Speeches & Floor Statements

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

Posted on October 14, 2009

Mr. ALEXANDER. Mr. President, the Senator from Oklahoma, a practicing physician who has delivered hundreds or thousands of babies – Mr. COBURN. Thousands. Mr. ALEXANDER. -- thousands of babies is one of the most eloquent spokesmen for what needs to be done in health care in the Senate. I am delighted he took time to come to the Senate floor today. It helps to have someone here who has such a passion for patients and who can talk to the American people on this complicated subject in terms of what this health care plan means for us. That is why so many of us on the Republican side agree with what eight Democratic Senators wrote to the majority leader the other day. They said: We would like to read the bill and know what it costs before we start voting on it. That seems so sensible that maybe the American people would laugh out loud if that would be a request, but it is. It is important to us and them and many more of the Senators -- I believe virtually all of the American people -- that we honor that request. What that means is that the legislative text being put together by Majority Leader Reid somewhere -- the merging of the Finance bill and the HELP bill -- that full text, and as the Democratic Senator said, the complete budget scores should be made available for 72 hours on the Internet before we begin to vote. The Director of the Budget Office has said it might take 2 weeks, 3 weeks, to have complete budget scores so we can know what the bill costs. But if it takes 2 weeks, if it takes 3 weeks, if it takes 4 weeks, we need to know. The President has said we cannot add a dime to the deficit. How are we going to know if we are adding a dime to the deficit if we do not read the bill and do not know what it costs. We cannot guess what is in the bill. We cannot guess at what it costs when we are talking about huge numbers -- hundreds of billions, trillions of dollars. We have our work cut out for us. We can stay here and do this. We are prepared to do this. We Republicans agree with the Democratic Senators that we need to read the bill and know what it costs. We need to see the complete legislative text and the complete budget numbers. Why is that so important? Among other reasons, what we are hearing is that what the bill coming out of the Finance Committee does is, among other things, three big things. Instead of reducing costs, it has higher premiums, it has higher taxes, and it has Medicare cuts. That is not health care reform if it has higher premiums, higher taxes, and Medicare cuts for more government. What is the goal of this exercise? The first goal is reducing costs for each person who buys insurance. How many of us go home and hear that every weekend? I cannot afford my insurance; do something about it. Reducing costs. What else do we hear? People are saying: I cannot afford my government.. You guys are running up the debt trillions of dollars, hundreds of billions of dollars. What we need to do is to reduce the cost of health care for individuals across America and for the government of individuals. But this bill raises premiums, raises taxes, and cuts Medicare to create more government. How does it drive up premiums? The Congressional Budget Office has said the obvious, which is that when we impose taxes on medical devices and on the insurance companies, what do they do with it? It is $900 billion-plus worth of taxes. They pass it on to us. So our premiums go up. Or there are new "government approved" policies that we will need to buy. If you are one of those Americans who likes to buy a catastrophic policy -- that is, pay a lower premium so that you pay your own medical expenses unless something really terrible happens to you or your family -- that is a pretty wise choice for many Americans. You may not be able to do that quite so easily under this bill because you will have to buy a government-approved plan or pay a fine. And then younger Americans may be surprised by the amount of money they have to pay. So it is very likely that for millions of Americans this bill will raise their premiums instead of reducing their cost, and 250 million Americans either pay premiums or have premiums paid for them. Then raising taxes. Here we are in the middle of a recession, 10 percent unemployment, and we are talking about nearly $1 trillion of tax increases that will be passed on to us in one way or the other. There is a $1,500 penalty per family if you don't buy insurance. There is an employer mandate.. So if you are a small business, you will have to either provide insurance or pay that penalty. Then the governors of both parties -- Democrats and Republicans -- are in a near cardiac arrest over the prospect of the Medicaid expansion. I mean 14 million new people -- low-income Americans -- dumped into State Medicaid Programs. I say "dumped" because doctors and hospitals are reimbursed so poorly that only 40 percent of doctors will see Medicaid patients. So we are going to say: Congratulations, Mr. and Ms. Low-Income American, into the Medicaid you go in your State. Not only is it not health care reform for those individuals, but the governors can't manage it, the legislators can't manage it, and the taxpayers can't manage it. I have read, on the floor, comments from most Democratic Governors and most Republican Governors. They are in a situation where their States' budgets are in the worst shape since the 1960s. Medicaid is going up at 6 and 7 percent. They are taking money from higher education and K-12 grades and spending it on Medicaid, and now we are about to dump not only more low-income Americans into Medicaid, but we are going to send a part of the bill to the State governments which can't afford it. So that is State taxes, and it cuts your Medicare. The question I would like to raise is, what about those Medicare cuts and are doctors themselves going to be paying for this bill? There is an article today, or October 13, the former head of the Congressional Budget Office, Douglas Holtz-Eakin. These Congressional Budget Office heads are known to be pretty straight. This one was appointed by the Republican Congress; Mr. Elmendorf, whom we all respect, was appointed by a Democratic Congress, but they are all nonpartisan. Mr. Holtz-Eakin says: ...the plan proposed by the Democrats and the Obama administration would not only fail to reduce the cost burden on middle-class families, it would make that burden significantly worse. The bill creates a new health entitlement program that the Congressional Budget Office estimates will grow over the longer term at a rate of 8 percent annually. To avoid the fate of the House bill... the Senate did three things: It promised that future Congresses would make tough choices to slow entitlement spending, and it dropped the hammer on the middle class. Here is what Mr. Holtz-Eakin said: One inconvenient truth is the fact that Congress will not allow doctors to suffer a 24 percent cut in their Medicare reimbursements. Doctors today are paid about 80 percent of what private insurers will pay if they see Medicare patients and, under the law, that gets cut every year and every year we come in and fix that. Continuing to read from his article:Senate Democrats chose to ignore this reality and rely on the promise of a cut to make their bill add up. Taking note of this fact pushes the cost of the bill well over $1 trillion and destroys any pretense of budget balance. In other words, Mr. Holtz-Eakin is saying he doesn't believe we in Congress are going to cut doctors' pay when they serve Medicare patients by roughly $250 billion over the next 10 years. That is about the amount of money it would take just to pay doctors 10 years from now what they are being paid today, and most wouldn't be happy with that. So either the doctors are going to pay for this bill -- $250 billion of it -- or you are, because it is going to add to your debt, or your children or your grandchildren are. It is one way or the other. It is either doctors pay or your kids pay because it is not deficit neutral. He says:It is beyond fantastic to promise that future Congresses, for 10 straight years, will allow planned cuts in reimbursements to hospitals, other providers, and Medicare Advantage -- thereby reducing the benefits of 25 percent of seniors in Medicare. His point is these are not only cuts in Medicare -- $1/2 trillion worth of cuts -- the cuts are being used to start a new government program. And here, as both Senator Harkin and Senator Coburn reminded us, Medicare in 5 or 6 years is going bankrupt -- belly up. What we are proposing to do is cut Medicare -- take money from grandma -- and instead of spending it on grandma by making Medicare more solvent, we are going to take that money, while the program is about to go insolvent, and create a new program. So these are the kinds of questions the American people have a right to ask and have answered. That is why we want to read the bill. Because we see, as we look at this bill, higher premiums, higher taxes, Medicare cuts for more government, and we don't believe that is health care reform. Mr. President, I ask unanimous consent to have printed in the Record the entire article from which I quoted. ###