,001 --> 08:30:43,000 WAS CREATED TO FIX SOME OF THE 12946 08:30:43,001 --> 08:30:47,000 FLAWS WITH MEDICARE 12947 08:30:47,001 --> 08:30:49,000 FEE-FOR-SERVICE TO GIVE SENIORS 12948 08:30:49,001 --> 08:30:50,000 MORE AFFORDABLE AND BETTER 12949 08:30:50,001 --> 08:30:52,000 COORDINATED HEALTH CARE, WHICH 12950 08:30:52,001 --> 08:30:53,000 NONE OF US ARE STANDING UP HERE 12951 08:30:53,001 --> 08:30:57,000 AND SAYING THAT THE PROPOSED 12952 08:30:57,001 --> 08:30:58,000 BILL IS ALL BAD, BECAUSE SOME OF 12953 08:30:58,001 --> 08:31:01,000 THE POSITIVE DEVELOPMENTS IN 12954 08:31:01,001 --> 08:31:04,000 THIS BILL CALL FOR GREATER 12955 08:31:04,001 --> 08:31:05,000 COORDINATION OF HEALTH CARE. 12956 08:31:05,001 --> 08:31:07,000 BUT, ON BALANCE, IT MAKES THINGS 12957 08:31:07,001 --> 08:31:09,000 WORSE THAN IT DOES BETTER 12958 08:31:09,001 --> 08:31:10,000 BECAUSE OF THESE CUTS IN THINGS 12959 08:31:10,001 --> 08:31:11,000 LIKE MEDICARE ADVANTAGE. 12960 08:31:11,001 --> 08:31:13,000 THE PRESIDENT OF THE UNITED 12961 08:31:13,001 --> 08:31:16,000 STATES HAS SAID THAT PROVIDING 12962 08:31:16,001 --> 08:31:17,000 AMERICANS WITH A CHOICE OF 12963 08:31:17,001 --> 08:31:19,000 QUALITY AFFORDABLE HEALTH CARE 12964 08:31:19,001 --> 08:31:21,000 WAS A GUIDING PRINCIPLE FOR HIM, 12965 08:31:21,001 --> 08:31:22,000 AND I AGREE WITH THAT STATEMENT 12966 08:31:22,001 --> 08:31:23,000 OF PRINCIPLE. 12967 08:31:23,001 --> 08:31:25,000 MEDICARE ADVANTAGE WAS CREATED 12968 08:31:25,001 --> 08:31:27,000 FOR THAT VERY PURPOSE, BECAUSE, 12969 08:31:27,001 --> 08:31:30,000 AS I SAID, MEDICARE ITSELF DOES 12970 08:31:30,001 --> 08:31:31,000 NOT ALWAYS WORK WELL FOR 12971 08:31:31,001 --> 08:31:33,000 PATIENTS. 12972 08:31:33,001 --> 08:31:36,000 WHERE I LIVE IN AUSTIN, TEXAS, 12973 08:31:36,001 --> 08:31:39,000 WHICH IS TRAVIS COUNTY, LAST 12974 08:31:39,001 --> 08:31:41,000 TIME I SAW A REPORT, ONLY 17% OF 12975 08:31:41,001 --> 08:31:42,000 PHYSICIANS WILL SEE A NEW 12976 08:31:42,001 --> 08:31:43,000 MEDICARE PATIENT BECAUSE 12977 08:31:43,001 --> 08:31:44,000 MEDICARE 12978 08:31:44,001 --> 08:31:47,000 SO LOW. 12979 08:31:47,001 --> 08:31:50,000 THOSE PROBLEMS ARE AVOIDED IN 12980 08:31:50,001 --> 08:31:54,000 LARGE PART BY MEDICARE ADVANTAGE 12981 08:31:54,001 --> 08:31:56,000 BECAUSE IT PAYS PHYSICIANS 12982 08:31:56,001 --> 08:31:59,000 PROVIDERS BETTER THAN MEDICARE FEE-FOR-SERVICE. 12983 08:31:59,001 --> 08:32:01,000 ACCORDING TO THE AMERICAN 12984 08:32:01,001 --> 08:32:06,000 MEDICAL ASSOCIATION'S 2008 12985 08:32:06,001 --> 08:32:09,000 NATIONAL HEALTH INSURANCE REPORT 12986 08:32:09,001 --> 08:32:10,000 CARD, 12987 08:32:10,001 --> 08:32:12,000 HEALTH INSURANCE -- BUT MEDICARE 12988 08:32:12,001 --> 08:32:15,000 HAD THE HIGHEST PERCENTAGE AND 12989 08:32:15,001 --> 08:32:18,000 THE LARGEST NUMBER OF DENIED MEDICAL CLAIMS. 12990 08:32:18,001 --> 08:32:21,000 IN FACT, MEDICARE DENIED TEN 12991 08:32:21,001 --> 08:32:22,000 TIMES MORE MEDICAL CLAIMS THAN 12992 08:32:22,001 --> 08:32:24,000 PRIVATE INSURERS. 12993 08:32:24,001 --> 08:32:25,000 THAT'S ANOTHER REASON WHY 12994 08:32:25,001 --> 08:32:27,000 SENIORS DESERVE A CHOICE BETWEEN 12995 08:32:27,001 --> 08:32:30,000 MEDICARE 12996 08:32:30,001 --> 08:32:33,000 WILL OFFER THEM BETTER BENEFITS. 12997 08:32:33,001 --> 08:32:35,000 AS I MENTIONED TODAY, 11 MILLION 12998 08:32:35,001 --> 08:32:37,000 AMERICANS HAVE MADE THAT CHOICE 12999 08:32:37,001 --> 08:32:40,000 OF BETTER BENEFITS AND BETTER 13000 08:32:40,001 --> 08:32:41,000 CARE COORDINATION THROUGH THE 13001 08:32:41,001 --> 08:32:43,000 MEDICARE ADVANTAGE PROGRAM. 13002 08:32:43,001 --> 08:32:45,000 THE PROPOSED BILL, THE REID BILL 13003 08:32:45,001 --> 08:32:47,000 WILL TAKE AWAY THOSE CHOICES AND 13004 08:32:47,001 --> 08:32:49,000 THE BENEFITS OF THOSE 11 MILLION 13005 08:32:49,001 --> 08:32:51,000 SENIORS BY CUTTING ABOUT $120 13006 08:32:51,001 --> 08:32:53,000 BILLION FROM THE PROGRAM. 13007 08:32:53,001 --> 08:32:56,000 NOW, MANY OF OUR FRIENDS ACROSS 13008 08:32:56,001 --> 08:32:57,000 THE AISLE WILL SAY WE CAN CUT 13009 08:32:57,001 --> 08:33:00,000 $120 BILLION OUT OF MEDICARE 13010 08:33:00,001 --> 08:33:02,000 ADVANTAGE AND IT WILL HAVE NO 13011 08:33:02,001 --> 08:33:03,000 IMPACT ON DELIVERY OF SERVICES, 13012 08:33:03,001 --> 08:33:05,000 BUT THE CONGRESSIONAL BUDGET 13013 08:33:05,001 --> 08:33:07,000 OFFICE DISAGREES WITH THEM, THE 13014 08:33:07,001 --> 08:33:09,000 DIRECTOR DOES, WHO SAID THAT 13015 08:33:09,001 --> 08:33:10,000 THEIR BENEFITS, THEIR AITIONAL 13016 08:33:10,001 --> 08:33:12,000 BENEFITS WILL BE CUT ROUGHLY IN HALF. 13017 08:33:12,001 --> 08:33:14,000 WE NEED TO SET THE RECORD 13018 08:33:14,001 --> 08:33:17,000 RAIGHT ON THESE SO-CALLED 13019 08:33:17,001 --> 08:33:18,000 OVERPAYMENTS ALLEGEDLY GOING TO 13020 08:33:18,001 --> 08:33:20,000 INSURANCE COMPANY PROFITS. 13021 08:33:20,001 --> 08:33:22,000 IT'S SIMPLY A FALSE STATEMENT. 13022 08:33:22,001 --> 08:33:24,000 IT'S NOT TRUE. 13023 08:33:24,001 --> 08:33:25,000 OUR COLLEAGUES KNOW THAT THE 13024 08:33:25,001 --> 08:33:27,000 SO-CALLED OVERPAYMENTS TO 13025 08:33:27,001 --> 08:33:29,000 MEDICARE ADVANTAGE PLANS DON'T 13026 08:33:29,001 --> 08:33:32,000 GO INTO THOSE PLANS. 13027 08:33:32,001 --> 08:33:33,000 THEY GO TO SENIORS IN THE FORM 13028 08:33:33,001 --> 08:33:36,000 OF ADDITIONAL BENEFITS. 13029 08:33:36,001 --> 08:33:38,000 THAT'S BECAUSE UNDER FEDERAL 13030 08:33:38,001 --> 08:33:39,000 LAW, 75% OF ADDITIONAL PAYMENTS 13031 08:33:39,001 --> 08:33:42,000 TO MEDICARE ADVANTAGE PLANS ARE 13032 08:33:42,001 --> 08:33:43,000 USED TO PROVIDE SENIORS WITH 13033 08:33:43,001 --> 08:33:45,000 ADDITIONAL BENEFITS, BENEFITS 13034 08:33:45,001 --> 08:33:47,000 WHICH THEY WOULD NOT GET UNDER 13035 08:33:47,001 --> 08:33:50,000 MEDICARE FEE-FOR-SERVICE. 13036 08:33:50,001 --> 08:33:52,000 THINGS LIKE CHRONIC CARE 13037 08:33:52,001 --> 08:33:54,000 MANAGEMENT, HEARING 13038 08:33:54,001 --> 08:33:56,000 EYEGLASSES, AND THE LIKE. 13039 08:33:56,001 --> 08:33:58,000 ANDED OTHER 25 -- AND OTHER 25% 13040 08:33:58,001 --> 08:33:59,000 OF ANY EXTRA PAYMENTS IS 13041 08:33:59,001 --> 08:34:02,000 RETURNED TO THE FEDERAL GOVERNMENT. 13042 08:34:02,001 --> 08:34:03,000 SO LET'S BE CLEAR, CUTS TO 13043 08:34:03,001 --> 08:34:06,000 MEDICARE ADVANTAGE WOULD BE 13044 08:34:06,001 --> 08:34:08,000 TAKING AWAY SENIORS' HEALTH 13045 08:34:08,001 --> 08:34:09,000 BENEFITS FOR THOSE 11 MILLION 13046 08:34:09,001 --> 08:34:15,000 SENIORS. 13047 08:34:15,001 --> 08:34:16,000 AS I MENTIONED 500,000 TEXANS 13048 08:34:16,001 --> 08:34:18,000 ARE ON MEDICARE ADVANTAGE AND 13049 08:34:18,001 --> 08:34:20,000 THE REID BILL WOULD CUT THEIR 13050 08:34:20,001 --> 08:34:21,000 BENEFITS BY WELL OVER HALF. 13051 08:34:21,001 --> 08:34:22,000 YOU DON HAVE TO TAKE MY WORD 13052 08:34:22,001 --> 08:34:23,000 FOR IT. 13053 08:34:23,001 --> 08:34:27,000 LISTEN TO WHAT THE C.B.O. 13054 08:34:27,001 --> 08:34:28,000 DIRECTOR, DR. ELMENDORF, SAID, 13055 08:34:28,001 --> 08:34:30,000 WHEN SENATOR 13056 08:34:30,001 --> 08:34:31,000 DURING THE FINANCE COMMITTEE 13057 08:34:31,001 --> 08:34:32,000 HEARING, HE SAID APPROXIMATELY 13058 08:34:32,001 --> 08:34:35,000 HALF OF THE ADDITIONAL BENEFIT 13059 08:34:35,001 --> 08:34:38,000 WOULD BE LOST TO THOSE MEDICARE 13060 08:34:38,001 --> 08:34:43,000 ADVANTAGE POLICYHOLDERS? DR. ELMENDORF SAID -- QUOTE -- 13061 08:34:43,001 --> 08:34:45,000 "FOR THOSE WHO WOULD BE ENROLLED 13062 08:34:45,001 --> 08:34:46,000 OTHERWISE, UNDER CURRENT LAW, 13063 08:34:46,001 --> 08:34:48,000 YES." 13064 08:34:48,001 --> 08:34:50,000 NEARLY ONE OUT OF EVERY FOUR 13065 08:34:50,001 --> 08:34:52,000 SENIORS IN TEXAS WOULD LOSE 13066 08:34:52,001 --> 08:34:55,000 ABOUT $122 A MONTH IN HEALTH 13067 08:34:55,001 --> 08:34:56,000 CARE BENEFITS TO CREATE A NEW 13068 08:34:56,001 --> 08:34:58,000 $2.5 TRILLION ENTITLEMENT THAT 13069 08:34:58,001 --> 08:35:00,000 THEIR GRANDCHILDREN WILL 13070 08:35:00,001 --> 08:35:01,000 ULTIMATELY END UP HAVING TO PAY 13071 08:35:01,001 --> 08:35:03,000 FOR. 13072 08:35:03,001 --> 08:35:04,000 $122 A MONTH MAY NOT SOUND LIKE 13073 08:35:04,001 --> 08:35:08,000 A LOT TO PEOPLE INSIDE THE 13074 08:35:08,001 --> 08:35:10,000 BELTWAY, BUT A COUPLE FROM MY 13075 08:35:10,001 --> 08:35:13,000 HOMETOWN OF SAN ANTONIO RECENTLY 13076 08:35:13,001 --> 08:35:14,000 WROTE TO ME SAYING, "PLEASE VOTE 13077 08:35:14,001 --> 08:35:16,000 TO LEAVE OUR MEDICARE ADVANTAGE 13078 08:35:16,001 --> 08:35:18,000 PLANS ALONE. 13079 08:35:18,001 --> 08:35:21,000 WE CAN'T AFFORD ANYTHING ELSE AS 13080 08:35:21,001 --> 08:35:23,000 OUR PORTFOLIO IS WIPED OUT IN 13081 08:35:23,001 --> 08:35:24,000 THE STOCK MARKET CLAPSE LAST YEAR. 13082 08:35:24,001 --> 08:35:27,000 MY WIFE AND I HAVE HAD TO GO 13083 08:35:27,001 --> 08:35:28,000 BACK TO WORK, AND WE ARE IN OUR 13084 08:35:28,001 --> 08:35:30,000 70'S." 13085 08:35:30,001 --> 08:35:32,000 AND YET THIS BILL WOULD IMPOSE 13086 08:35:32,001 --> 08:35:34,000 ANOTHER $122 PER MONTH CUT IN 13087 08:35:34,001 --> 08:35:38,000 THEIR BENEFITS. 13088 08:35:38,001 --> 08:35:40,000 ANOTHER CONSTITUENT OF MINE FROM 13089 08:35:40,001 --> 08:35:42,000 CONROE, TEXAS, WROTE "PLEASE DO 13090 08:35:42,001 --> 08:35:43,000 WHAT YOU CAN TO PROBING THE 13091 08:35:43,001 --> 08:35:46,000 MEDICARE ADVANTAGE -- TO PROTECT 13092 08:35:46,001 --> 08:35:47,000 THE MEDICARE ADVANTAGE 13093 08:35:47,001 --> 08:35:49,000 I'M ON ONE. 13094 08:35:49,001 --> 08:35:50,000 IT'S SAVED ME AN ENORMOUS AMOUNT 13095 08:35:50,001 --> 08:35:53,000 OF MONEY AND GIVEN ME THE 13096 08:35:53,001 --> 08:35:55,000 BENEFITS THAT I'VE NEEDED." 13097 08:35:55,001 --> 08:35:56,000 SOME GROUPS THAT SUPPORT THESE 13098 08:35:56,001 --> 08:35:57,000 CUTS TO MEDICARE ADVANTAGE HAVE 13099 08:35:57,001 --> 08:35:59,000 A CONFLICT OF INTEREST, TO SAY 13100 08:35:59,001 --> 08:36:01,000 THE LEAST, BECAUSE THE BENEFITS 13101 08:36:01,001 --> 08:36:03,000 UNDER TRADITIONAL 13102 08:36:03,001 --> 08:36:05,000 FEE-FOR-SERVICE, AS I MENTIONED, 13103 08:36:05,001 --> 08:36:06,000 FOR MEDICARE IS ABOUT 80% OF 13104 08:36:06,001 --> 08:36:07,000 WHAT PRIVATE INSURANCE WILL PAY 13105 08:36:07,001 --> 08:36:09,000 IN ORDER T GET COVERAGE, IN 13106 08:36:09,001 --> 08:36:12,000 ORDER TO PAY THE BILLS MANY 13107 08:36:12,001 --> 08:36:14,000 SENIORS HAVE HAD TO BUY 13108 08:36:14,001 --> 08:36:16,000 ADDITIONAL INSURANCE COVERAGE. 13109 08:36:16,001 --> 08:36:18,000 FOR 11 MILLION SENIORS, MEDICARE 13110 08:36:18,001 --> 08:36:21,000 ADVANTAGE PROVIDES THOSE BENEFITS. 13111 08:36:21,001 --> 08:36:23,000 FOR MANY SENIORS, FORMER 13112 08:36:23,001 --> 08:36:25,000 EMPLOYERS SOMETIMES PROVIDE 13113 08:36:25,001 --> 08:36:28,000 WRAPAROUND PLANS 13114 08:36:28,001 --> 08:36:29,000 MILITARY, TRICARE PROVIDES A 13115 08:36:29,001 --> 08:36:32,000 WRAPAROUND PLAN. 13116 08:36:32,001 --> 08:36:33,000 FOR MANY VERY LOW-INCOME 13117 08:36:33,001 --> 08:36:34,000 SENIORS, MEDICAID HELPS WITH 13118 08:36:34,001 --> 08:36:37,000 COST SHARING AND PREMIUMS. 13119 08:36:37,001 --> 08:36:42,000 AND FOR MANY OTHER SENIORS THEY 13120 08:36:42,001 --> 08:36:44,000 PURCHASE A STANDALONE MEDIGAP POLICY. 13121 08:36:44,001 --> 08:36:46,000 WE HEARD FROM FRIENDS ACROSS THE 13122 08:36:46,001 --> 08:36:47,000 AISLE ABOUT AARP'S MEDICARE CUTS 13123 08:36:47,001 --> 08:36:50,000 IN THE REID BILL. 13124 08:36:50,001 --> 08:36:51,000 IF IT SOUNDS ODD THAT A S 13125 08:36:51,001 --> 08:36:54,000 ADVOCACY GROUP WOULD SUPPORT 13126 08:36:54,001 --> 08:36:55,000 TAKING NEARLY $500 BILLION FROM 13127 08:36:55,001 --> 08:36:58,000 AN ALREADY NEARLY BANKRUPT 13128 08:36:58,001 --> 08:37:01,000 MEDICARE PROGRAM, IT SHOULD. 13129 08:37:01,001 --> 08:37:04,000 THE FACT OF 13130 08:37:04,001 --> 08:37:08,000 "THE WASHINGTON POST" NOTED 13131 08:37:08,001 --> 08:37:10,000 OCTOBER 27, THE "POST" SAYS BUT 13132 08:37:10,001 --> 08:37:11,000 NOT ADVERTISED IN ITS LOBBYING 13133 08:37:11,001 --> 08:37:13,000 CAMPAIGN HAVE BEEN AARP'S 13134 08:37:13,001 --> 08:37:15,000 SUBSTANTIAL EARNINGS FROM 13135 08:37:15,001 --> 08:37:18,000 INSURANCE ROYALTIES AND THE POTENTIAL BENEFITS THAT COULD 13136 08:37:18,001 --> 08:37:19,000 COME ITS WAY FROM MANY OF THE 13137 08:37:19,001 --> 08:37:22,000 REFORM PROPOSALS. 13138 08:37:22,001 --> 08:37:23,000 DEMOCRATIC PROPOSALS TO SLASH 13139 08:37:23,001 --> 08:37:24,000 REIMBURSEMENTS FOR ANOTHER 13140 08:37:24,001 --> 08:37:26,000 PROGRAM CALLED MEDICARE 13141 08:37:26,001 --> 08:37:29,000 ADVANTAGE ARE WIDELY EXPECTED TO 13142 08:37:29,001 --> 08:37:32,000 DRIVE UP DEMAND 13143 08:37:32,001 --> 08:37:37,000 MEDIGAP COVERAGE, LIKE THE ONES 13144 08:37:37,001 --> 08:37:41,000 OFFERED BY AARP, ACCORDING TO 13145 08:37:41,001 --> 08:37:44,000 HEALTH CARE EXPERTS, LEGISLATIVE 13146 08:37:44,001 --> 08:37:47,000 AIDES AND DOCUMENTS." 13147 08:37:47,001 --> 08:37:52,000 SO AARP, THE SO-CALLED SENIORS' 13148 08:37:52,001 --> 08:37:55,000 ADVOCACY GROUP THAT'S ADVOCATED 13149 08:37:55,001 --> 08:37:56,000 FOR CUT IN THE BENEFITS TO 11 IS 13150 08:37:56,001 --> 08:37:57,000 MILLION BENEFICIARIES OF 13151 08:37:57,001 --> 08:37:59,000 MEDICARE ADVANTAGE, A SUGGESTION 13152 08:37:59,001 --> 08:38:00,000 IS ONE REASON THEY WILL DO SO IS 13153 08:38:00,001 --> 08:38:02,000 BECAUSE THEY WILL PROFIT FROM 13154 08:38:02,001 --> 08:38:04,000 THIS BILL BECAUSE THESE SENIORS 13155 08:38:04,001 --> 08:38:06,000 WILL, IF THEY CAN AFFORD IT, 13156 08:38:06,001 --> 08:38:09,000 HAVE TO GO OUT AND BUY MEDIGAP 13157 08:38:09,001 --> 08:38:12,000 COVERAGE FROM, LO AND BEHOLD, 13158 08:38:12,001 --> 08:38:13,000 ENTIES LIKE AARP. 13159 08:38:13,001 --> 08:38:14,000 THE FACT OF THE MATTER IS 13160 08:38:14,001 --> 08:38:17,000 MEDICARE ADVANTAGE ALLOWS 13161 08:38:17,001 --> 08:38:19,000 PRIVATE PLANS TO INNOVATE BETTER 13162 08:38:19,001 --> 08:38:20,000 AND PROVIDES BETTER COORDINATED 13163 08:38:20,001 --> 08:38:25,000 CARE FOR SENIORS. 13164 08:38:25,001 --> 08:38:28,000 GROUPS LIKE THE KELSEY SEABOLD 13165 08:38:28,001 --> 08:38:33,000 CLINIC IN HOUSTON, TEXAS, WHICH 13166 08:38:33,001 --> 08:38:35,000 IS BASICALLY NOT SEEING MEDICARE 13167 08:38:35,001 --> 08:38:36,000 FEE-FOR-SERVICE PATIENTS BUT IS 13168 08:38:36,001 --> 08:38:37,000 SEEING MEDICARE ADVANTAGE 13169 08:38:37,001 --> 08:38:40,000 PAENTS BECAUSE THEY CAN AFFORD 13170 08:38:40,001 --> 08:38:42,000 TO COORDINATE CARE, THE KINDS OF 13171 08:38:42,001 --> 08:38:43,000 THINGS WE KNOW THEY OUGHT TO BE 13172 08:38:43,001 --> 08:38:45,000 DOING TO PROVIDE BETTER CARE, 13173 08:38:45,001 --> 08:38:47,000 BUT THEY CAN'T AFFORD TO DO I 13174 08:38:47,001 --> 08:38:49,000 ON THE FEE-FOR-SERVICE OF MEDICARE. 13175 08:38:49,001 --> 08:38:51,000 WE'VE HAD THE MEDICARE PROGRAM 13176 08:38:51,001 --> 08:38:53,000 AROUND FOR MORE THAN 40 YEARS, 13177 08:38:53,001 --> 08:38:54,000 AND THE FACT IS THAT GOVERNMENT 13178 08:38:54,001 --> 08:38:57,000 BUREAUCRS ARE STILL TRYING TO 13179 08:38:57,001 --> 08:39:00,000 GET THE COMPLEX REIMBURSEMENT 13180 08:39:00,001 --> 08:39:02,000 FORMULAS RIGHT. 13181 08:39:02,001 --> 08:39:04,000 WE KNOW, CHAIRMAN OF THE FINANCE 13182 08:39:04,001 --> 08:39:06,000 COMMITTEE HAS SAID, THAT UNDER 13183 08:39:06,001 --> 08:39:07,000 THE FEE-FOR-SERVICE PROGRAM, 13184 08:39:07,001 --> 08:39:10,000 WHICH IS PART OF WHAT NEEDS TO 13185 08:39:10,001 --> 08:39:13,000 BE REFORMED IN THIS HEALTH CARE 13186 08:39:13,001 --> 08:39:15,000 BILL, MEDICARE PAYS FOR VOLUME 13187 08:39:15,001 --> 08:39:17,000 AND NOT VALUE. 13188 08:39:17,001 --> 08:39:19,000 NOW, SOME OF THE POSITIVE THINGS 13189 08:39:19,001 --> 08:39:21,000 WHICH I'VE COMPLIMENTED THE BILL 13190 08:39:21,001 --> 08:39:24,000 ON IS IT INCLUDES SOME SMALL 13191 08:39:24,001 --> 08:39:28,000 STEPS TO CHANGE OUR CURRENT PAY 13192 08:39:28,001 --> 08:39:31,000 FOR VOLUME PROGRAM TO A 13193 08:39:31,001 --> 08:39:33,000 PAY-PER-VALUE APTPROEFP THROUGH 13194 08:39:33,001 --> 08:39:34,000 VARIOUS DELIVER SYSTEM REFORM 13195 08:39:34,001 --> 08:39:35,000 DEMONSTRATION PROGRAMS. 13196 08:39:35,001 --> 08:39:37,000 THE IRONY IS MEDICARE DIDN'T 13197 08:39:37,001 --> 08:39:40,000 THINK OF THESE SYSTEM REFORMS. 13198 08:39:40,001 --> 08:39:41,000 RATHER, WASHINGTON IS FINALLY 13199 08:39:41,001 --> 08:39:42,000 CATCHING UP ON WHAT 13200 08:39:42,001 --> 08:39:43,000 PRIVATE-SECTOR INNOVATORS HAVE 13201 08:39:43,001 --> 08:39:46,000 BEEN DOING FOR YEARS. 13202 08:39:46,001 --> 08:39:49,000 WE HEARD THE DISTINGUISHED SENATOR FROM MINNESOTA TALK 13203 08:39:49,001 --> 08:39:50,000 ABOUT THE MAYO CLINIC. 13204 08:39:50,001 --> 08:39:51,000 MAYO CLINIC'S HAS BEEN DOING 13205 08:39:51,001 --> 08:39:54,000 THAT. 13206 08:39:54,001 --> 08:39:55,000 I MENTIONED KELSEY SEABOLD IN 13207 08:39:55,001 --> 08:39:56,000 HOUSTON, TEXAS. 13208 08:39:56,001 --> 08:39:58,000 PRIVATE-SECTOR INNOVATORS HAVE 13209 08:39:58,001 --> 08:39:59,000 BEEN DOING THIS THROUGH THE 13210 08:39:59,001 --> 08:40:01,000 MEDICARE ADVANTAGE PROGRAM ALREADY. 13211 08:40:01,001 --> 08:40:03,000 THE DELIVERY SYSTEM REFORMS IN 13212 08:40:03,001 --> 08:40:05,000 THE REID BILL WOULD ALLOW 13213 08:40:05,001 --> 08:40:07,000 MEDICARE TO EXPERIMENT WITH 13214 08:40:07,001 --> 08:40:08,000 DIFFERENT APPROACHES TO CHANGING 13215 08:40:08,001 --> 08:40:10,000 PHYSICIAN INCENTIVES SUCH AS 13216 08:40:10,001 --> 08:40:13,000 ACCOUNTABLE CARE ORGANIZATIONS 13217 08:40:13,001 --> 08:40:14,000 OR PHYSICIAN QUALITY REPORTING INITIATIVE. 13218 08:40:14,001 --> 08:40:16,000 WILL THEY WORK? 13219 08:40:16,001 --> 08:40:19,000 WELL, I HAPPEN TO THINK THEY WILL. 13220 08:40:19,001 --> 08:40:20,000 BUT WE DO KNOW THAT 13221 08:40:20,001 --> 08:40:22,000 PRIVATE-SECTOR INNOVATORS HAVE 13222 08:40:22,001 --> 08:40:23,000 ALREADY FIGURED OUT HOW TO 13223 08:40:23,001 --> 08:40:25,000 CHANGE PHYSICIAN INCENTIVES IN 13224 08:40:25,001 --> 08:40:27,000 THE SORTS OF WAYS THAT WE REALLY 13225 08:40:27,001 --> 08:40:30,000 OUGHT TO BE DOING MORE OF AND 13226 08:40:30,001 --> 08:40:32,000 NOT PUNISHING BY CUTTING 13227 08:40:32,001 --> 08:40:35,000 MEDICARE ADVANTAGE. 13228 08:40:35,001 --> 08:40:36,000 ONE MEDICARE ADVANTAGE PLAN 13229 08:40:36,001 --> 08:40:37,000 HEALTH SPRING SERVES 20,000 13230 08:40:37,001 --> 08:40:38,000 SENIORS IN MY STATE. 13231 08:40:38,001 --> 08:40:40,000 THEY HAVE BEEN A LEADER IN 13232 08:40:40,001 --> 08:40:43,000 CHANGING THE INCENTIVES FOR 13233 08:40:43,001 --> 08:40:44,000 PHYSICIANS TO FOCUS ON QUALITY 13234 08:40:44,001 --> 08:40:47,000 RATHER THAN QUANTITY. 13235 08:40:47,001 --> 08:40:50,000 I MET WITH THEIR LEADERSHIP AND 13236 08:40:50,001 --> 08:40:52,000 HEARD HOW THEY'VE DONE IT. 13237 08:40:52,001 --> 08:40:53,000 WHAT THEY'VE KNOLLED ME IS 13238 08:40:53,001 --> 08:40:54,000 THEY'RE -- TOLD ME IS THEY ARE A 13239 08:40:54,001 --> 08:40:55,000 COLLABORIVE PARTNERSHIP WITH 13240 08:40:55,001 --> 08:40:57,000 THEIR PHYSICIANS. 13241 08:40:57,001 --> 08:40:58,000 THEY CALL IT PARTNERSHIP FOR QUALITY. 13242 08:40:58,001 --> 08:41:02,000 PHYSICIANS ARE ACCOUNTABLE FOR 13243 08:41:02,001 --> 08:41:03,000 BOTH COST AND QUALITY BASED ON 13244 08:41:03,001 --> 08:41:04,000 EVIDENCE-BASED SETS OF QUALITY 13245 08:41:04,001 --> 08:41:06,000 MEASURES. 13246 08:41:06,001 --> 08:41:08,000 THE RESULTS ARE A WIN-WIN. 13247 08:41:08,001 --> 08:41:10,000 BETTER QUALITY CARE IS LEADING 13248 08:41:10,001 --> 08:41:13,000 TO HEALTHIER SENIORS AND 13249 08:41:13,001 --> 08:41:14,000 PHYSICIANS TO SUCCEED IN MEETING 13250 08:41:14,001 --> 08:41:16,000 EVIDENCE-BASED QUALITY STANDARDS 13251 08:41:16,001 --> 08:41:18,000 AND ULTIMATELY LOWER HEALTH CARE 13252 08:41:18,001 --> 08:41:19,000 COSTS, WHICH I THOUGHT WAS 13253 08:41:19,001 --> 08:41:22,000 SUPPOSED TO BE ONE OF THE GOALS 13254 08:41:22,001 --> 08:41:25,000 OF HEALTH CARE REFORM. 13255 08:41:25,001 --> 08:41:27,000 PARTICIPATING PHYSICIANS WERE 13256 08:41:27,001 --> 08:41:29,000 PAID FINANCIAL INCENTIVES FOR 13257 08:41:29,001 --> 08:41:32,000 MEETING THEIR GOAL, BUT AS A 13258 08:41:32,001 --> 08:41:34,000 RESULT OF COORDINATION OF CARE 13259 08:41:34,001 --> 08:41:35,000 AND EVIDENCE-BASED QUALITY 13260 08:41:35,001 --> 08:41:39,000 STANDARDS, THEY ACTUALLY ENDED 13261 08:41:39,001 --> 08:41:40,000 UP CHARGING LESS. 13262 08:41:40,001 --> 08:41:41,000 AND PATIENTS EXPERIENCED BETTER 13263 08:41:41,001 --> 08:41:43,000 RESULTS TOO. 13264 08:41:43,001 --> 08:41:45,000 MEMBERS NEEDED FEWER 13265 08:41:45,001 --> 08:41:47,000 HOSPITALIZATIONS AND EMERGENCY 13266 08:41:47,001 --> 08:41:49,000 ROOM VISITS. 13267 08:41:49,001 --> 08:41:52,000 PREVENTIVE MEASURES INCREASED 13268 08:41:52,001 --> 08:41:56,000 MAMMOGRAMS BY 80%, DIABETIC FOOT 13269 08:41:56,001 --> 08:41:58,000 EXAMS BY 360%, AND FLU 13270 08:41:58,001 --> 08:42:01,000 VACCINATIONS BY 246%. 13271 08:42:01,001 --> 08:42:05,000 I'VE HEARD ABOUT HEALTH SPRINGS 13272 08:42:05,001 --> 08:42:07,000 SUCCESS FROM A COUPLE AT FARMERS 13273 08:42:07,001 --> 08:42:08,000 BRANCHES, TEXAS, WHO RECENTLY 13274 08:42:08,001 --> 08:42:10,000 WROTE TO ME. 13275 08:42:10,001 --> 08:42:11,000 THEY SAID WE HAD A MEDICARE 13276 08:42:11,001 --> 08:42:13,000 SUPPLEMENTAL POLICY FOR SEVERAL 13277 08:42:13,001 --> 08:42:15,000 YEARS UNTIL THEY PRICED 13278 08:42:15,001 --> 08:42:17,000 THEMSELVES OUT OF THE MARKET. 13279 08:42:17,001 --> 08:42:19,000 FOR NOW WITH A MEDICARE 13280 08:42:19,001 --> 08:42:20,000 ADVANTAGE PLAN CALLED HEALTH 13281 08:42:20,001 --> 08:42:21,000 SPRING, AND WE'VE BEEN VERY 13282 08:42:21,001 --> 08:42:23,000 HAPPY WITH THIS PLAN AND THE WAY 13283 08:42:23,001 --> 08:42:25,000 THEY ARE SAVING US MONEY. 13284 08:42:25,001 --> 08:42:26,000 PLEASE DO NOT CHANGE OR 13285 08:42:26,001 --> 08:42:27,000 ELIMINATE THIS PROGRAM, THEY 13286 08:42:27,001 --> 08:42:28,000 SAID. 13287 08:42:28,001 --> 08:42:32,000 LET ME TELL YOU ABOUT ONE OTHER 13288 08:42:32,001 --> 08:42:35,000 TEXAS COMPANY CALLED WELLMED. 13289 08:42:35,001 --> 08:42:38,000 WHILE THE REID BILL WOULD 13290 08:42:38,001 --> 08:42:40,000 FINALLY GIVE MEDICARE THE 13291 08:42:40,001 --> 08:42:42,000 ABILITY TO EXPERIMENT WITH 13292 08:42:42,001 --> 08:42:44,000 MEDICAL HOMES AND CARE 13293 08:42:44,001 --> 08:42:45,000 COORDINATION, A SAN 13294 08:42:45,001 --> 08:42:47,000 ANTONIO-BASED COMPANY CALLED 13295 08:42:47,001 --> 08:42:49,000 WELL MED HAS BEEN USING A 13296 08:42:49,001 --> 08:42:51,000 MEDICAL HOME MODEL TO COORDINATE 13297 08:42:51,001 --> 08:42:52,000 PATIENT CARE AND EMPHASIZE 13298 08:42:52,001 --> 08:42:54,000 PREVENTION FOR NEARLY 20 YEARS. 13299 08:42:54,001 --> 08:42:59,000 TO QUOTE FROM AN ARTICLE LAST 13300 08:42:59,001 --> 08:43:00,000 MONTH IN "INSIDE SAN ANTONIO," 13301 08:43:00,001 --> 08:43:01,000 THE HEALTH CARE DELIVERY MODEL 13302 08:43:01,001 --> 08:43:03,000 AT WELL MED PUTS THE PATIENT AT 13303 08:43:03,001 --> 08:43:05,000 THE CENTER OF THE TEAM DIRECD 13304 08:43:05,001 --> 08:43:07,000 BY A PRIMARY CARE PHYSICIAN. 13305 08:43:07,001 --> 08:43:10,000 THAT TEAM MAY INCLUDE A NURSE, A 13306 08:43:10,001 --> 08:43:12,000 HEALTH COACH, A HOSPITALLIST, A 13307 08:43:12,001 --> 08:43:13,000 SOCIAL SERVICE WORKER A A 13308 08:43:13,001 --> 08:43:15,000 PHYSICIAN ASSISTANT. 13309 08:43:15,001 --> 08:43:17,000 ACCORDING TO WELL MED'S C.E.O., 13310 08:43:17,001 --> 08:43:19,000 WE REALLY DO HAVE TO BRING BACK 13311 08:43:19,001 --> 08:43:22,000 THE OLD-TIME PRIMARY CARE 13312 08:43:22,001 --> 08:43:23,000 DOCTORS WHO CARED FOR YOU, WHO 13313 08:43:23,001 --> 08:43:25,000 IS CONCERNED ABOUT YOU, WHO IS 13314 08:43:25,001 --> 08:43:27,000 PART OF YOUR FAMILY AND YOU WERE 13315 08:43:27,001 --> 08:43:29,000 PART OF THEIR FAMILY. 13316 08:43:29,001 --> 08:43:31,000 IT'S THE PRIMARY CARE PHYSICIAN 13317 08:43:31,001 --> 08:43:35,000 WHO KNOWS ALL ABOUT YOU. 13318 08:43:35,001 --> 08:43:37,000 SO IF YOU NEED A SPECIALT, IF 13319 08:43:37,001 --> 08:43:38,000 YOU KNOW -- THEY KNOW THE BEST 13320 08:43:38,001 --> 08:43:39,000 SPECIALIST TO SEND TO YOU. 13321 08:43:39,001 --> 08:43:41,000 IF YOU NEED TO GO TO THE 13322 08:43:41,001 --> 08:43:42,000 HOSPITAL, THEY MAKE SURE YOU GET 13323 08:43:42,001 --> 08:43:45,000 THE APPROPRIATE CARE AT THE RIGHT HOSPITAL. 13324 08:43:45,001 --> 08:43:47,000 THEY ARE A COORDINATOR OF YOUR CARE. 13325 08:43:47,001 --> 08:43:49,000 AND THAT'S REALLY THE CONCEPT OF 13326 08:43:49,001 --> 08:43:50,000 THE MEDICAL HOME. 13327 08:43:50,001 --> 08:43:52,000 THERE'S NO QUESTION IN MY MIND 13328 08:43:52,001 --> 08:43:55,000 THAT THIS MODEL HAS BEEN SAVING 13329 08:43:55,001 --> 08:43:59,000 LIVES IN MY STATE. 13330 08:43:59,001 --> 08:44:01,000 HERE'S A STORY ABOUT ONE TEXANS 13331 08:44:01,001 --> 08:44:03,000 WHOSE LIFE WAS SAVED BY 13332 08:44:03,001 --> 08:44:04,000 PHYSICIANS CARING FOR HIM AT 13333 08:44:04,001 --> 08:44:08,000 WELL MED. 13334 08:44:08,001 --> 08:44:11,000 "FOR YEARS CROHN'S DISEASE 13335 08:44:11,001 --> 08:44:13,000 WEAKENED" -- WE'LL CALL HIM 13336 08:44:13,001 --> 08:44:14,000 ED -- "AND LEFT HIM SUSCEPTIBLE 13337 08:44:14,001 --> 08:44:16,000 TO INFECTIONS. 13338 08:44:16,001 --> 08:44:18,000 ONE MORNING IN 2001 HE LACKED 13339 08:44:18,001 --> 08:44:21,000 ENERGY TO EVEN GET OUT OF BED. 13340 08:44:21,001 --> 08:44:22,000 HIS BREATHING BAKE LABORED AND 13341 08:44:22,001 --> 08:44:24,000 HE DEVELOPED -- BECAME LABORED 13342 08:44:24,001 --> 08:44:25,000 AND HE DEVELOPED A COUGH WHICH 13343 08:44:25,001 --> 08:44:29,000 SOUNDED WET. 13344 08:44:29,001 --> 08:44:30,000 HIS WORRIED WIFE CALLED HIS 13345 08:44:30,001 --> 08:44:33,000 PRIMARY PHYSICIAN AT WELL MED 13346 08:44:33,001 --> 08:44:35,000 WHO WANTED ED HOSPITALIZED 13347 08:44:35,001 --> 08:44:37,000 IMMEDIATELY SO SHE COULD ORDER A 13348 08:44:37,001 --> 08:44:38,000 NUCLEAR SCAN OF HIS LUNGS, BUT 13349 08:44:38,001 --> 08:44:40,000 HE PROTESTED. 13350 08:44:40,001 --> 08:44:43,000 SHE TOLD ME IF HE REFUSED TO GO 13351 08:44:43,001 --> 08:44:44,000 I SHOULD CALL 911 AND HAVE THE 13352 08:44:44,001 --> 08:44:46,000 PARAMEDICS COME GET HIM. 13353 08:44:46,001 --> 08:44:48,000 HIS WIFE, ANNETTE, SAID SHE 13354 08:44:48,001 --> 08:44:53,000 HEARD DR. SANCHEZ TALK TO GO ME. 13355 08:44:53,001 --> 08:44:54,000 THE URGENCY IN H 13356 08:44:54,001 --> 08:44:57,000 -- 13357 08:44:57,001 --> 08:44:59,000 THE SCAN CONFIRMED THE DOCTOR'S 13358 08:44:59,001 --> 08:45:01,000 SUSPICION: A POTENTIALLY FATAL 13359 08:45:01,001 --> 08:45:03,000 BLOOD CLOT HAD TRAVELED FROM HIS 13360 08:45:03,001 --> 08:45:05,000 LEG TO HIS LUNGS. 13361 08:45:05,001 --> 08:45:07,000 FORTUNATELY, HE WAS SUCCESSFULLY 13362 08:45:07,001 --> 08:45:10,000 EATED AND RECOVERED AND ED AND 13363 08:45:10,001 --> 08:45:12,000 HIS WIFE RECENTLY CELEBRATED HIS 13364 08:45:12,001 --> 08:45:15,000 74th BIRTHDAY. 13365 08:45:15,001 --> 08:45:16,000 NOW, ANNETTE CREDITS DR. SANCHEZ 13366 08:45:16,001 --> 08:45:18,000 FOR SAVING HER HUSBAND, ED'S 13367 08:45:18,001 --> 08:45:20,000 LIFE AND FOR ACTING AS A 13368 08:45:20,001 --> 08:45:23,000 CATALYST THAT KEEPS HIM THRIVING 13369 08:45:23,001 --> 08:45:24,000 EVEN IN HIS GOLDEN YEARS. 13370 08:45:24,001 --> 08:45:26,000 SHE SAID, WE'VE SEEN AN 13371 08:45:26,001 --> 08:45:29,000 ABUNDANCE OF DOCTORS FROM THE 13372 08:45:29,001 --> 08:45:30,000 CANCER DOCTORS TO THE 13373 08:45:30,001 --> 08:45:31,000 DERMATOLOGIST, GASTRO 13374 08:45:31,001 --> 08:45:33,000 ENTEROLOGIST, THE BLOOD DOCTOR, 13375 08:45:33,001 --> 08:45:34,000 THE HEART SPECIALIST. 13376 08:45:34,001 --> 08:45:37,000 ED HAS GONE THROUGH IT ALL. 13377 08:45:37,001 --> 08:45:38,000 AND THEY'VE ALL BEEN COORDINATED 13378 08:45:38,001 --> 08:45:40,000 BY HIS PRIMARY CAREOCTOR. 13379 08:45:40,001 --> 08:45:43,000 I'VE BEEN TO OTHER DOCTORS 13380 08:45:43,001 --> 08:45:45,000 OUTSIDE OF WELL MED AND YOU 13381 08:45:45,001 --> 08:45:47,000 DON'T GET THE FEELING THAT THEY 13382 08:45:47,001 --> 08:45:48,000 ARE COMMUNICATING LIKE THIS. 13383 08:45:48,001 --> 08:45:50,000 WELL, MANY TEXAS SENIORS 13384 08:45:50,001 --> 08:45:53,000 CURRENTLIEN JOY THESE EXTRA 13385 08:45:53,001 --> 08:45:55,000 BENEFITS UNDER MEDICARE 13386 08:45:55,001 --> 08:45:58,000 ADVANTAGE LIKE ANOTHER BENEFIT 13387 08:45:58,001 --> 08:45:59,000 -- LIKE THE SILVER SNEAKERS 13388 08:45:59,001 --> 08:46:02,000 PROGRAM, THE NATION'S LEADING 13389 08:46:02,001 --> 08:46:06,000 EXERCISE PROGRAM FOR OLDER AMERICANS. 13390 08:46:06,001 --> 08:46:07,000 THIS PAST YEAR ONE OF THE SILVER 13391 08:46:07,001 --> 08:46:09,000 SNEAKERS MEMBERS PERSONALLY 13392 08:46:09,001 --> 08:46:12,000 VISITED MY TOFFS DELER 13393 08:46:12,001 --> 08:46:13,000 TESTIMONIALS FROM OTHER SILVER 13394 08:46:13,001 --> 08:46:14,000 SNEAKERS MEMBERS. 13395 08:46:14,001 --> 08:46:16,000 ONE SAID "AT MY AGE, I NEED A 13396 08:46:16,001 --> 08:46:17,000 PROGRAM TO STRENGTHEN ME ALL 13397 08:46:17,001 --> 08:46:19,000 OVER BUT PRIMARILY TO HELP ME 13398 08:46:19,001 --> 08:46:20,000 KEEP MY BALANCE AND 13399 08:46:20,001 --> 08:46:21,000 COORDINATION. 13400 08:46:21,001 --> 08:46:24,000 I NEED THESE SKILLS TO KEEP ME 13401 08:46:24,001 --> 08:46:26,000 FROM FALLING AND BREAKING MY BONES." 13402 08:46:26,001 --> 08:46:28,000 ANOTHER PARTICIPANT IN THE 13403 08:46:28,001 --> 08:46:29,000 SILVER SNEAKERS PROGRAM SAID, 13404 08:46:29,001 --> 08:46:31,000 "I'M 66 AND I'VE BEEN ON THE 13405 08:46:31,001 --> 08:46:34,000 PROGRAM FOR A YEAR. 13406 08:46:34,001 --> 08:46:37,000 PRIOR TO THAT I'D HAD HAD A 13407 08:46:37,001 --> 08:46:42,000 SEDENTARY LIFE WHICH INCLUDED 13408 08:46:42,001 --> 08:46:45,000 MANY PROBLEMS: HYPERTENSION, 13409 08:46:45,001 --> 08:46:46,000 MILD DEPRESSION, HIGH BLOOD PRESSURE. 13410 08:46:46,001 --> 08:46:48,000 SINCE COMING TO THE CLASS, MY 13411 08:46:48,001 --> 08:46:50,000 LIFE HAS IMPROVED IMMENSELY. 13412 08:46:50,001 --> 08:46:52,000 MY BLOOD PRESSURE HAS DROPPED, 13413 08:46:52,001 --> 08:46:54,000 MY CHOLESTEROL HAS BEEN LOWERED, 13414 08:46:54,001 --> 08:46:56,000 MY CHRONIC BLADDER CONDITION HAS 13415 08:46:56,001 --> 08:46:57,000 IMPROVED AND I JUST FEEL BETTER 13416 08:46:57,001 --> 08:46:59,000 ALL AROUND. 13417 08:46:59,001 --> 08:47:00,000 I'M NO LONGER DEPRESSED BECAUSE 13418 08:47:00,001 --> 08:47:03,000 I LOOK BETTER AND I LOOK FORWARD 13419 08:47:03,001 --> 08:47:04,000 TO GOING TO CLASS AND VISITING 13420 08:47:04,001 --> 08:47:10,000 WITH MY FRIENDS." 13421 08:47:10,001 --> 08:47:11,000 WELL, MR. PRESIDENT, THESE CUTS 13422 08:47:11,001 --> 08:47:14,000 IN MEDICARE ADVANTAGE ARE GOING 13423 08:47:14,001 --> 08:47:16,000 TO HAVE A DIRECT IMPACT ON THE 13424 08:47:16,001 --> 08:47:21,000 BENEFITS THAT MY CONSTITUENTS IN 13425 08:47:21,001 --> 08:47:22,000 TEXAS ARE BENEFITING FROM, THE 13426 08:47:22,001 --> 08:47:24,000 532,000 TEXANS WHO ARE CURRENTLY 13427 08:47:24,001 --> 08:47:26,000 ON MEDICARE VAFNLGT WHAT THEY'RE 13428 08:47:26,001 --> 08:47:27,000 ASKING ME AND WHICH I CAN'T 13429 08:47:27,001 --> 08:47:30,000 ANSWER THEM IS, WHY IN THE WORLD 13430 08:47:30,001 --> 08:47:31,000 WOUL WE WANT TO CUT MEDICAR 13431 08:47:31,001 --> 08:47:33,000 ADVANTAGE, WHICH IS ACTUALLY -- 13432 08:47:33,001 --> 08:47:36,000 WHICH ACTUALLY WORKS AS OPPOSED 13433 08:47:36,001 --> 08:47:39,000 TO MEDICARE FEE-FOR-SERVICE 13434 08:47:39,001 --> 08:47:42,000 WHICH DOES NOT WORK WELL, TO 13435 08:47:42,001 --> 08:47:44,000 TAKE A FISCALLY UNSUSTAINABLE 13436 08:47:44,001 --> 08:47:46,000 PROGRAM LIKE MEDICARE, WHICH IS 13437 08:47:46,001 --> 08:47:50,000 GOING TO GO INSOLVED IN 2017 AND 13438 08:47:50,001 --> 08:47:51,000 USE THAT TO CREATE A $2.5 13439 08:47:51,001 --> 08:47:54,000 TRILLION NEW ENTITLEMENT PROGRAM? 13440 08:47:54,001 --> 08:47:55,000 NOW, MY CONSTITUENTS, THE 13441 08:47:55,001 --> 08:47:58,000 SENIORS WHO PAID INTO MEDICARE 13442 08:47:58,001 --> 08:48:00,000 ALL THESE YEARS, ARE SAYING, 13443 08:48:00,001 --> 08:48:03,000 IT'S NOT FAIR TO TAKE THE MONEY 13444 08:48:03,001 --> 08:48:05,000 THAT WE PAID INTO MEDICARE, TO 13445 08:48:05,001 --> 08:48:08,000 USE IT TO CREATE YET ANOTHER 13446 08:48:08,001 --> 08:48:12,000 ENTITLEMENT PROGRAM AND NOT TO 13447 08:48:12,001 --> 08:48:16,000 FIX MEDICARE ITSELF. 13448 08:48:16,001 --> 08:48:17,000 SO I BELIEVE THAT WE NEED TO FIX 13449 08:48:17,001 --> 08:48:19,000 MEDICARE'S NEARLY $38 TRILLION 13450 08:48:19,001 --> 08:48:20,000 IN UNFUNDED LIABILITIES. 13451 08:48:20,001 --> 08:48:24,000 WE NEED TO FIX THE IMPROPER 13452 08:48:24,001 --> 08:48:26,000 PAYMENT RATE OF ROUGHLY ONE OUT 13453 08:48:26,001 --> 08:48:27,000 OF EVERY TEN MEDICARE DOLLARS, 13454 08:48:27,001 --> 08:48:28,000 WHICH RESULTS IN PROBABLY 13455 08:48:28,001 --> 08:48:30,000 SOMEWHERE AROUND THE ORDER OF A 13456 08:48:30,001 --> 08:48:32,000 MINIMUM OF $60 BILLION OF 13457 08:48:32,001 --> 08:48:34,000 FRAUDULENT PAYMENTS EACH YEAR. 13458 08:48:34,001 --> 08:48:37,000 WE NEED TO PUT IT ON A FISCALLY 13459 08:48:37,001 --> 08:48:39,000 SUSTAINABLE PATH RATHER THAN 13460 08:48:39,001 --> 08:48:42,000 TAKING A HALF A TRILLION DOLLARS 13461 08:48:42,001 --> 08:48:44,000 FROM MEDICARE ON ANOTHER 13462 08:48:44,001 --> 08:48:45,000 ILL-CONCEIVED WASHINGTON HEALTH 13463 08:48:45,001 --> 08:48:47,000 CARE TAKEOVER. 13464 08:48:47,001 --> 08:48:48,000 I JUST DON'T BELIEVE, 13465 08:48:48,001 --> 08:48:49,000 MR. PRESIDENT, THAT MY 13466 08:48:49,001 --> 08:48:53,000 CONSTITUENTS BELIEVE THAT YOU 13467 08:48:53,001 --> 08:48:55,000 CAN TAKE A-A TRILLIONS OUT OF 13468 08:48:55,001 --> 08:48:56,000 THESE PROGRAMS SCWUS AS THEY 13469 08:48:56,001 --> 08:49:00,000 DON'T BELIEVE THAT YOU CAN TAKE 13470 08:49:00,001 --> 08:49:02,000 MORE THAN $100 BILLION OUT OF 13471 08:49:02,001 --> 08:49:05,000 MEDICARE ADVANTAGE AND IT WILL 13472 08:49:05,001 --> 08:49:06,000 HAVE NO IMPAC ON THERE -- ON 13473 08:49:06,001 --> 08:49:07,000 THEIR BENEFITS. 13474 08:49:07,001 --> 08:49:08,000 THEY JUST DON'T BUY IT. 13475 08:49:08,001 --> 08:49:09,000 THEY JUST DON'T BELIEVE IT AND I 13476 08:49:09,001 --> 08:49:10,000 DON'T EITHER. 13477 08:49:10,001 --> 08:49:12,000 MR. PRESID 13478 08:49:12,001 --> 08:49:13,000 FLOOR. 13479 08:49:13,001 --> 08:49:17,000 THE PRESIDING OFFICER: THE 13480 08:49:17,001 --> 08:49:18,000 SENATOR IOWA. 13481 08:49:18,001 --> 08:49:19,000 MR. GRASSLEY: MR. PRESIDENT, 13482 08:49:19,001 --> 08:49:21,000 IT IS LATE IN THE EVENING. 13483 08:49:21,001 --> 08:49:22,000 I WAS GOING TO ADDRESS THREE 13484 08:49:22,001 --> 08:49:23,000 DIFFERENT ISSUES TONIGHT, BUT 13485 08:49:23,001 --> 08:49:25,000 OUT OF RESPECT FOR SENATOR 13486 08:49:25,001 --> 08:49:26,000 BAUCUS, THE CHAIRMAN OF MY 13487 08:49:26,001 --> 08:49:28,000 COMMITTEE, I'M GOING TO ADDRESS 13488 08:49:28,001 --> 08:49:31,000 JUST ONE OF THE ISSUES AND I'LL 13489 08:49:31,001 --> 08:49:32,000 COME BACK TOMORROW MORNING ON 13490 08:49:32,001 --> 08:49:33,000 SATURDAY AND SPEAK ON THE REST 13491 08:49:33,001 --> 08:49:35,000 OF THE ISSUES. 13492 08:49:35,001 --> 08:49:38,000 SO I'M GOING TO -- THE ONE ISSUE 13493 08:49:38,001 --> 08:49:41,000 I'M GOING TO ADDRESS THIS 13494 08:49:41,001 --> 08:49:44,000 EVENING IS TO SUPPORT THE 13495 08:49:44,001 --> 08:49:50,000 SENATOR FROM NEBRASKA'S MOTION 13496 08:49:50,001 --> 08:49:54,000 TO COMMIT WITH INSTRUCTIONS ON 13497 08:49:54,001 --> 08:49:56,000 THIS 2,074-PAGE BILL. 13498 08:49:56,001 --> 08:49:57,000 THAT'S SENATOR JOHANNS' AMENDMENT. 13499 08:49:57,001 --> 08:50:00,000 WE'RE NOW CONSIDERING A BILL 13500 08:50:00,001 --> 08:50:01,000 THAT CUTS A HALF A TRILLION 13501 08:50:01,001 --> 08:50:04,000 DOLLARS FROM THE MEDICARE 13502 08:50:04,001 --> 08:50:05,000 PROGRAM TO FUND YET ANOTHER 13503 08:50:05,001 --> 08:50:07,000 UNSUSTAINABLE HEALTH CARE 13504 08:50:07,001 --> 08:50:10,000 ENTITLEMENT PROGRAM. 13505 08:50:10,001 --> 08:50:13,000 AROUND $42 BILLION COMES FROM 13506 08:50:13,001 --> 08:50:17,000 CUTS TO HOME HEALTH CARE PROVIDERS. 13507 08:50:17,001 --> 08:50:20,000 HENCE, THE PURPOSE OF SENATOR 13508 08:50:20,001 --> 08:50:22,000 JOHANNS' AMENDMENT THAT THAT NOT HAPPEN. 13509 08:50:22,001 --> 08:50:25,000 YOU'VE HEARD FROM MEMBERS ON 13510 08:50:25,001 --> 08:50:28,000 THIS SIDE OF THE GRAVE 13511 08:50:28,001 --> 08:50:30,000 CONSEQUENCES OF THESE CUTS. 13512 08:50:30,001 --> 08:50:33,000 SEVERAL SENATORS HAVE ALREADY ADDRESSED THESE. 13513 08:50:33,001 --> 08:50:35,000 THESE SEVERE CUTS POSE A 13514 08:50:35,001 --> 08:50:36,000 LEGITIMATE THREAT TO 13515 08:50:36,001 --> 08:50:38,000 BENEFICIARIES' ACCESS TO HOME 13516 08:50:38,001 --> 08:50:41,000 HEALTH SERVICES. 13517 08:50:41,001 --> 08:50:45,000 IN MY STATE OF IOWA ALONE, THERE 13518 08:50:45,001 --> 08:50:46,000 ARE AROUND 160 HOME HEALTH 13519 08:50:46,001 --> 08:50:48,000 AGEN 13520 08:50:48,001 --> 08:50:50,000 SEICES TO MEDICARE 13521 08:50:50,001 --> 08:50:53,000 BENEFICIARIES ACROSS 13522 08:50:53,001 --> 08:50:56,000 NOW, THANKS TO THESE HOME HEALTH 13523 08:50:56,001 --> 08:50:58,000 CARE PROVIDERS, SENIORS IN IOWA 13524 08:50:58,001 --> 08:51:01,000 ARE ABLE TO CONTINUE TO LIVE AT 13525 08:51:01,001 --> 08:51:04,000 HOME INSTEAD OF IN INSTITUTIONAL 13526 08:51:04,001 --> 08:51:06,000 SETTINGS LIKE NURSING HOMES. 13527 08:51:06,001 --> 08:51:10,000 THESE SENIORS PLACE GREAT VALUE 13528 08:51:10,001 --> 08:51:12,000 ON BEING ABLE TO STAY HOME, AND 13529 08:51:12,001 --> 08:51:14,000 I'D HAVE TO 13530 08:51:14,001 --> 08:51:17,000 THAT I'VE BEEN INVOLVED IN 13531 08:51:17,001 --> 08:51:19,000 SENIOR ISSUES, WHETHER IT'S BEEN 13532 08:51:19,001 --> 08:51:20,000 CHAIRMAN OF THE AGING COMMITTEE, 13533 08:51:20,001 --> 08:51:22,000 CHAIRMAN AND NOW 13534 08:51:22,001 --> 08:51:25,000 MEMBER OF THE FINANCE COMMITTEE, 13535 08:51:25,001 --> 08:51:27,000 I HAVEN'T RUN 13536 08:51:27,001 --> 08:51:29,000 SENIOR CITIZEN IN MY STATE THAT 13537 08:51:29,001 --> 08:51:31,000 SAID TO ME, I'M JUST DYING TO 13538 08:51:31,001 --> 08:51:33,000 GET INTO A NURSING HOME. 13539 08:51:33,001 --> 08:51:35,000 THEY DON'T WANT TO GO THERE. 13540 08:51:35,001 --> 08:51:38,000 SO, THAT'S THE PURPOSE OF HOME 13541 08:51:38,001 --> 08:51:41,000 HEALTH AGENCIES, TO SAVE MONEY 13542 08:51:41,001 --> 08:51:42,000 BUT ALSO TO RETAIN QUALITY OF 13543 08:51:42,001 --> 08:51:45,000 LIFE AND MAINTAIN QUALITY OF 13544 08:51:45,001 --> 08:51:48,000 LIFE. 13545 08:51:48,001 --> 08:51:54,000 FOR THESE CITIZENS. 13546 08:51:54,001 --> 08:51:56,000 I RARELY HEAR 13547 08:51:56,001 --> 08:51:57,000 ANYTHING ABOUT LIVING IN A 13548 08:51:57,001 --> 08:51:59,000 NURSING HOME EXCEPT NOT TO GO 13549 08:51:59,001 --> 08:52:01,000 THERE. 13550 08:52:01,001 --> 08:52:04,000 AND SINCE LIVING AT HOME HAS 13551 08:52:04,001 --> 08:52:06,000 BEEN FOUND TO BE A MORE 13552 08:52:06,001 --> 08:52:08,000 COST-EFFECTIVE ALTERNATIVE THAN 13553 08:52:08,001 --> 08:52:11,000 INSTITUTIONAL CARE, THIS RESULTS 13554 08:52:11,001 --> 08:52:15,000 IN MEDICARE SPENDING LESS. 13555 08:52:15,001 --> 08:52:17,000 THESE CUTS THAT ARE IN THIS 13556 08:52:17,001 --> 08:52:21,000 2,074-PAGE REID BILL WILL MAKE 13557 08:52:21,001 --> 08:52:22,000 IT EVEN HARDER FOR IOWA HOME 13558 08:52:22,001 --> 08:52:25,000 HEALTH CARE PROVIDERS TO CARE 13559 08:52:25,001 --> 08:52:30,000 FOR MEDICARE BENEFICIA 13560 08:52:30,001 --> 08:52:32,000 A GOOD PART OF MEDICARE 13561 08:52:32,001 --> 08:52:34,000 CUTS COME FROM PRODUCTIVITY ADJUSTMENT. 13562 08:52:34,001 --> 08:52:39,000 LET'S LOOK AT THE POSSIBILITY -- 13563 08:52:39,001 --> 08:52:40,000 OR I'LL SAY, I'VE CONCLUDED, THE 13564 08:52:40,001 --> 08:52:44,000 IMPOSSIBILITY OF BRINGING 13565 08:52:44,001 --> 08:52:46,000 GREATER PRODUCTIVITY TO NURSING 13566 08:52:46,001 --> 08:52:48,000 HOME CARE. 13567 08:52:48,001 --> 08:52:51,000 YOU'VE HEARD THIS WEEK ABOUT HOW 13568 08:52:51,001 --> 08:52:53,000 MEDICARE'S CHIEF 13569 08:52:53,001 --> 08:52:57,000 THAT SAVINGS FROM THESE 13570 08:52:57,001 --> 08:53:02,000 PRODUCTIVITY 13571 08:53:02,001 --> 08:53:05,000 AND JUST SO YOU KNOW THAT THE 13572 08:53:05,001 --> 08:53:08,000 LETTER I REFER TO FROM THE CHIEF 13573 08:53:08,001 --> 08:53:09,000 ACTUARY IS REAL, JUST OBSERVE 13574 08:53:09,001 --> 08:53:12,000 THIS CHART. 13575 08:53:12,001 --> 08:53:14,000 YOU ALSO HEARD THIS WEEK HOW 13576 08:53:14,001 --> 08:53:20,000 THESE PERMANENT CUTS WOULD MAKE 13577 08:53:20,001 --> 08:53:22,000 IT HARDER TO PROVIDE FOR 13578 08:53:22,001 --> 08:53:24,000 PROVIDERS TO REMAIN IN THE BLACK. 13579 08:53:24,001 --> 08:53:25,000 AND YOU ALSO HEARD THESE 13580 08:53:25,001 --> 08:53:28,000 PROVIDERS MIGHT END THEIR 13581 08:53:28,001 --> 08:53:30,000 PARTICIPATION IN MEDICARE AND 13582 08:53:30,001 --> 08:53:32,000 POSSIBLY THEN JEOPARDIZE ACCESS 13583 08:53:32,001 --> 08:53:34,000 TO CARE FOR BENEFICIARIES AND 13584 08:53:34,001 --> 08:53:36,000 PROBABLY THEN MORE PEOPLE ENDING 13585 08:53:36,001 --> 08:53:39,000 UP IN THE MORE EXPENSIVE 13586 08:53:39,001 --> 08:53:44,000 ENVIRONMENT OF A NURSING HOME. 13587 08:53:44,001 --> 08:53:45,000 THE THREAT TO ACCESS HOME HEALTH 13588 08:53:45,001 --> 08:53:48,000 FROM THESE PERMANENT 13589 08:53:48,001 --> 08:53:49,000 PRODUCTIVITY CUTS ISN'T 13590 08:53:49,001 --> 08:53:50,000 THEORETICAL. 13591 08:53:50,001 --> 08:53:53,000 'S REAL. 13592 08:53:53,001 --> 08:53:56,000 LIKE MANY OTHER MEDICARE 13593 08:53:56,001 --> 08:53:59,000 PROVIDERS, HOME HEALTH AGENCIES 13594 08:53:59,001 --> 08:54:01,000 PROVIDE LABOR-INTENSIVE SERVICES. 13595 08:54:01,001 --> 08:54:02,000 AND BECAUSE OF THESE 13596 08:54:02,001 --> 08:54:06,000 LABOR-INTENSIVE SERVICES, THAT'S 13597 08:54:06,001 --> 08:54:08,000 WHY I RAISE THE QUESTION AND THE 13598 08:54:08,001 --> 08:54:11,000 POSSIBILIT-- AND I SAY IT ENDS 13599 08:54:11,001 --> 08:54:14,000 UP BEING AN IMPOSSIBILITY -- 13600 08:54:14,001 --> 08:54:17,000 REALLY BE MORE PRODUCTIVE. 13601 08:54:17,001 --> 08:54:19,000 BECAUSE THERE ARE FEW 13602 08:54:19,001 --> 08:54:21,000 HOME HEALTH THAT WILL INCREASE 13603 08:54:21,001 --> 08:54:23,000 PRODUCTIVITY. 13604 08:54:23,001 --> 08:54:26,000 AND WHATEVER AVAILABLE GADTS 13605 08:54:26,001 --> 08:54:28,000 ARE UNAFFORDABLE FOR MANY IOWA 13606 08:54:28,001 --> 08:54:31,000 HOME HEALTH AGENCIES, BECAUSE 13607 08:54:31,001 --> 08:54:34,000 THEY ARE SMALL OPERATIONS WITH 13608 08:54:34,001 --> 08:54:37,000 LIMITED FINANCIAL RESOURCES. 13609 08:54:37,001 --> 08:54:39,000 HOME HEALTH CARE IS ABOUT 13610 08:54:39,001 --> 08:54:42,000 DOCTORS, IT'S ABOUT NURSES, AND 13611 08:54:42,001 --> 08:54:44,000 HOME HEALTH AIDES, AND IT'S 13612 08:54:44,001 --> 08:54:50,000 ABOUT ALL OF THESE PROVIDING 13613 08:54:50,001 --> 08:54:53,000 CARE TO THE MOST NEEDY. 13614 08:54:53,001 --> 08:54:56,000 SO, IT IS INCORRECT IN MY 13615 08:54:56,001 --> 08:54:57,000 JUDGMENT TO ASSUME THAT THESE 13616 08:54:57,001 --> 08:54:59,000 PROVIDERS WILL ACHIEVE THE 13617 08:54:59,001 --> 08:55:04,000 LEVELS OF PRODUCTIVITY, LIKE THE 13618 08:55:04,001 --> 08:55:08,000 REST OF THE ECONOMY. 13619 08:55:08,001 --> 08:55:10,000 THE H.H.S. ACTUARY'S -- CHIEF 13620 08:55:10,001 --> 08:55:11,000 ACTUARY'S FINDINGS CLEARLY APPLY 13621 08:55:11,001 --> 08:55:15,000 TO HOME HEALTH IN MY STATE OF 13622 08:55:15,001 --> 08:55:18,000 IOWA, LIKE THEY DO NATIONALLY. 13623 08:55:18,001 --> 08:55:21,000 JUST TO REMIND YOU, "THE 13624 08:55:21,001 --> 08:55:25,000 ESTIMATED SAVINGS MAY BE UNREALISTIC." 13625 08:55:25,001 --> 08:55:27,000 AND, "POSSIBLY JEOPARDIZING 13626 08:55:27,001 --> 08:55:29,000 ACCESS" FOR OUR SENIORS. 13627 08:55:29,001 --> 08:55:32,000 MORE PEOPLE IN NURSING 13628 08:55:32,001 --> 08:55:34,000 BE 13629 08:55:34,001 --> 08:55:36,000 PERCENT OF IOWA HOME HEALTH 13630 08:55:36,001 --> 08:55:40,000 AGENCIES THAT HAVE NEGATIVE 13631 08:55:40,001 --> 08:55:42,000 MEDICARE MARGINS WILL INCREASE 13632 08:55:42,001 --> 08:55:48,000 TO 75%. 13633 08:55:48,001 --> 08:55:50,000 SO OVER 120 OF THE 160 HOME 13634 08:55:50,001 --> 08:55:53,000 HEALTH PROVIDERS WILL 13635 08:55:53,001 --> 08:55:56,000 NEGATIVE MARGINS BECAUSE OF THIS 13636 08:55:56,001 --> 08:55:59,000 2,074-PAGE REID BIL 13637 08:55:59,001 --> 08:56:03,000 AND IOWA PROVIDERS ARE NOT ALONE ALONE. 13638 08:56:03,001 --> 08:56:07,000 FROM ONE HALF TO 90% OF HOME 13639 08:56:07,001 --> 08:56:09,000 HEALTH AGENCIE 13640 08:56:09,001 --> 08:56:10,000 THE COUNTRY WOULD HAVE NEGATIVE 13641 08:56:10,001 --> 08:56:12,000 MEDICARE MARGINS. 13642 08:56:12,001 --> 08:56:15,000 I HAVE A LETTER HERE -- I'M 13643 08:56:15,001 --> 08:56:16,000 GOING TO MAKE ONE REQUEST FOR 13644 08:56:16,001 --> 08:56:19,000 THREE INSERTS THAT 13645 08:56:19,001 --> 08:56:21,000 PUT IN AT VARIOUS PLACES IN MY REMARKS. 13646 08:56:21,001 --> 08:56:22,000 BUT SO I WOULD ASK THAT 13647 08:56:22,001 --> 08:56:24,000 PERMISSION, MR. PRESIDENT. 13648 08:56:24,001 --> 08:56:25,000 THE PRESIDING OFFICER: TWOWKS. 13649 08:56:25,001 --> 08:56:31,000 MR. GRASSLEY: I HAVE HERE A 13650 08:56:31,001 --> 08:56:34,000 LETTER DATED SEPTEMBER 13651 08:56:34,001 --> 08:56:37,000 -- FROM SEPTEMBER 23 OF THIS 13652 08:56:37,001 --> 08:56:38,000 YEAR FROM THE PRESIDENT OF THE 13653 08:56:38,001 --> 08:56:40,000 NATIONAL ASSOCIATION OF HOME 13654 08:56:40,001 --> 08:56:42,000 HEALTH AND HOSPICE. 13655 08:56:42,001 --> 08:56:44,000 THIS ORGANIZATION REPRESENTS 13656 08:56:44,001 --> 08:56:45,000 HEALTH AGENCIES ACROSS THE 13657 08:56:45,001 --> 08:56:47,000 COUNTRY. 13658 08:56:47,001 --> 08:56:50,000 HE WROTE THIS LETTER IN RESPONSE 13659 08:56:50,001 --> 08:56:52,000 TO THE $43 BILLION IN HOME 13660 08:56:52,001 --> 08:56:54,000 HEALTH CUTS IN 13661 08:56:54,001 --> 08:56:56,000 COMMITTEE PACKAGE, WHICH 13662 08:56:56,001 --> 08:56:58,000 PRESUMES TO BE THE SAME NUMBER 13663 08:56:58,001 --> 08:57:02,000 THAT IS USED IN THE REID BILL. 13664 08:57:02,001 --> 08:57:04,000 IN THIS LETTER, HE STATED, "IT 13665 08:57:04,001 --> 08:57:08,000 IS CRUCIAL TO THE SURVIVAL OF 13666 08:57:08,001 --> 08:57:10,000 HOME HEALTH SERVICES' DELIVERY 13667 08:57:10,001 --> 08:57:12,000 SYST 13668 08:57:12,001 --> 08:57:13,000 THE $43 BILLION IN CUT 13669 08:57:13,001 --> 08:57:15,000 CURRENTLY CONTAINED IN THE 13670 08:57:15,001 --> 08:57:16,000 SENATE FINANCE COMMITTEE'S 13671 08:57:16,001 --> 08:57:20,000 HEALTH REFORM PACKAGE. 13672 08:57:20,001 --> 08:57:23,000 OUR ANALYSIS INDICATES THAT BY 13673 08:57:23,001 --> 08:57:25,000 2016 THE PROPOSED CUTS IN HOME 13674 08:57:25,001 --> 08:57:28,000 HEALTH SERVICES PAYMENT RATES 13675 08:57:28,001 --> 08:57:31,000 WILL LEAD TO NEARLY 70% OF THE 13676 08:57:31,001 --> 08:57:34,000 PROVIDER'S NATIONWIDE AT RISK OF 13677 08:57:34,001 --> 08:57:37,000 CLOSING BECAUSE THEIR COSTS WILL 13678 08:57:37,001 --> 08:57:41,000 EXCEED MEDICARE PAYMENTS. 13679 08:57:41,001 --> 08:57:43,000 IF THAT OCCURS," THE LETR 13680 08:57:43,001 --> 08:57:45,000 SAYS, "PRESIDENT OBAMA'S PROMISE 13681 08:57:45,001 --> 08:57:48,000 THAT MEDICARE BENEFICIARIES WILL 13682 08:57:48,001 --> 08:57:53,000 NOT BE ADVERSELY AFFECTED BY 13683 08:57:53,001 --> 08:57:57,000 HEALTH CARE REFORM WILL BE BROKEN." 13684 08:57:57,001 --> 08:58:00,000 END 13685 08:58:00,001 --> 08:58:02,000 I HAVE YET TO HEAR FROM A HOME 13686 08:58:02,001 --> 08:58:04,000 HEALTH PROVIDER IN 13687 08:58:04,001 --> 08:58:06,000 THESE PERMANENT CUTS WILL MAKE 13688 08:58:06,001 --> 08:58:09,000 IT EASIER FOR THETO CARE FOR 13689 08:58:09,001 --> 08:58:11,000 THEIR MEDICARE BENEFICIARIES. 13690 08:58:11,001 --> 08:58:13,000 AND INSTEAD I HEAR THAT THESE 13691 08:58:13,001 --> 08:58:15,000 CUTS WOULD REDUCE ACCESS TO HOME 13692 08:58:15,001 --> 08:58:18,000 HEALTH 13693 08:58:18,001 --> 08:58:20,000 SO I HAVE THE SECOND LETTER THAT 13694 08:58:20,001 --> 08:58:25,000 I JUST ASKED TO HAVE INSERTED, 13695 08:58:25,001 --> 08:58:31,000 AND THAT LTER IS FROM THE IOWA 13696 08:58:31,001 --> 08:58:33,000 ASSOCIATION OF HOME CARE, AND 13697 08:58:33,001 --> 08:58:35,000 THEY WROTE, "ENSURING THAT 13698 08:58:35,001 --> 08:58:37,000 MEDICARE HOME HEALTH PAYMENTS 13699 08:58:37,001 --> 08:58:40,000 ARE NOT FURTHER REDUCE -- 13700 08:58:40,001 --> 08:58:49,000 REDUCED FURTHER IS ESSENTIAL TO 13701 08:58:49,001 --> 08:58:51,000 AVOID THE RESULTING LIMITS OR NO 13702 08:58:51,001 --> 08:58:55,000 ACCESS TO HOME HEALTH SERVICES 13703 08:58:55,001 --> 08:58:56,000 FOR MANY IOWANS WHO PREFER TO 13704 08:58:56,001 --> 08:58:58,000 RECEIVE SERVICES IN THEIR HOME." 13705 08:58:58,001 --> 08:59:04,000 END OF QUOTE. 13706 08:59:04,001 --> 08:59:07,000 SO, AS THE C 13707 08:59:07,001 --> 08:59:11,000 THE CHART SHOWS, NOT JUST THE 13708 08:59:11,001 --> 08:59:13,000 CHIEF ACTUARY SAYING IT, BUT 13709 08:59:13,001 --> 08:59:15,000 PEOPLE THAT ARE CONNECTED WITH 13710 08:59:15,001 --> 08:59:18,000 THE BUSINESS OF HOME HEALTH CARE 13711 08:59:18,001 --> 08:59:21,000 SAY IT, 13712 08:59:21,001 --> 08:59:23,000 WILL IN FACT JEOPARDIZE ACCESS 13713 08:59:23,001 --> 08:59:26,000 TO HOME CARE IN IOWA. 13714 08:59:26,001 --> 08:59:30,000 SO, IF THE HOME HEALTH CUTS IN 13715 08:59:30,001 --> 08:59:34,000 THE REID BILL ARE ALLOWED TO GO 13716 08:59:34,001 --> 08:59:36,000 INTO EFFECT, THENOWA'S SENIORS 13717 08:59:36,001 --> 08:59:38,000 WHO PREFER TO LIVE FUL LIVES 13718 08:59:38,001 --> 08:59:41,000 FROM THEIR HOMES WILL BE FORCED 13719 08:59:41,001 --> 08:59:44,000 TO LIVE IN THE MORE EXPENSIVE 13720 08:59:44,001 --> 08:59:46,000 SETTINGS, LIKE NURSING HOMES. 13721 08:59:46,001 --> 08:59:48,000 I BELIEVE THAT MANY MEMBERS ON 13722 08:59:48,001 --> 08:59:50,000 BOTH SIDES OF THE AISLE SHARE MY 13723 08:59:50,001 --> 08:59:53,000 CONCERN ABOUT HOME HEALTH CARE 13724 08:59:53,001 --> 08:59:56,000 CUTS. 13725 08:59:56,001 --> 08:59:57,000 I HAVE HERE A LETTER -- THE 13726 08:59:57,001 --> 09:00:02,000 THIRD LETTER I REFERRED TO. 13727 09:00:02,001 --> 09:00:06,000 NOW, THIS LETTER IS FROM JULY 13728 09:00:06,001 --> 09:00:07,000 27, 2007, AND IT'S WRITTEN TO 13729 09:00:07,001 --> 09:00:08,000 SENATOR BAUCUS AND ME. 13730 09:00:08,001 --> 09:00:10,000 BUT THE REASON I USE THIS 13731 09:00:10,001 --> 09:00:12,000 LETTER, EVEN THOUGH IT'S TWO 13732 09:00:12,001 --> 09:00:14,000 YEARS OLD, WE WERE GETTING 13733 09:00:14,001 --> 09:00:16,000 ENTREATIES FROM 61 OF OUR 13734 09:00:16,001 --> 09:00:17,000 COLLEAGUES, OF WHICH 52 NOW 13735 09:00:17,001 --> 09:00:22,000 SERVE -- STILL SERVE IN THE 13736 09:00:22,001 --> 09:00:24,000 UNITED STATES SENATE, ABOUT A 13737 09:00:24,001 --> 09:00:25,000 LEGISLATIVE PROPOSAL TO CUT 13738 09:00:25,001 --> 09:00:33,000 MEDICARE 13739 09:00:33,001 --> 09:00:35,000 THAT YEAR, 2007, BY $ 13740 09:00:35,001 --> 09:00:39,000 9.7 BILLION AND HOSPICE PAYMENTS 13741 09:00:39,001 --> 09:00:40,000 BY MORE THAN $1.1 BILLION. 13742 09:00:40,001 --> 09:00:42,000 THEY URGED ME AND SENATOR BCUS 13743 09:00:42,001 --> 09:00:44,000 AT THAT TIME TO ENSURE THAT HOME 13744 09:00:44,001 --> 09:00:49,000 HEALTH AND HOSPICE PROVIDERS 13745 09:00:49,001 --> 09:00:50,000 RECEIVE FULL MARKET BASKET 13746 09:00:50,001 --> 09:00:52,000 INFLATION ADJUSTMENTS. 13747 09:00:52,001 --> 09:00:54,000 THEY ALSO URGED US TO OPPOSE ANY 13748 09:00:54,001 --> 09:00:55,000 CUTS IN PAYMENT RATES THROUGH 13749 09:00:55,001 --> 09:00:56,000 ADMINISTRATIVE ACTIONS. 13750 09:00:56,001 --> 09:00:58,000 IN THE LETTER, THESE MEMBERS 13751 09:00:58,001 --> 09:01:00,000 STATED THAT HOME HEALTH AND 13752 09:01:00,001 --> 09:01:04,000 HOSPICE CARE -- QUOTE -- "HAVE 13753 09:01:04,001 --> 09:01:05,000 BEEN DEMONSTRATED TO BE 13754 09:01:05,001 --> 09:01:06,000 COST-EFFECTIVE ALTERNATIVES TO 13755 09:01:06,001 --> 09:01:09,000 INSTITUTIONAL CARE IN BOTH 13756 09:01:09,001 --> 09:01:12,000 MEDICARE AND MEDICAID PROGRAMS 13757 09:01:12,001 --> 09:01:13,000 AND THEY STATED THAT -- QUOTE -- 13758 09:01:13,001 --> 09:01:15,000 "REDUCING MEDICARE HOME HEALTH 13759 09:01:15,001 --> 09:01:17,000 AND HOSPICE PAYMENTS WOULD PLACE 13760 09:01:17,001 --> 09:01:20,000 THE QUALITY OF HOME HEALTH CARE 13761 09:01:20,001 --> 09:01:22,000 AND HOSPICE AND THE HOME CARE 13762 09:01:22,001 --> 09:01:25,000 DELIVERY SYSTEM AT SIGNIFICANT 13763 09:01:25,001 --> 09:01:27,000 RISK 13764 09:01:27,001 --> 09:01:31,000 OF THESE 61 SENATORS THAT SIGNED 13765 09:01:31,001 --> 09:01:34,000 THIS LETTER TWO YEARS AGO, 52 13766 09:01:34,001 --> 09:01:36,000 ARE CURRENTLY HERE DEBATING THIS 13767 09:01:36,001 --> 09:01:40,000 BILL IN THE UNITED STATES SENATE. 13768 09:01:40,001 --> 09:01:48,000 AND OF THOSE 52 SENATORS, 37 ARE 13769 09:01:48,001 --> 09:01:51,000 ARE NOW PROPOSING $43 BILLION IN 13770 09:01:51,001 --> 09:01:54,000 CUTS INSTEAD OF $9.7 BILLION IN 13771 09:01:54,001 --> 09:01:57,000 HOME PAYMENT CUTS AND 13772 09:01:57,001 --> 09:01:58,000 $1.1 BILLION IN HOSPICE PAYMENT 13773 09:01:58,001 --> 09:02:02,000 CUTS, AS I WOULD THINK THAT THEY 13774 09:02:02,001 --> 09:02:06,000 WOULD FIND THESE KIND OF CUTS 13775 09:02:06,001 --> 09:02:08,000 THREE OR FOUR TIMES -- FOUR 13776 09:02:08,001 --> 09:02:13,000 TIMES WHAT WE WERE TALKING ABOUT 13777 09:02:13,001 --> 09:02:14,000 TWO YEARS 13778 09:02:14,001 --> 09:02:17,000 UNREALISTIC AND TO KEEP HOME 13779 09:02:17,001 --> 09:02:18,000 HEALTH AS A VIABLE ORGANIZATION 13780 09:02:18,001 --> 09:02:20,000 GOING. 13781 09:02:20,001 --> 09:02:22,000 WE ALSO MUST LOOK BEYOND HEALTH 13782 09:02:22,001 --> 09:02:23,000 CARE WHEN WE LOOK AT THE IMPACT 13783 09:02:23,001 --> 09:02:25,000 OF THESE PERMANENT CUTS. 13784 09:02:25,001 --> 09:02:26,000 I'VE ALSO HEARD FROM PROVIDERS 13785 09:02:26,001 --> 09:02:28,000 IN IOWA THAT PERMANENT CUTS LIKE 13786 09:02:28,001 --> 09:02:30,000 THIS WILL MAKE IT EVEN HARDER 13787 09:02:30,001 --> 09:02:31,000 FOR THEM TO KEEP THEIR DOORS 13788 09:02:31,001 --> 09:02:34,000 OPEN. 13789 09:02:34,001 --> 09:02:35,000 SO AROUND 3,500 IOWANS WHO WORK 13790 09:02:35,001 --> 09:02:38,000 IN HOME HEALTH AGENCIES ARE AT 13791 09:02:38,001 --> 09:02:40,000 RISK OF LOSING THEIR JOBS AT THE 13792 09:02:40,001 --> 09:02:42,000 TIME WE HAVE 10% UNEMPYMENT. 13793 09:02:42,001 --> 09:02:44,000 AT A TIME WHEN MORE OF THIS 13794 09:02:44,001 --> 09:02:45,000 COUNTRY IS CONCERNED THAT 13795 09:02:45,001 --> 09:02:49,000 CONGRESS OUGHT TO BE WORKING ON 13796 09:02:49,001 --> 09:02:52,000 CREATING JOBS, JOBS, JOBS 13797 09:02:52,001 --> 09:02:54,000 OPPOSED TO THE HEALTH CARE ISSUE 13798 09:02:54,001 --> 09:02:55,000 AND IN SOME CASES CUTTING JOBS 13799 09:02:55,001 --> 09:02:58,000 OUT. 13800 09:02:58,001 --> 09:03:00,000 THE LABOR DEPARTMENT REPORTED 13801 09:03:00,001 --> 09:03:03,000 YESTERDAY -- OR TODAY IT WAS 13802 09:03:03,001 --> 09:03:05,000 THAT UNEMPLOYMENTS 10%. 13803 09:03:05,001 --> 09:03:07,000 NOW IS NOT THE TIME TO CONSIDER 13804 09:03:07,001 --> 09:03:08,000 BILLS THAT INCREASE UNEMPLOYMENT 13805 09:03:08,001 --> 09:03:10,000 RATES. 13806 09:03:10,001 --> 09:03:13,000 SO ABOUT AN HOUR AGO, THE 13807 09:03:13,001 --> 09:03:15,000 SENATOR FROM NEBRASKA HAS 13808 09:03:15,001 --> 09:03:18,000 OFFERED THIS MOTION THAT I'M 13809 09:03:18,001 --> 09:03:19,000 SPEAKING IN FAVOR OF NOW TO SEN 13810 09:03:19,001 --> 09:03:20,000 THIS BILL TO THE FINANCE 13811 09:03:20,001 --> 09:03:24,000 COMMITTEE WITH INSTRUCTIONS TO 13812 09:03:24,001 --> 09:03:27,000 REPORT A BILL WITHOUT THESE VERY 13813 09:03:27,001 --> 09:03:28,000 ENORMOUS HOME HEALTH CUTS THAT 13814 09:03:28,001 --> 09:03:29,000 ARE IN IT. 13815 09:03:29,001 --> 09:03:34,000 WE SHOULD TAKE THIS OPPORTUNI 13816 09:03:34,001 --> 09:03:35,000 TO FIX THE BILL AND THEN COME 13817 09:03:35,001 --> 09:03:36,000 BACK IT FULL SENATE WITH A BETTER BILL. 13818 09:03:36,001 --> 09:03:39,000 THAT'S WHY I SUPPORT THE SENATOR 13819 09:03:39,001 --> 09:03:41,000 FROM NEBRASKA'S MOTION TO COMMIT 13820 09:03:41,001 --> 09:03:45,000 AND I URGE MY COLLEAGUES TO DO THE 13821 09:03:45,001 --> 09:03:46,000 I YIELD THE FLOOR. 13822 09:03:46,001 --> 09:03:47,000 MR THE PRESIDING OFFICER: THE 13823 09:03:47,001 --> 09:03:49,000 SENATOR FROM ALABAMA. 13824 09:03:49,001 --> 09:03:51,000 MR. SESSIONS SESSIONS: BEFORE THE SENATOR 13825 09:03:51,001 --> 09:03:53,000 LEAVES, HE'S A MAN OF GREAT 13826 09:03:53,001 --> 09:03:54,000 CHARACTER AND EXPERIENCE IN 13827 09:03:54,001 --> 09:04:00,000 THESE MATTERS, AND I HAVE A 13828 09:04:00,001 --> 09:04:04,000 LETTER FROM A CONSTITUENT WHO 13829 09:04:04,001 --> 09:04:05,000 WRITES TO URGE -- TO QUOTE -- 13830 09:04:05,001 --> 09:04:06,000 "URGE YOU TO VOTE AGAINST THIS 13831 09:04:06,001 --> 09:04:09,000 HEALTH CARE BILL." 13832 09:04:09,001 --> 09:04:10,000 THIS IS FROM MR. BILL EBBERLY IN 13833 09:04:10,001 --> 09:04:12,000 HUNTSVILLE, ALABAMA. 13834 09:04:12,001 --> 09:04:13,000 HE SAYS, "THE WORST PART OF THIS 13835 09:04:13,001 --> 09:04:16,000 BILL IS THAT MOST OF THE CUTS 13836 09:04:16,001 --> 09:04:17,000 WILL BE PAID FOR BY CUTS TO MEDICARE." 13837 09:04:17,001 --> 09:04:18,000 I THINK THE SENATOR INDICATED HE 13838 09:04:18,001 --> 09:04:21,000 BELIEVES THAT ACCURATE. 13839 09:04:21,001 --> 09:04:23,000 HE GOES TO SAY -- QUOTE -- "I AM 13840 09:04:23,001 --> 09:04:26,000 68 YEARS OLD AND I HAVE PAID 13841 09:04:26,001 --> 09:04:27,000 INTO MEDICARE FOR 40 YEARS 13842 09:04:27,001 --> 09:04:29,000 BELIEVING IT WOULD COVER MUCH OF 13843 09:04:29,001 --> 09:04:30,000 MY HEALTH CARE COSTS WHEN I 13844 09:04:30,001 --> 09:04:32,000 BECAME 65. 13845 09:04:32,001 --> 09:04:34,000 NOW I AM BEING TOLD THAT THE 13846 09:04:34,001 --> 09:04:37,000 GOVERNMENT HAS FOUND PEOPLE WHO 13847 09:04:37,001 --> 09:04:39,000 NEED THE COVERAGE MORE THAN I DO DO. 13848 09:04:39,001 --> 09:04:42,000 AND THEY WILL CUT THE CARE FOR 13849 09:04:42,001 --> 09:04:44,000 WHICH I HAVE PAID FOR 40 YEARS 13850 09:04:44,001 --> 09:04:47,000 IN ORDER TO COVER PEOPLE WHO 13851 09:04:47,001 --> 09:04:49,000 HAVE PAID NOTHING INTO THE PROGRAM. 13852 09:04:49,001 --> 09:04:51,000 IT'S NOT THE GOVERNMENT'S MONEY. 13853 09:04:51,001 --> 09:04:56,000 THE MONEY BELONGS TO THOSE OF US 13854 09:04:56,001 --> 09:04:58,000 WHO PAID INTO FOR SO MANY YEARS 13855 09:04:58,001 --> 09:05:00,000 TAKEN AWAY FROM US." 13856 09:05:00,001 --> 09:05:02,000 AND I GUESS MY QUESTION TO YOU, 13857 09:05:02,001 --> 09:05:03,000 SINCE YOU'VE BEEN SO INTIMATELY 13858 09:05:03,001 --> 09:05:05,000 INVOLVED WITH MEDICARE OVER THE 13859 09:05:05,001 --> 09:05:09,000 YEARS, IS IT NOT TRUE THAT EVERY 13860 09:05:09,001 --> 09:05:13,000 WORKING AMERICAN HAS MONEY TAKEN 13861 09:05:13,001 --> 09:05:16,000 OUT OF THEIR PAYCHECK TO FUND 13862 09:05:16,001 --> 09:05:19,000 THEIR 13863 09:05:19,001 --> 09:05:21,000 THAT THEY BELIEVE AND WE HAVE A 13864 09:05:21,001 --> 09:05:22,000 COMPACT WITH THEM THAT WHEN THEY 13865 09:05:22,001 --> 09:05:26,000 REACH 75, THEY WILL HAVE THE 13866 09:05:26,001 --> 09:05:28,000 BENEFIT OF THAT. 13867 09:05:28,001 --> 09:05:29,000 MR. GRASSLEY: 65 THEY GET THE 13868 09:05:29,001 --> 09:05:31,000 BENEFIT OF IT. 13869 09:05:31,001 --> 09:05:33,000 MR. SESSIONS: 65, Y 13870 09:05:33,001 --> 09:05:37,000 MR. GRASSLEY: YES, TO THE TUNE 13871 09:05:37,001 --> 09:05:39,000 OF 2.9% OF PAYROLL. 13872 09:05:39,001 --> 09:05:40,000 THAT'S WHAT A SELF-EMPLOYED 13873 09:05:40,001 --> 09:05:44,000 PERSON WOULD PLAY. 13874 09:05:44,001 --> 09:05:47,000 AND AN EMPLOYEE 13875 09:05:47,001 --> 09:05:48,000 AND THE EMPLOYER WOULD PAY 1.45% 13876 09:05:48,001 --> 09:05:53,000 1.45%. 13877 09:05:53,001 --> 09:05:54,000 AND YOU KNOW THIS 2,074-PAGE 13878 09:05:54,001 --> 09:05:55,000 BILL ADDS A HALF A PERCENTAGE 13879 09:05:55,001 --> 09:05:56,000 APPOINT TO THOSE. 13880 09:05:56,001 --> 09:05:58,000 SO YOU'RE GOING TO GET IT TO A 13881 09:05:58,001 --> 09:05:59,000 POINT WHERE IT'S ALMOST 2% FOR 13882 09:05:59,001 --> 09:06:04,000 THE EMPLOYER, 2% FOR THE 13883 09:06:04,001 --> 09:06:06,000 EMPLOYEE AND IT WOULD BE ALMOST 13884 09:06:06,001 --> 09:06:08,000 4% FOR A SELF-EMPLOYED PERSON 13885 09:06:08,001 --> 09:06:13,000 PAYING INTO THIS FUND THAT IS 13886 09:06:13,001 --> 09:06:15,000 NOW GOING TO BE RAIDED TO -- TO 13887 09:06:15,001 --> 09:06:16,000 FINANCE A B 13888 09:06:16,001 --> 09:06:17,000 PROGRAM. 13889 09:06:17,001 --> 09:06:19,000 MR. SESSIONS: SO MY CONSTITUENT 13890 09:06:19,001 --> 09:06:21,000 IS FUNDAMENTALLY CORRECT INIS CONCERN? 13891 09:06:21,001 --> 09:06:22,000 MR. GRASSLEY: WELL, THERE'S A 13892 09:06:22,001 --> 09:06:23,000 GREAT -- I SENSE A GREAT DEAL OF 13893 09:06:23,001 --> 09:06:24,000 RESENTMENT IN THAT COMING 13894 09:06:24,001 --> 09:06:29,000 THROUGH IN THE WORDS OF THAT 13895 09:06:29,001 --> 09:06:30,000 WHAT HE'S PAID INTO 13896 09:06:30,001 --> 09:06:32,000 PROBABLY 40 YEARS THAT HE WAS 13897 09:06:32,001 --> 09:06:35,000 WORKING, OR MAYBE 45 YEARS THAT 13898 09:06:35,001 --> 09:06:38,000 HE'S WORKING BEFORE HE RETIRED, 13899 09:06:38,001 --> 09:06:41,000 THAT -- THAT 13900 09:06:41,001 --> 09:06:44,000 ALREADY BEING IN JEOPARDY BASED 13901 09:06:44,001 --> 09:06:46,000 ON THE TRUSTEES' REPORT WHICH 13902 09:06:46,001 --> 09:06:47,000 SAYS BY 2017 THAT THERE'S NOT 13903 09:06:47,001 --> 09:06:51,000 GOING TO BE ANY MONEY IN THE 13904 09:06:51,001 --> 09:06:52,000 TRUST FUND, AND THEN HAVING 13905 09:06:52,001 --> 09:06:55,000 $464 BILLION TAKEN OUT OF THAT 13906 09:06:55,001 --> 09:06:56,000 TRUST FUND TO HELP FINANCE A NEW 13907 09:06:56,001 --> 09:06:58,000 ENTITLEMENT PROGRAM AT A TIME 13908 09:06:58,001 --> 09:07:01,000 WHEN THE PRESENT ENTITLEMENT 13909 09:07:01,001 --> 09:07:05,000 PROGRAMS ARE IN SOME -- A GREAT 13910 09:07:05,001 --> 09:07:06,000 DEAL 13911 09:07:06,001 --> 09:07:07,000 MR. SESSIONS: I THINK YOU STATED 13912 09:07:07,001 --> 09:07:12,000 THAT SO WELL. 13913 09:07:12,001 --> 09:07:15,000 AND JUST TO REEMPHASIZE, THAT 13914 09:07:15,001 --> 09:07:16,000 JUDGE, MR. EBBERLY, WHO PAID IN 13915 09:07:16,001 --> 09:07:18,000 ARE FOR 40 YEARS INTO MEDICARE, 13916 09:07:18,001 --> 09:07:21,000 UNTIL HE GOT 65, HE GOT NOT A 13917 09:07:21,001 --> 09:07:22,000 DIME OF MEDICARE BENEFIT, DID HE? 13918 09:07:22,001 --> 09:07:23,000 MR. GRASSLEY: NO. 13919 09:07:23,001 --> 09:07:26,000 THE ONLY WAY HE WOULD HAVE GOT 13920 09:07:26,001 --> 09:07:31,000 BENEFITS IS IF HE HAD BECOME 13921 09:07:31,001 --> 09:07:34,000 DISABLED BEFORE AGE 6567895. 13922 09:07:34,001 --> 09:07:36,000 THESE YEARS AND JUST NOW GETS TO 13923 09:07:36,001 --> 09:07:37,000 DRAW IT AND START TAKING IT OUT. 13924 09:07:37,001 --> 09:07:38,000 WELL, I WANT TO THANK YOU, 13925 09:07:38,001 --> 09:07:40,000 SENATOR GRASSLEY, FOR YOUR 13926 09:07:40,001 --> 09:07:41,000 LEADERSHIP ON THIS ISSUE. 13927 09:07:41,001 --> 09:07:44,000 AND I THINK YOU AND I KIND OF 13928 09:07:44,001 --> 09:07:48,000 COME OUT OF THE SOIL OF OUR 13929 09:07:48,001 --> 09:07:50,000 STATES, OUT OF THE REAL WORLD, 13930 09:07:50,001 --> 09:07:52,000 AND MY IMPRESSION IS THAT NOTHING COMES FROM NOTHING. 13931 09:07:52,001 --> 09:07:53,000 WOULD 13932 09:07:53,001 --> 09:07:54,000 SOMEBODY'S GOT TO PAYMENT 13933 09:07:54,001 --> 09:07:56,000 MR. GRASSLEY: SAY IT THIS WAY. 13934 09:07:56,001 --> 09:07:57,000 WE'RE IN A TOWN WHERE WE'RE 13935 09:07:57,001 --> 09:07:58,000 DEALING WAY LOT OF WASHINGTON 13936 09:07:58,001 --> 09:07:59,000 NONSENSE AND I HE FROM THE 13937 09:07:59,001 --> 09:08:02,000 RURAL AREAS OF ALABAMA, LIKE THE 13938 09:08:02,001 --> 09:08:03,000 STATE OF IOWA, YOU BRING A LOT 13939 09:08:03,001 --> 09:08:06,000 OF COMMONSENSE TO THIS TOWN 13940 09:08:06,001 --> 09:08:07,000 WHERE THERE ISN'T A LOT OF IT. 13941 09:08:07,001 --> 09:08:09,000 MR. SESSIONS: THANK YOU, VERY 13942 09:08:09,001 --> 09:08:14,000 MUCH. 13943 09:08:14,001 --> 09:08:16,000 MR. 13944 09:08:16,001 --> 09:08:18,000 THAT THE MATTER IS A VERY 13945 09:08:18,001 --> 09:08:19,000 SERIOUS ONE THAT WE'RE DEALING 13946 09:08:19,001 --> 09:08:20,000 WITH. 13947 09:08:20,001 --> 09:08:23,000 I TODAY HAD THE OPPORTUNITY TO 13948 09:08:23,001 --> 09:08:24,000 TALK ABOUT A -- TALK TO A VERY 13949 09:08:24,001 --> 09:08:27,000 EXPERIENCED PERSON INVOLVED IN 13950 09:08:27,001 --> 09:08:31,000 HEALTH CARE ISSUES FOR MANY 13951 09:08:31,001 --> 09:08:32,000 YEARS, AND 13952 09:08:32,001 --> 09:08:34,000 BAFFLEMENT ABOUT SE OF THE 13953 09:08:34,001 --> 09:08:36,000 DISAGREEMENTS WE HAVE ABOUT HUGE 13954 09:08:36,001 --> 09:08:38,000 ISSUES. 13955 09:08:38,001 --> 09:08:39,000 AND ONE OF MY STAFFERS WROTE IT 13956 09:08:39,001 --> 09:08:42,000 DOWN WHAT HE SAID. 13957 09:08:42,001 --> 09:08:46,000 HE SAID, IN ALL MY YEARS, 13958 09:08:46,001 --> 09:08:47,000 I'VE -- QUOTE -- "NEVER SEEN 13959 09:08:47,001 --> 09:08:48,000 SUCH TRANSPARENT DISHONESTY IN 13960 09:08:48,001 --> 09:08:50,000 THE CONGRESS." 13961 09:08:50,001 --> 09:08:52,000 HE SAID, IT'S THE BIGGEST FRAUD THAT'S BEEN PERPETRATED IN THE 13962 09:08:52,001 --> 09:08:53,000 HISTORY OF OUR COUNTRY, IN HIS 13963 09:08:53,001 --> 09:08:55,000 OPINION. 13964 09:08:55,001 --> 09:08:59,000 I MEAN, SO HERE WE HAVE A 13965 09:08:59,001 --> 09:09:01,000 SITUATION -- I JUST WANT TO SAY 13966 09:09:01,001 --> 09:09:05,000 I'M GOING TO PURSUE THIS A 13967 09:09:05,001 --> 09:09:07,000 LITTLE MORE, IN MORE GREAT 13968 09:09:07,001 --> 09:09:08,000 DETAIL, AND I'M NOT GOING TO GO 13969 09:09:08,001 --> 09:09:11,000 INTO IT HERE TONIGHT, BUT WE HAD 13970 09:09:11,001 --> 09:09:13,000 AN AMENDMENT -- SENATOR BENNETT 13971 09:09:13,001 --> 09:09:15,000 HAD AN AMENDMENT YESTERDAY THAT 13972 09:09:15,001 --> 09:09:17,000 SAID WE WOULDN'T CUT GUARANTEED 13973 09:09:17,001 --> 09:09:19,000 BENEFITS. 13974 09:09:19,001 --> 09:09:22,000 AND, WELL, THE WAY THIS -- FOR MEDICARE. 13975 09:09:22,001 --> 09:09:25,000 BUT THE WAY THIS DEAL IS BEING 13976 09:09:25,001 --> 09:09:29,000 DONE IS THEY'RE CUTTING PAYMENTS 13977 09:09:29,001 --> 09:09:30,000 TO PROVIDERS OF MEDICARE, AND WE 13978 09:09:30,001 --> 09:09:34,000 ARE ALREADY REACHING, AS SENATOR 13979 09:09:34,001 --> 09:09:36,000 GRASSLEY SAID, A NATIONAL 13980 09:09:36,001 --> 09:09:39,000 CRIS, BECAUSE BY 2017, WE 13981 09:09:39,001 --> 09:09:40,000 WON'T BE ABLE TO HAVE A SURPLUS 13982 09:09:40,001 --> 09:09:41,000 IN MEDICARE. 13983 09:09:41,001 --> 09:09:44,000 WE'RE GOING INTO DEFAULT IN 13984 09:09:44,001 --> 09:09:48,000 MEDICARE AND WHERE ARE WE GOING 13985 09:09:48,001 --> 09:09:49,000 TO GET THE MONEY. 13986 09:09:49,001 --> 09:09:51,000 WELL, COULD WE HAVE 13987 09:09:51,001 --> 09:09:52,000 EFFICIENCIES, COULD WE SAVE SOME 13988 09:09:52,001 --> 09:09:54,000 MONEY IN MEDICARE, COULD WE DO 13989 09:09:54,001 --> 09:09:56,000 SOME THINGS TO KEEP THE PROGRAM 13990 09:09:56,001 --> 09:09:58,000 AFLOAT? 13991 09:09:58,001 --> 09:09:59,000 PERHAPS. 13992 09:09:59,001 --> 09:10:03,000 BUT IF WE DO SO, SHOULD WE NOT 13993 09:10:03,001 --> 09:10:04,000 USE IT, SHOULDN'T WE NOT USE ANY 13994 09:10:04,001 --> 09:10:06,000 EFFICIENCIES AND SAVINGS THAT WE 13995 09:10:06,001 --> 09:10:07,000 COULD SCRAPE TOGETHER WITHOUT 13996 09:10:07,001 --> 09:10:08,000 DAMAGING THE COMMITMENT WE HAVE 13997 09:10:08,001 --> 09:10:11,000 TO OUR SENIORS? 13998 09:10:11,001 --> 09:10:14,000 SHOULDN'T WE USE THOSE SAVINGS 13999 09:10:14,001 --> 09:10:16,000 TO SAVE MEDICARE, THAT'S GOING 14000 09:10:16,001 --> 09:10:17,000 INTO DETAUGHT? 14001 09:10:17,001 --> 09:10:19,000 I SUGGEST -- 14002 09:10:19,001 --> 09:10:20,000 THAT'S GOING INTO DEFAULT? 14003 09:10:20,001 --> 09:10:22,000 I SUGGEST THAT'S A MOR AND 14004 09:10:22,001 --> 09:10:24,000 LEGAL COMMITMENT. 14005 09:10:24,001 --> 09:10:26,000 AS THIS MR. EBBERLY HAS WRITTEN 14006 09:10:26,001 --> 09:10:27,000 TO ME, HE'S PAID FOR 40 YEARS. 14007 09:10:27,001 --> 09:10:29,000 HE'S 14008 09:10:29,001 --> 09:10:30,000 ANYTHING OUT OF IT, FOR 40 YEARS 14009 09:10:30,001 --> 09:10:33,000 AS HE'S PAID INTO IT. 14010 09:10:33,001 --> 09:10:34,000 AND NOW HE GETS READY TO DRAW, 14011 09:10:34,001 --> 09:10:39,000 WE'RE TELLING HIM WE'RE GOING TO 14012 09:10:39,001 --> 09:10:46,000 CUT MEDICARE PAYMENTS. 14013 09:10:46,001 --> 09:10:48,000 AND THIS IS MATTER. 14014 09:10:48,001 --> 09:10:50,000 AND WE SEEM TO HAVE, 14015 09:10:50,001 --> 09:10:51,000 WE SEEM TO HAVE THIS DISPUTE. 14016 09:10:51,001 --> 09:10:57,000 AND ONE GROUP FROM THE OTHER 14017 09:10:57,001 --> 09:11:00,000 SIDE SAYS THAT, DON'T WORRY, 14018 09:11:00,001 --> 09:11:02,000 WE'RE NOT TAKING $465 BILLION 14019 09:11:02,001 --> 09:11:03,000 FROM MEDICARE, AND WE WOULDN'T 14020 09:11:03,001 --> 09:11:05,000 CUT MEDICARE, AND WE DON'T 14021 09:11:05,001 --> 09:11:07,000 BELIEVE IN CUTTING MEDICARE, AND 14022 09:11:07,001 --> 09:11:08,000 WE DON'T WANT TO HURT MEDICARE 14023 09:11:08,001 --> 09:11:11,000 IN ANY WAY. 14024 09:11:11,001 --> 09:11:16,000 AND OUR SIDE'S OVER HERE SAYING, 14025 09:11:16,001 --> 09:11:18,000 BUT YOU ARE. 14026 09:11:18,001 --> 09:11:21,000 NOW, ACCORDING TO THE NUMBERS 14027 09:11:21,001 --> 09:11:22,000 THAT WE'VE -- THAT ARE PRETTY 14028 09:11:22,001 --> 09:11:27,000 PLAIN IN THIS LEGISLATION, 14029 09:11:27,001 --> 09:11:28,000 HOSPITALS WILL HAVE $134 BILLION 14030 09:11:28,001 --> 09:11:30,000 REDUCTION. 14031 09:11:30,001 --> 09:11:37,000 HOSPICES, AS THE SENATOR -- 14032 09:11:37,001 --> 09:11:38,000 HOSPICES, $7 BILLI, 14033 09:11:38,001 --> 09:11:41,000 LIFE-ENDING CARE THAT HAS BEEN 14034 09:11:41,001 --> 09:11:44,000 SO HELPFUL TO SO MANY PEOPLE. 14035 09:11:44,001 --> 09:11:45,000 NURSING 14036 09:11:45,001 --> 09:11:47,000 HOME HEALTH AGENCIES THAT 14037 09:11:47,001 --> 09:11:48,000 SENATOR GRASSLEY TALKED ABOUT, 14038 09:11:48,001 --> 09:11:49,000 $42 BILLION REDUCTIONS. 14039 09:11:49,001 --> 09:11:52,000 ARE WE IMAGINING THIS? 14040 09:11:52,001 --> 09:11:53,000 IS THIS SOMEHOW WE'VE JUST 14041 09:11:53,001 --> 09:11:56,000 FORMULATED THIS UP? 14042 09:11:56,001 --> 09:11:59,000 IT ALL TOTALS UP TO ABOUT 14043 09:11:59,001 --> 09:12:01,000 $465 BILLION. 14044 09:12:01,001 --> 09:12:06,000 SO THIS MATTER I SUGGEST IS NOT 14045 09:12:06,001 --> 09:12:07,000 GOING AWAY. 14046 09:12:07,001 --> 09:12:11,000 EITHER WE HAVE REALITY HER OR NOT. 14047 09:12:11,001 --> 09:12:14,000 I BELIEVE THAT THE 14048 09:12:14,001 --> 09:12:16,000 SHOW THAT WE ARE RAIDING 14049 09:12:16,001 --> 09:12:19,000 MEDICARE, WE ARE WEAKENING THAT 14050 09:12:19,001 --> 09:12:22,000 PROGRAM WHEN IT IS ALREADY KNOWN 14051 09:12:22,001 --> 09:12:26,000 TO ALL OF US IN THIS BODY THAT 14052 09:12:26,001 --> 09:12:32,000 MEDICARE IS NOT ACTUARIALLY SOUND. 14053 09:12:32,001 --> 09:12:34,000 I REMEMBER WHEN PRESIDENT BUSH 14054 09:12:34,001 --> 09:12:37,000 DETERMINED IN A FAILED EFFORT TO 14055 09:12:37,001 --> 09:12:38,000 TRY TO ALTER SOCIAL SECURITY IN 14056 09:12:38,001 --> 09:12:40,000 A WAY THAT HE FELT WOULD PUT IT 14057 09:12:40,001 --> 09:12:41,000 ON A SOUNDER FOOTING, GOT NO 14058 09:12:41,001 --> 09:12:42,000 HELP AT ALL. 14059 09:12:42,001 --> 09:12:44,000 WE HAD MANY OF OUR SENATORS ON 14060 09:12:44,001 --> 09:12:45,000 BOTH SIDES OF THE AISLE SAYING, 14061 09:12:45,001 --> 09:12:50,000 WELL, IF YOU REALLY WANT TO DO 14062 09:12:50,001 --> 09:12:52,000 SOMETHING 14063 09:12:52,001 --> 09:12:54,000 IS, MEDICARE IS IN MUCH WORSE FINANCIAL FIX. 14064 09:12:54,001 --> 09:12:57,000 WHY AREN'T YOU FIXING IT? 14065 09:12:57,001 --> 09:12:59,000 I REMBER A NUMBER OF YEARS 14066 09:12:59,001 --> 09:13:01,000 AGO, TEN OR MORE, WHEN SENATOR 14067 09:13:01,001 --> 09:13:06,000 JUDGE GREGG, THEN CHAIRMAN OF 14068 09:13:06,001 --> 09:13:07,000 THE BUDGET COMMITTEE, TRIED TO 14069 09:13:07,001 --> 09:13:08,000 COME UP WITH SOME LEGISLATION TO 14070 09:13:08,001 --> 09:13:10,000 CONTAIN A LITTLE BIT OF THE 14071 09:13:10,001 --> 09:13:12,000 GROWTH IN MEDICARE, AND OVER $5 14072 09:13:12,001 --> 09:13:14,000 YEARS HE HAD A PLAN THAT WOULD 14073 09:13:14,001 --> 09:13:16,000 CONTAIN THE GROWTH BY $10 BILLION. 14074 09:13:16,001 --> 09:13:18,000 NOT A SINGLE DEMOCRAT VOTED FOR 14075 09:13:18,001 --> 09:13:19,000 THE GREGG PROPOSAL. 14076 09:13:19,001 --> 09:13:21,000 EVERY BIT OF IT. 14077 09:13:21,001 --> 09:13:23,000 AND THEY HAD ACCUSED THE 14078 09:13:23,001 --> 09:13:24,000 REPUBLICANS OF TRYING TO DAMAGE 14079 09:13:24,001 --> 09:13:28,000 MEDICARE WHEN, IN FACT, EVERY 14080 09:13:28,001 --> 09:13:29,000 PENNY OF THE $10 B 14081 09:13:29,001 --> 09:13:31,000 VED WAS GOING TO BE UTILIZED 14082 09:13:31,001 --> 09:13:34,000 TO STRENGTHEN MEDICARE AND TRY 14083 09:13:34,001 --> 09:13:37,000 TO KEEP IT FROM GOING IN 14084 09:13:37,001 --> 09:13:39,000 DEFAULT. 14085 09:13:39,001 --> 09:13:42,000 SO NOW WE'RE TALKING ABOUT 14086 09:13:42,001 --> 09:13:46,000 TAKING $465 BIION OUT OF 14087 09:13:46,001 --> 09:13:48,000 MEDICARE AND STARTING A NEW 14088 09:13:48,001 --> 09:13:50,000 ENTITLEMENT PROGRAM, A NEW 14089 09:13:50,001 --> 09:13:55,000 ENTITLEMENT PROGRAM AT THE TIME 14090 09:13:55,001 --> 09:13:58,000 THAT THIS NATION HAS JUST 14091 09:13:58,001 --> 09:13:59,000 PASSED -- OR JUST 14092 09:13:59,001 --> 09:14:03,000 LARGEST SINGLE DEFICIT IN 14093 09:14:03,001 --> 09:14:06,000 HISTORY OF THE 14094 09:14:06,001 --> 09:14:08,000 REPUBLIC, $1.4 TRILLION. 14095 09:14:08,001 --> 09:14:09,000 AND NEXT YEAR WE'LL BE OVER 14096 09:14:09,001 --> 09:14:10,000 $1 TRILLION, ACCORDING TO THE 14097 09:14:10,001 --> 09:14:15,000 CONGRESSIONAL BUDGET OFFICE. 14098 09:14:15,001 --> 09:14:16,000 NOT ME. 14099 09:14:16,001 --> 09:14:18,000 SO IS THIS SMART TO HAVE A 14100 09:14:18,001 --> 09:14:20,000 PROGRAM THAT PEOPLE HAVE 14101 09:14:20,001 --> 09:14:22,000 DEPENDED ON, THAT WE HAVE A 14102 09:14:22,001 --> 09:14:24,000 MORAL COMPACT TO SUPPORT OUR 14103 09:14:24,001 --> 09:14:27,000 SENIORS WHO PAID INTO THIS PLAN 14104 09:14:27,001 --> 09:14:30,000 FOR 40 YEARS 14105 09:14:30,001 --> 09:14:34,000 OUT OF THAT TO CREATE A NEW PROGRAM? 14106 09:14:34,001 --> 09:14:38,000 IT IS, IN FACT, IN QUITE A 14107 09:14:38,001 --> 09:14:40,000 NUMBER OF AREAS GOING TO COST 14108 09:14:40,001 --> 09:14:42,000 FAR MORE THAN IS BEING SUGGESTED 14109 09:14:42,001 --> 09:14:43,000 BY THE PEOPLE WHO ARE PROMOTING 14110 09:14:43,001 --> 09:14:45,000 THE LEGISLATION. 14111 09:14:45,001 --> 09:14:48,000 WE'RE GOING 14112 09:14:48,001 --> 09:14:49,000 TO DIG INTO THIS AND TRY ANALYZE 14113 09:14:49,001 --> 09:14:51,000 IT WITH MORE CLARITY. 14114 09:14:51,001 --> 09:14:53,000 BUT THE TRU 14115 09:14:53,001 --> 09:14:54,000 JUST DON'T ADD UP. 14116 09:14:54,001 --> 09:14:56,000 THEY WON'T WORK. 14117 09:14:56,001 --> 09:14:58,000 WE -- WE JUST OUGHT N TO BE 14118 09:14:58,001 --> 09:15:00,000 ESTABLISHING A NEW ENTITLEMENT 14119 09:15:00,001 --> 09:15:03,000 PROGRAM OF MASSIVE PROPORTIONS 14120 09:15:03,001 --> 09:15:05,000 IN A WAY THAT WE REALLY HAVE 14121 09:15:05,001 --> 09:15:08,000 LITTLE CONCEPT OF HOW IT'S GOING 14122 09:15:08,001 --> 09:15:09,000 TO PLAY OUT AT A TIME OF THE 14123 09:15:09,001 --> 09:15:11,000 LARGEST DEFICITS THIS NATION HAS 14124 09:15:11,001 --> 09:15:13,000 EF HER. 14125 09:15:13,001 --> 09:15:14,000 -- EVER HAD. 14126 09:15:14,001 --> 09:15:15,000 DEFICITS THAT ACCORDING TO OUR 14127 09:15:15,001 --> 09:15:18,000 OWN CONGRESSIONAL BUDGET OFFICE 14128 09:15:18,001 --> 09:15:21,000 WILL DOUBLE THE NATIONAL DEBT IN 14129 09:15:21,001 --> 09:15:23,000 FIVE YEARS AN TRIPLE IT TO DZ -- 14130 09:15:23,001 --> 09:15:24,000 AND TRIPLE IT TO $17 TRILLION IN 14131 09:15:24,001 --> 09:15:26,000 10 YEARS. 14132 09:15:26,001 --> 09:15:31,000 IT IS AN UNSUSTAINABLE COURSE. 14133 09:15:31,001 --> 09:15:33,000 AND ONE OF THE FIRST THINGS YOU SPEND YOUR MONEY. 14134 09:15:33,001 --> 09:15:36,000 I TALKED TO AN INDIVIDUAL TODAY. 14135 09:15:36,001 --> 09:15:39,000 HE SAID IT'S LIKE YOUR HOUSE IS 14136 09:15:39,001 --> 09:15:42,000 IN SERIOUS NEED OF REPAIR. 14137 09:15:42,001 --> 09:15:43,000 YOU REALLY DON'T HAVE THE MONEY 14138 09:15:43,001 --> 09:15:45,000 TO FIX IT. 14139 09:15:45,001 --> 09:15:47,000 YOU FINALLY DECIDE YOU'VE GOT TO 14140 09:15:47,001 --> 09:15:50,000 BORROW MONEY TO FIX THE HOUSE 14141 09:15:50,001 --> 09:15:52,000 AND INSTEAD YOU BORROW MONEY AND 14142 09:15:52,001 --> 09:15:54,000 ADD A WING ON TO THE HOUSE. 14143 09:15:54,001 --> 09:15:57,000 WE NEED TO FIX THE HOUSE WE'VE GOT. 14144 09:15:57,001 --> 09:16:02,000 WE NEED TO MAKE 14145 09:16:02,001 --> 09:16:04,000 HONOR OUR COMMITMENT TO MEDICARE RECIPIENTS. 14146 09:16:04,001 --> 09:16:06,000 YOU SEE, THEY'VE ALREADY PAID. 14147 09:16:06,001 --> 09:16:08,000 THAT'S THE IMPORTANT POINT TO REMEMBER. 14148 09:16:08,001 --> 09:16:13,000 THEY ALREADY PD THEIR WORKING 14149 09:16:13,001 --> 09:16:14,000 LIFE UNDER A COMPACT AND 14150 09:16:14,001 --> 09:16:17,000 COMMITMENT THAT THAT MONEY WOULD 14151 09:16:17,001 --> 09:16:19,000 BE IN THE FUND 14152 09:16:19,001 --> 09:16:20,000 THEM AND WE OUGHT NOT TO TAKE IT 14153 09:16:20,001 --> 09:16:21,000 AWAY. 14154 09:16:21,001 --> 09:16:23,000 I URGE MY COLLEAGUES TO THINK ABOUT THIS. 14155 09:16:23,001 --> 09:16:26,000 AND THIS IS JUST PERHAPS THE 14156 09:16:26,001 --> 09:16:27,000 MOST SIGNIFICANT FATAL FLAW IN 14157 09:16:27,001 --> 09:16:29,000 THE LEGISLATION. 14158 09:16:29,001 --> 09:16:31,000 IT JUST DOESN'T ADD UP. 14159 09:16:31,001 --> 09:16:34,000 THERE ARE A LOT OF OTHERS. 14160 09:16:34,001 --> 09:16:37,000 BUT THIS ONE, TO ME, IS THE 14161 09:16:37,001 --> 09:16:39,000 DRAMATIC, THE MOST 14162 09:16:39,001 --> 09:16:42,000 THE ONE THAT IS MOST UNWISE. 14163 09:16:42,001 --> 09:16:44,000 AND WE SIMPLY NEED TO SLOW DOWN, 14164 09:16:44,001 --> 09:16:45,000 ASK OURSELVES HOW WE CAN MAKE 14165 09:16:45,001 --> 09:16:48,000 OUR HEALTH CARE SYSTEM BETTER. 14166 09:16:48,001 --> 09:16:49,000 HO 14167 09:16:49,001 --> 09:16:50,000 BREAKING THE BANK. 14168 09:16:50,001 --> 09:16:52,000 AREN'T THERE SOME THINGS THAT WE 14169 09:16:52,001 --> 09:16:54,000 CAN DO TO IMPROVE HEALTH CARE IN 14170 09:16:54,001 --> 09:16:55,000 AMERICA WITHOUT A HUGE COST? 14171 09:16:55,001 --> 09:16:57,000 YES, THERE ARE. 14172 09:16:57,001 --> 09:16:59,000 AND LET'S START WITH EVERY 14173 09:16:59,001 --> 09:17:02,000 SINGLE ONE OF THOSE THAT WE CAN 14174 09:17:02,001 --> 09:17:05,000 AGREE ON AND IF WE DO THAT, I 14175 09:17:05,001 --> 09:17:06,000 THINK THAT WE CAN MAKE A 14176 09:17:06,001 --> 09:17:07,000 PROGRESS. 14177 09:17:07,001 --> 09:17:10,000 AND WHO KNOWS, IF THIS ECONOMY 14178 09:17:10,001 --> 09:17:12,000 TURNS AROUND, AND WE ALL HOPE IT 14179 09:17:12,001 --> 09:17:13,000 WILL, WE'LL BE IN A BETTER 14180 09:17:13,001 --> 09:17:15,000 FOOTING TO CONSIDER SOMETHING -- 14181 09:17:15,001 --> 09:17:16,000 CONSIDER A NEW B 14182 09:17:16,001 --> 09:17:17,000 FUTURE. 14183 09:17:17,001 --> 09:17:26,000 I WOULD THANK THE CHAIR AND 14184 09:17:26,001 --> 09:17:27,000 YIEL 14185 09:17:27,001 --> 09:17:28,000 THE PRESIDING OFFICER: THE 14186 09:17:28,001 --> 09:17:30,000 SENATOR FROM MONTANA. 14187 09:17:30,001 --> 09:17:31,000 MR. BAUCUS: I ASK CONSENT THAT 14188 09:17:31,001 --> 09:17:33,000 THE SENATE PROCEED TO A PERIOD 14189 09:17:33,001 --> 09:17:34,000 OF MORNING BUSINESS WITH 14190 09:17:34,001 --> 09:17:35,000 SENATORS PERMITTED TO SPEAK UP 14191 09:17:35,001 --> 09:17:36,000 TO 10 MINUTES EACH. 14192 09:17:36,001 --> 09:17:38,000 THE PRESIDING OFFICER: WITHOUT OBJECTION. 14193 09:17:38,001 --> 09:17:41,000 MR. BAUCUS: I ASK THAT THE 14194 09:17:41,001 --> 09:17:43,000 COMMITTEE ON HOMELAND GOVERNMENT 14195 09:17:43,001 --> 09:17:45,000 AFFAIRS -- THE BILL 14196 09:17:45,001 --> 09:17:46,000 THE THE PRESIDING OFFICER: WITHOUT 14197 09:17:46,001 --> 09:17:48,000 OBJECTION. 14198 09:17:48,001 --> 09:17:49,000 MR. BAUCUS: MR. PRESIDENT, I ASK CONSENT THAT THE SENATE PROCEED 14199 09:17:49,001 --> 09:17:54,000 TO THE IMMEDIATE CONSIDERATION 14200 09:17:54,001 --> 09:17:55,000 OF CALENDAR NUM 14201 09:17:55,001 --> 09:17:57,000 341. THE PRESIDING OFFICER: THE CLE 14202 09:17:57,001 --> 09:18:00,000 WILL REPORT. 14203 09:18:00,001 --> 09:18:02,000 THE CLERK: CALENDAR 212, 14204 09:18:02,001 --> 09:18:04,000 341, SUPPORTING PEACE, SECURITY 14205 09:18:04,001 --> 09:18:07,000 AND INNOCENT CIVILIANS AFFECTED 14206 09:18:07,001 --> 09:18:09,000 BY CONFLICT IN YEMEN. 14207 09:18:09,001 --> 09:18:11,000 THE PRESIDING 14208 09:18:11,001 --> 09:18:13,000 PROCEED TO THE MEASURE. 14209 09:18:13,001 --> 09:18:15,000 MR. BAUCUS: MR. PRESIDENT, I ASK UNANIMOUS CONSENT THAT THE 14210 09:18:15,001 --> 09:18:17,000 RESOLUTION BE AGREED TO, THE 14211 09:18:17,001 --> 09:18:18,000 PREAMBLE B MOTION TO RECONSIDER BE LAID ON 14212 09:18:18,001 --> 09:18:20,000 THE TABLE WITH NO INTERVENING 14213 09:18:20,001 --> 09:18:21,000 ACTION OR DEBATE AND ANY 14214 09:18:21,001 --> 09:18:22,000 STATEMENTS RELATED TO THE 14215 09:18:22,001 --> 09:18:23,000 RESOLUTION BE PLACED IN THE 14216 09:18:23,001 --> 09:18:25,000 RECORD AT THE APPROPRIATE PLACE 14217 09:18:25,001 --> 09:18:26,000 AS IF READ. 14218 09:18:26,001 --> 09:18:29,000 THE PRESIDING OFFICER: WITHO 14219 09:18:29,001 --> 09:18:31,000 OBJECTION. 14220 09:18:31,001 --> 09:18:32,000 MR. BAUCUS: MR. PRESIDENT, I ASK 14221 09:18:32,001 --> 09:18:33,000 UNANIMOUS CONSENT THAT THE 14222 09:18:33,001 --> 09:18:35,000 SENATE NOW PROCEED 14223 09:18:35,001 --> 09:18:36,000 CONSIDERATION OF S. RES. 370, 14224 09:18:36,001 --> 09:18:37,000 WHICH WAS SUBMITTED EARLIER 14225 09:18:37,001 --> 09:18:38,000 TODAY. 14226 09:18:38,001 --> 09:18:41,000 THE PRESIDING OFFI WILL REPORT. 14227 09:18:41,001 --> 09:18:43,000 THE CLERK: S. RES. 370, RELATIVE 14228 09:18:43,001 --> 09:18:45,000 TO THE DEATH OF PAULA F. 14229 09:18:45,001 --> 09:18:46,000 HAWKINS, FORMER UNITED STATES 14230 09:18:46,001 --> 09:18:48,000 SENATOR FOR THE STATE OF 14231 09:18:48,001 --> 09:18:49,000 FLORIDA. 14232 09:18:49,001 --> 09:18:50,000 TH 14233 09:18:50,001 --> 09:18:51,000 OBJECT 14234 09:18:51,001 --> 09:18:53,000 PROCEED TO THE MEASURE. 14235 09:18:53,001 --> 09:18:54,000 MR. BAUCUS: MR. PRESIDENT, I ASK 14236 09:18:54,001 --> 09:18:55,000 UNANIMOUS CONSENT THAT THE 14237 09:18:55,001 --> 09:18:58,000 RESOLUTION BE AGREED TO, THE 14238 09:18:58,001 --> 09:18:59,000 PREAMBLE BE AGREED MOTION TO RECONSIDER BE LAID ON 14239 09:18:59,001 --> 09:19:01,000 THE TABLE. THE PRESIDING OFFICER: WITHOUT 14240 09:19:01,001 --> 09:19:02,000 OBJECTION. 14241 09:19:02,001 --> 09:19:04,000 MR. BAUCUS: MR. PRESIDENT, I ASK 14242 09:19:04,001 --> 09:19:06,000 UNANIMOUS CONSENT THAT WHEN THE 14243 09:19:06,001 --> 09:19:08,000 SENATE COMPLETES ITS BUSINESS 14244 09:19:08,001 --> 09:19:10,000 TODAY, 14245 09:19:10,001 --> 09:19:13,000 10:00 A.M. ON SATURDAY, SEPTEMBER 5. 14246 09:19:13,001 --> 09:19:14,000 THAT FOLLOWING THE PRAYER AND 14247 09:19:14,001 --> 09:19:15,000 PLEDGE, THE JOURNAL OF 14248 09:19:15,001 --> 09:19:16,000 PROCEEDINGS BE APPROVED TO DATE, 14249 09:19:16,001 --> 09:19:18,000 THE MORNING HOUR BE DEEMED 14250 09:19:18,001 --> 09:19:19,000 EXPIRED, THE TIME FOR THE TWO 14251 09:19:19,001 --> 09:19:21,000 LEADERS BE RESERVED FOR THEIR 14252 09:19:21,001 --> 09:19:23,000 USE LATER IN THE DAY AND SENATE 14253 09:19:23,001 --> 09:19:25,000 RESUME CONSIDERATION OF H.R. 14254 09:19:25,001 --> 09:19:26,000 3590, THE HEALTH CARE REFORM 14255 09:19:26,001 --> 09:19:27,000 LEGISLATION. 14256 09:19:27,001 --> 09:19:28,000 THAT THE FIRST THREE HOURS 14257 09:19:28,001 --> 09:19:30,000 FOLLOWING ANY LEADER REMARKS 14258 09:19:30,001 --> 09:19:33,000 EQUALLY DIVIDED BETWEEN THE TWO 14259 09:19:33,001 --> 09:19:35,000 LEADERS OR THEIR DESIGNEES AND 14260 09:19:35,001 --> 09:19:36,000 CONTROLLED IN 45 MINUTE 14261 09:19:36,001 --> 09:19:37,000 ALTERNATING BLOCKS OF TIME. 14262 09:19:37,001 --> 09:19:39,000 WITH THE MAJORITY CONTROLLING 14263 09:19:39,001 --> 09:19:41,000 THE FIRST BLOCK AND NO OTHER 14264 09:19:41,001 --> 09:19:42,000 MOTIONS OR AMENDMENTS IN ORDER DURING THE CONTROLLED TIME. 14265 09:19:42,001 --> 09:19:43,000 THE PRESIDING OFFICER: WITHOUT 14266 09:19:43,001 --> 09:19:44,000 OBJECTION. 14267 09:19:44,001 --> 09:19:46,000 MR. BAUCUS: MR. PRESIDENT, 14268 09:19:46,001 --> 09:19:47,000 SENATORS SHOULD EXPECT ROLL CALL 14269 09:19:47,001 --> 09:19:50,000 VOTES TOMORROW AFTERNOON. 14270 09:19:50,001 --> 09:19:52,000 THERE WILL BE NO ROLL CALL VOTES 14271 09:19:52,001 --> 09:19:53,000 REQUIRE PRIOR TO 1:00 P.M. 14272 09:19:53,001 --> 09:19:59,000 I ASK THAT THE SENATE ADJOURN 14273 09:19:59,001 --> 09:20:03,000 UNDER THE PROVISION OF S. YES 3 14274 09:20:03,001 --> 09:20:04,000 -- S. RES. 370 FOR PAULA 14275 09:20:04,001 --> 09:20:05,000 HAWKINS, THE PREVIOUS SENATOR 14276 09:20:05,001 --> 09:20:06,000 FOR STATE OF FLORIDA. 14277 09:20:06,001 --> 09:20:09,000 THE PRESIDING OFFICER: THE 14278 09:20:09,001 --> 09:20:11,000 SENATE WILL ADJOURN UNTIL 14279 09:20:11,001 --> 09:20:13,000 10:00 AND S. RES. 370, DOES SO 14280 09:20:13,001 --> 09:20:15,000 AS A MARK OF RESPECT FOR PAULA 14281 09:20:15,001 --> 09:20:19,000 HAWKINS, FORMER SENATOR FROM THE 14282 09:20:19,001 --> 09:20:19,000 STATE OF FLORIDA.