Medicare Improvements

Floor Speech

MEDICARE IMPROVEMENTS -- (Senate - June 26, 2008)

BREAK IN TRANSCRIPT

Mr. CORNYN. Mr. President, I have been talking to the physicians in my State who take Medicare patients, and frankly, this is a terrible way for Congress to do business. We see a 6-month patch on the physician reimbursement formula that will expire July 1, and unfortunately we are looking at what amounts to a partisan proposal here that we are basically being told to take or leave.

As all of our colleagues know, the ranking member on the Finance Committee, Senator Grassley, got together with Senator Baucus after cloture was denied previously and pretty well had things worked out in a bipartisan way until the House passed their version, and then, of course, those negotiations broke down, leading us to this cloture vote we are going to have here in just a few minutes. But I have to say that in 1996 when Congress passed the Balanced Budget Act and contemplated these Draconian cuts in the physician reimbursement payments, Congress should have known and should have told the truth that it never intended that any of those cuts would ever take place--and for good reason they should never take place, because even under the current Medicare reimbursement rates, doctors--for example, in Travis County where Austin, TX, is located, only about 18 percent of the physicians in that county will actually take new Medicare patients because the reimbursement rates are already so low.

Then we have this unbelievably bad way of doing business. I don't know anybody else who could get away with--other than the Congress--passing temporary patches on the reimbursements that are paid to physicians. They last for a year, they last for 6 months, such as this last one that leads us up to the edge of a cliff here on July 1, and then we are told by the distinguished chairman of the Finance Committee that we have to take it or leave it or the cuts will occur. Well, frankly, no one believes the cuts will actually occur because Congress will act.

I suggest that rather than this terrible way of doing business that nobody else could ever get by with and rather than frightening the Medicare beneficiaries who need access to the doctors who are paid using this Medicare reimbursement formula, we ought to scrap the entire method of reimbursing doctors for Medicare and start over again, recognizing that we are not going to allow these Draconian cuts to occur, this 10-percent-plus cut that goes into effect July 1 and the 20-percent-plus cut that will occur 18 months from now. I think we ought to acknowledge that we are not going to let those cuts go into effect and scrap the sustainable growth rate formula by which those Medicare reimbursements are calculated because it is just not honest. It is not honest. It is scaring not only the Medicare beneficiaries, it is impairing access to health care for those to whom we promised the Medicare Program would actually work.

So I don't know what is going to happen on this vote on cloture. I suspect cloture may not be invoked. My hope is that there would be a bipartisan way to find our way forward. I believe it already exists in the form of a negotiation that Senator Grassley and Senator Baucus have undertaken here in the Senate and that we shouldn't use this

kind of brinkmanship to scare not only the Medicare beneficiaries--the seniors who depend on this health care--but also the physicians who are reimbursed under this formula.

GASOLINE PRICES

Mr. CORNYN. I wish to talk just a minute about gasoline prices. I don't know of any subject I hear more about and more concern about from my constituents in Texas than high gasoline prices, whether it is parents driving their children to school or their afterschool activities or truckers who have to buy diesel, which is breaking the bank and which they are finding it harder and harder to pay for, or whether it is the airlines--Continental Airlines and American Airlines and Southwest Airlines, all three of which are located in the State of Texas. The price of aviation fuel made from petroleum products is making it almost impossible for them to do business under their current model, and prices are going up. It is becoming harder and harder for consumers to deal with.

There is a way Congress could act to help bring down prices at the pump on a temporary basis, and it involves exploring for and producing more American energy. That is important from a number of perspectives.

First of all, it is important from a national security perspective because right now we depend on 60 percent of our energy needs, our oil and gas needs, from foreign sources. What would happen if something were to occur that were to blockade the tankers that would prevent that oil from being transported? Well, it would mean in Iraq and Afghanistan that the Department of Defense vehicles owned by the Army, Marines, and others wouldn't have the petroleum products they need in order to function. It would exact a crippling blow against our economy. So why in the world would we continue to allow 60 percent of our dependency for oil to come from foreign sources when we have here in America enough oil under our own Outer Continental Shelf, in the oil shale in the West, and in the Arctic that could produce as much as 3 million additional barrels of oil a day? That is more than 10 percent of our current use here in the United States. As a matter of fact, it is a substantial amount--more than 10 percent, closer to 12 percent of what we use right here in the United States.

We know the money we are paying--$135 a barrel--is enriching people such as Hugo Chavez of Venezuela, and he is using that money to buy weapons from Russia and to arm himself as he continues to take in and protect the FARC, a narcoterrorist organization, to the detriment of our friends in Colombia and stability in South America.

But it is absolutely crazy for this Congress to have in place, as it does--and it has since 1981 or 1982--a moratorium or ban on developing more of our own natural resources and becoming more self-reliant rather than more dependent on foreign sources of oil. It is up to Congress to get out of the way and to allow America to become more energy self-sufficient. We can do it, and only Congress can get that done. It is completely inexcusable when gasoline is at $4 a gallon on average to do that, to be the impediment, to be the blockade, to be the cause of so much pain at the pump and so much sacrifice and hardship among hard-working American families.

We understand it is more than just a matter of producing oil, but that is a first and necessary step because we know when it comes to transportation fuel, we depend upon petroleum products right now to get that job done.

But we also know we need to be more fuel efficient and we need to conserve. Indeed, that is one area where Congress has acted by passing corporate fuel efficiency standards for our cars. But we know that is a long-term effort because the average age of a car in America--of the 250 million cars in America--is about 9 years. So let's assume that, in 2010, everybody started buying a new car. It would take a long time, an average of 9 years, before that entire fleet of cars would be replaced with these new more fuel-efficient cars. So that is a long-term solution but a necessary and important one for us to take.

We also need to make sure we use good old-fashioned American ingenuity and technology to help us as we transition from this petroleum dependence we have now. It is not going to happen overnight. But for our friends who say that if we started pumping oil out of ANWR or the Outer Continental Shelf or from the oil shale in the West today, it would be years before that oil would get online. Unfortunately, that is where we put ourselves, as a result of the irrational moratoria on the development of American natural resources. It is going to take some time to transition into greater energy independence.

But for those of us who are concerned about the environment, we know we are going to have to continue to look for cleaner ways to drive and to fly and in terms of our energy needs. That is why it is so important that we use good old-fashioned American ingenuity and technology to help us find a way--development of things such as plug-in hybrid cars that can be plugged in and would charge a battery that could drive 40 miles or so before it would need to be recharged. That would help a lot of people who would only need such a vehicle, with a plug-in, to avoid petroleum products altogether. Then we would need to worry about the electricity, which is another story altogether.

There are some who have said that abusive speculation in the commodities futures markets is the cause of the problem. That is something we need to look at very closely. As a matter of fact, today, a number of us--43 Senators--have introduced legislation that we believe will create greater transparency and will finance more ``cops on the beat,'' so to speak, when it comes to the commodity futures market, to make sure that doesn't contribute to the reason for prices going through the roof.

So we need to produce more energy right here at home so we don't have to depend so much on those who wish us harm or those who would use the money from oil to buy weapons to kill us or our troops in Iraq or Afghanistan or elsewhere--or in the case of Iran, which we know is supplying troops and training to special forces in Iraq and Afghanistan and has threatened and, in some cases, is responsible for killing troops. We find ourselves dependent, in part, on countries such as Iran for the very oil we use to refine into gasoline to drive our cars. Does that make sense to anybody? It doesn't make any sense to me.

I think what we need to do is produce more and use less oil as we transition into a cleaner, more independent energy economy. It would be better for our national security, better for our economy, and it will actually help us control prices so hard-working American families will not be spending all the money they may have, which they would like to spend on other things, or which they need to spend on other things but cannot because of the increases in the high price of gasoline and oil, and they have to spend on those.

In conclusion--and I see the Senator from Utah, my friend, Mr. Hatch, who wishes to speak--if we will not do this when gasoline is $4 a gallon, will we do this when gasoline is $5 a gallon? If we will not do it when oil is $135 a barrel, will we do it when oil is $150 a barrel, or even higher?

The solution is not to sue OPEC to get them to open the spigot even wider to increase our dependency on foreign oil. The solution is not to raise taxes, which we know will reduce American production, while allowing foreign oil sources, such as Saudi Arabia, Venezuela, and Iran, to continue to operate without those taxes. The solution is not to increase taxes and costs on the consumer, who is already paying too much. We have it within our power to do something that will actually help the American people when it comes to the thing that most of them care a lot about today and that is the high price of gasoline.

Congress is the problem. It is high time our friends on the other side of the aisle, who control the agenda because they are in the majority, work with us to bring realistic solutions to this problem. We can do it but not if people play partisan games and refuse to cooperate on something that causes a lot of hardship to the average American family.

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