FISA Amendments Act of 2008 - Motion to Proceed
Floor Speech
FISA AMENDMENTS ACT OF 2008--MOTION TO PROCEED -- (Senate - June 26, 2008)
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MEDICARE ADVANTAGE
Mr. DURBIN. Mr. President, pending before the Senate is an important measure about compensating medical providers who treat Medicare patients. Medicare patients, of course, are the elderly and the disabled. This program that was started over 40 years ago reaches 40 million Americans. It is an important lifesaver. It is a lifeline for many people who have reached a point where they can no longer afford to pay for their own major medical bills. Many of these people are on fixed incomes. Many of these folks have no health insurance, other than Medicare. They are desperate to find the kind of care they need.
Medicare, a program that was once criticized as being too much government and socialism, has turned out to be one of the most valuable programs the Federal Government offers. For 40 million Americans, it means they have the peace of mind that when they are sick, there is a place to go and someone to pay for it, that they will not sacrifice their savings and everything they have because of a medical catastrophe. There is a suggestion of cutting the compensation to Medicare providers by 10 percent. The fear is, if we cut that pay to these Medicare providers, fewer doctors will take Medicare patients; they will decide that the economic benefits are with other patients who might be paying more through private health insurance or even out of their own pockets.
We have a deadline. On July 1, this 10-percent cut goes into place. We have been trying, week after week, month after month, to pass in the Senate a provision that will protect these Medicare providers from this proposed cut of 10 percent. Imagine, if you will, that seniors who have doctors' appointments in the first or second week of July call to find that the appointments have been canceled because their doctor no longer takes Medicare patients. I don't want that to happen in Illinois. I don't think it should happen anywhere across this country.
A bill comes through the House of Representatives which proposes that we stop this 10-percent cut and make sure Medicare does not suffer this change and that the Medicare beneficiaries are not disadvantaged. The vote was called earlier this week in the House of Representatives. The final vote was 355 to 59. By a margin of 5, or 6 to 1, a bipartisan vote in the House of Representatives, they voted to take care of this problem and do it now before the July 1 deadline kicks in. The bill that passed in the House is supported by physicians, consumer groups, pharmacists, hospitals, and many others. Who opposes this bill? Two groups. I should say two entities--the health insurance industry and the White House. Why? Because the bill provides for savings from private fee-for-service Medicare plans. In other words, the additional 10 percent that is going to be paid to these Medicare providers, part of it at least is offset by saying that private health insurance companies are going to receive less in reimbursement for treating Medicare patients.
Why should they receive less, you ask? Because the so-called Medicare Advantage plans, private health insurance plans providing benefits that look a lot like Medicare, charge more than the Medicare plan, 12 to 13 percent more. Those aren't figures dreamed up by Congress. They come to us from the executive branch of Government. We suggested some savings in the amount of money paid to private health insurance companies and the resistance comes, obviously, from those companies, the White House, and this morning from the Republican side of the aisle. They refuse to let us cut any reimbursement to the private health insurance companies that charge more for the same services that Medicare is providing.
So we have reached an impasse. It is an impasse that has to be broken to the benefit of Medicare beneficiaries. I think we should be guided in breaking it by what happened in the House of Representatives by a vote of 355 to 59. Private fee-for-service plans are paid more than what it costs to treat the same Medicare patient in the traditional Medicare Program. We are paying these private insurance companies more than the ordinary Medicare reimbursement.
For some on the other side of the aisle, this is all well and good. They want to privatize Medicare. They want to end this so-called Government health insurance plan. I am not one of those. After more than 40 years of success in Medicare, I don't want to see this program go away. This program has been a lifeline when all else has failed. Medicare Advantage plans, those private health insurance company plans I talked about, cost taxpayers, on average, 13 percent more than Medicare for the same benefits. Private fee-for-service Medicare Advantage costs even more, 19 percent. This payment disparity gives private fee-for-service plans a competitive advantage over traditional Medicare. In other words, they can offer a little bit more, some bells and whistles, and they charge dramatically more when it comes to billing taxpayers and the Government for their services. We are trying to trim that back a bit.
The howls and screams from the other side of the aisle come because they want to protect these private health insurance companies. These unjustified higher payments are fueling large increases in enrollment in these types of plans that charge more because they offer a little bit more here and there. Even CMS has been concerned about the marketing practices of these private fee-for-service plans. Understand, these private health insurance companies, trying to enroll Medicare beneficiaries into their private health insurance alternative to Medicare, are going door to door, using telephone, mail, soliciting many seniors. Some of them are misled. Some of them are confused by the solicitations. There is outright fraud taking place. There have been numerous reports of sales agents using strong-arm tactics to enroll Medicare beneficiaries in these plans without the beneficiaries understanding how the plans differ from traditional Medicare.
Yesterday, the Government Accountability Office released a report that shows that private Medicare Advantage plans spent less on medical care than they report to the CMS which, in turn, earned them $1.14 billion in additional profits over what was expected. This is money going directly into the pockets of the insurance industry, not for the health benefits of Medicare patients. This report confirms the deal that was offered to Medicare beneficiaries and American taxpayers by these private plans is even worse than we thought. Yet today, on the Republican side of the aisle, they are objecting to this fix in Medicare to protect these private health insurance plans that have been found over and over again to charge too much, to be abusive in their marketing and, frankly, to provide less medical care than they promised.
In this report, for the first time in the history of the Medicare Advantage Program, GAO compared the private plans' projected spending on medical care and profit margins with their actual profit margins and spending on medical care. They found that in 2005, the Medicare Advantage plans projected spending 90.2 percent of total costs on medical services but actually spent 85.7 percent. By spending less on helping Medicare patients, these plans increased their profits. That is what it is all about--giving the Medicare patients as little as possible.
These private health insurance plans are big winners when it comes to making money but at the expense of medical care for the Medicare patients. These are the same companies Republicans are trying to protect by objecting to our fixing this Medicare reimbursement problem.
It is a shame we are putting the health of America's seniors on the line for the profit of a handful of private insurance companies. The Bush administration is disguising the truth. They claim the Medicare Advantage plans are helping, when they aren't doing a good job. This GAO report is more evidence of waste and abuse in this program, evidence which those who object to our moving forward refuse to even read or acknowledge. The changes in this bill are modest. They are nowhere close to payment cuts the House approved earlier this year. What Republicans and the White House are objecting to is taking away another special advantage that private fee-for-service plans have been given, the ability to deem a doctor or hospital as part of its necessary work. This bill merely requires private fee-for-service to enter into contracts with health care providers, as all other private Medicare plans already do. This reform is good for patients, good for health care providers, and good for taxpayers.
The overwhelming vote in the House for this bill shows Congress will no longer allow the Bush administration, as it is packing to leave town over the next 6 months, to protect the health insurance industry at the expense of Americans, our families, and Medicare beneficiaries.
I urge my colleagues, support the Medicare Program, make sure Medicare providers are adequately funded. Don't stand in defense of private health insurance at the expense of this valuable program.
I yield the floor.
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