Speeches & Floor Statements

Floor Remarks of U.S. Senator Lamar Alexander (R-Tenn.) -- Health Care Reform

Posted on October 8, 2009

Mr. President, I congratulate the Republican leader for his comments. If it weren't so serious, he and I and the Senator from Texas would probably all be amused to hear the Democratic leader come here day after day and say the Republicans don't have a health care plan and then attack our plan. That is typical of the kind of talk we are getting about health care reform from the Democratic side. We are getting double-talk. It reminds me, a few years after I was Governor of Tennessee -- it must have been the early 1990s -- I was driving along in Nashville as a private citizen. I had the radio on. It might have been an Arkansas radio station, but I think it was a Nashville station. The announcer said: Big news. The Tennessee legislature has passed a new law creating a Medicaid program called TennCare. Here is what it will do. It will cover twice as many people for the same amount of money. Everybody was happy about that. Nobody had to raise taxes. Nobody had to pay any more money. Twice as many people get health care. I remember what went through my mind: I bet that doesn't happen. That sounds too good to be true. The same idea went through my mind when I picked up a paper this morning and read: The Senate Finance Committee has finished its work. We are going to give 29 million more Americans health care. It is going to cost hundreds of billions of dollars more, and it is going to reduce the Federal deficit all at once. What went through my mind was: That sounds too good to be true. It sounds like the TennCare story. Let's remind ourselves what the Republican leader said a minute ago. The focus is reducing cost. We all know there are people who don't have health care and who need it. We would like to extend it to them. But we can't afford to do that until we reduce the cost of the health care we have. It is going to bankrupt us as individuals if we don't reduce the cost of our health care premiums. It is going to bankrupt our government if we don't stop the growth of health care. Our first goal is reducing cost, which is why the Republican plan for health care is to take several commonsense steps in the right direction -- reducing cost -- that will get us where we want to go.. We have said those on the floor time after time after time. They include allowing small businesses to pool their resources so they can offer insurance to more of their employees. They include taking steps to stop junk lawsuits against doctors, which are driving up malpractice premiums and causing problems for patients. For example, many women who are pregnant in rural West Tennessee counties have to drive all the way to Memphis to see a doctor because doctors would not practice there anymore because of the high cost of medical malpractice premiums, which is driving up the cost of health care. We could create exchanges in each State so people could shop for individual insurance. We could allow people to buy their insurance across State lines. We all believe that if we did a better job of encouraging technology, we could reduce cost and reduce paperwork. All doctors and nurses and medical assistants know that. Those are five steps we could take together to reduce cost, and we could begin to add to our rolls the 11 or 12 million people who are already eligible for programs we have today. That would make a big difference. Instead, what our friends on the other side want to do is transform the system at a cost of closer to $1.6 to $1.8 trillion, when fully implemented. The question will be, Will it reduce our costs? That is why we want to read the bill. We want to know what it costs. This is not a bill. This is some pages of concepts. This is not a formal, complete estimate of its cost. That only comes when we have a bill. We have had 8 Democratic Senators who have written to the majority leader and said what all 40 Republicans have said. The legislative text and the complete budget scores from the Congressional Budget Office that are going to be considered should be available on a Web site for 72 hours prior to the first vote. Democrats voted that down in the Finance Committee. They voted down the idea of allowing 72 hours to read a 1,000-page bill and to find out what it costs. Apparently, some Democrats are coming to their senses and saying: No, we would like to have the bill. We would like to read it. We would like to have a formal, complete score -- their words -- of what it costs, and then we will start voting. This is not a bill. These are concepts. Then the majority leader is going to put this all together into another bill or create a bill. Then it will take a couple weeks to find out what that costs. We have some questions to ask in the meantime. First, we would like the Democrats to join us in step-by-step solutions to reduce cost. Next, we want to know whether it is going to reduce the cost to government and whether it will reduce the cost to each of us who is buying health insurance. As I look at the outlines, I think it might not. For example, as the Republican leader said, we know it is going to cost about twice as much as the $800 billion advertised because it doesn't start taking effect for a few years. The taxes start right away, but the benefits don't start for a few years. That is the first thing. The second thing is, it is going to put 14 million more people into the Medicaid Program -- not Medicare, this is the Medicaid Program. This is the program States operate that is paid for two-thirds by the Federal Government and a third by the States, about which all the Governors have said: If Washington is going to expand the Medicaid Program, Washington ought to pay for it. I suspect when we start asking questions, we will find Medicaid Program costs are underestimated. All the Governors think so. We had one of the most painful letters I have ever read from the Democratic Governor of Tennessee. Senator Corker put it in the Record. He talked about how Tennessee's condition was similar to the condition of most States. He said: For example, by 2013, we expect to return to our 2008 levels of revenue. We will already have cut programs dramatically. We will have to start digging out. We haven't given raises to State employees or teachers for 5 years. Our pension plans will need shoring up. Our rainy day fund will have been depleted. We would not have made any substantial investments in years. There will be major cuts to areas such as children's services. We are going to expand a program that is already causing the State of Tennessee and most other States to go toward bankruptcy. That is the way we are going to achieve reform. That is half the reform. Most Governors who have had anything to do with the Medicaid Program say that dumping low-income Americans into the Medicaid Program, where 40 percent of the doctors would not see them, is not health care reform. Medicaid costs are underestimated. Also, I don't think the Congressional Budget Office estimate of these concepts we saw includes what we inelegantly call the doc fix. Every year the system we have reduces payments to doctors who work on Medicare patients.. So we come back and raise the amount of money. If we only pay doctors 10 years from today what we are paying them today to serve Medicare patients, it will cost $285 billion, and that is not in this bill. When we ask our questions and read the bill and find out what it costs, we will find it doesn't reduce the deficit. Even if it did, it is going to cost $1.6 or $1.8 trillion. Who is going to pay for it? Half of it is going to come from cuts in Medicare, which serves seniors. Instead of putting any savings in Medicare to strengthen that program, which is going bankrupt in 2015-2017, we are going to spend it on a new program. Eight hundred billion will come in new taxes. Our insurance premiums are likely to go up instead of down because we will all be buying new government-approved programs. If Speaker Pelosi is successful in adding the government-run option into the bill before it finally gets through, millions of Americans will be losing their insurance because employers will be paying a fine, instead of the insurance, because their employees can go to the government program. We are going to be paying for it. If you are a Medicare beneficiary, if you pay taxes, if you are a State taxpayer, if you buy insurance, you are going to be paying for this program. So it is important for the next 3 to 4 weeks that as we debate this, we ask these questions. MOVE MOVE MOVE SATURN CAR COMPANY Mr. President, I ask unanimous consent to have printed in the Record remarks I made this weekend on the Saturn car company, which has lived and apparently passed away, in the State of Tennessee but has contributed a lot to our State over the last 20 years. Mr. President, I see the Senator from Texas on the floor, and I wonder, as I conclude my remarks, whether he has thought a little bit about whether it is going to be possible to ensure 29 million more people spend hundreds of billions of dollars and still reduce the deficit and reduce costs to the American people who are trying to afford their insurance premiums today.. The ACTING PRESIDENT pro tempore. The Senator from Texas. Mr. CORNYN. Mr. President, I would respond to the distinguished Senator from Tennessee, of course not. The American people are smart. They can understand that these numbers are not going to add up. As our Republican leader said this morning, this bill that was reported in the newspaper and scored by the Congressional Budget Office yesterday will never see the light of day. So this is a work in progress. We are committed, I think on a bipartisan basis, to reform our health care system. But the goal -- and we need to keep our eye on the goal -- is to bring down the cost and to cover people who currently are not covered. This bill, unfortunately, does not accomplish those goals. But we are going to keep working with our colleagues, if they will be open to our suggestions. But I have to tell you, as a member of the Finance Committee, virtually every suggestion Republicans made during the amendment process to this bill was voted down on a party-line basis. I came to the floor to talk about one of those amendments the Senator from Tennessee mentioned, where we asked merely that the bill -- once it is reduced to legislative language and the cost is determined -- be put on the Internet for 72 hours. That was voted down along a party-line vote. But I thank the Acting President pro tempore and other folks on the other side of the aisle, eight of whom have written to the majority leader saying that makes sense to them. So I hope we will build a bipartisan consensus for more transparency in the debate. I have also come to the floor to talk about how it makes no sense to cut Medicare benefits for 11 million Medicare beneficiaries who happen to be engaged in the Medicare Advantage Program in order to pay for this bill. Why would you take $1/2 trillion from Medicare, which is on a pathway to bankruptcy by 2017, in order to create a new government program? It can only make sense inside the beltway and if you voluntarily suspend your powers of disbelief. It does not make sense across the country. That is why it is so important to have these discussions, ask these questions, have transparency.