Foreign Intelligence Surveillance Amdenments Act of 2008--Continued

Floor Speech

FOREIGN INTELLIGENCE SURVEILLANCE AMENDMENTS ACT OF 2008--Continued -- (Senate - July 08, 2008)

Mr. WICKER. Mr. President, I am disappointed that the Senator from Michigan has objected to the unanimous consent request. I certainly hope, though, that we can have a conversation about this issue and move eventually to the consideration of S. 3118 as Senator Cochran suggested.

The American Medical Association has requested an 18-month fix--an 18-month extension--to give the medical community and Congress time to enact a permanent fix to the sustainable growth rate formula. This legislation--the Grassley bill--would provide for this 18-month extension. It would also provide an 18-month extension with a one-half percent increase in 2008 and a 1.1-percent increase in 2009 in physician reimbursement. This, I might add, is identical to the provision in the Stabenow bill, S. 2785, the Save Medicare Act, which was, in fact, a bipartisan bill and a bill I was happy to cosponsor.

The bill Senator Cochran just asked for unanimous consent to consider also increases Medicare payments for ground ambulance services, it extends the authorization for the Medicare Rural Hospital Flexibility Program grants, and it provides important provisions for community hospitals and for rural home health care.

The bill does make certain noncontroversial changes to the Medicare Advantage Program. It also extends critical programs involving Medicare, and it eliminates the double IME windfall to Medicare Advantage Programs. But it doesn't contain the controversial provider offsets that the legislation which was offered by the majority leader would have done and which the President promised to veto.

The legislation Senator Cochran just asked unanimous consent to consider could be passed tonight, sent to the President for his signature tomorrow, and the Members of the majority party in this Congress could claim a victory, and a bipartisan victory at that.

I believe it is important for people to understand the history of this legislation.

The Senate and House have been legislating to prevent these provider cuts from going into effect since the year 2002. For the past 6 years, as a Member of the House of Representatives, I have voted numerous times to prevent these physician cuts from going into effect, and each time, these cuts have been prevented. That has been done on a nonpartisan, bipartisan basis without political wrangling.

Indeed, this year, just a few days ago, before the Fourth of July recess, Chairman Baucus and Ranking Member Grassley were on the verge of presenting a bipartisan package which would have prevented these cuts from going into effect and prevented this entire controversy. They were moments away before the rug was pulled out from under them by the leadership in this body.

Why is it different this year? Why have we been able to do this on a nonpartisan basis, prevent these cuts from going into effect to the providers, to the physicians, and the harm that would ensue to the Medicare recipients in the past? Why is it different this year? It is clear to me that members of the Democratic leadership in this body and in the other body have decided to turn this so-called ``doc fix'' into a political issue.

I was struck by the exchange between the minority and the majority leader on the night of June 26 when Senator McConnell requested of the majority leader, after the cloture had not been invoked, that we have a simple 30-day extension in order to continue to work on this issue. In objecting to that unanimous consent request for a simple 30-day extension so we could continue to work on this, it became obvious to me what a political issue this is becoming. The majority leader, in objecting, mentioned elections this year for three House seats in which the Democrats won. He went on to say that this time next year, there would be 59 Democrats in the Senate at least. He mentioned the President's approval rating--and this is all in the Congressional Record, page S6233 of the Congressional Record, if Members would like to follow along--he mentioned the President's approval rating. He mentioned numbers of people in the Senate who are up for reelection this year, and he even mentioned polling before suggesting that his Republican friends did not truly want to prevent these cuts from taking effect.

There is not a single Member of the Senate who wants these cuts to take effect. There is not a single Member of the House of Representatives who wants these cuts to take effect. But the majority leader said that night: The only way out of this is to accept this legislation; it is this legislation or nothing, in effect. I will say this much for the distinguished Democratic leader of the Senate: He was open and frank about what is really at issue here. This is very much about this year's elections and less about preventing the cuts to doctors.

Now, what are we wrangling about here? We are wrangling about the offsets to prevent the cuts from going into effect, particularly what it would have done to Medicare Advantage, a program that some 22,000 Mississippians depend upon and a program I would like to protect for them.

Now, we have a disagreement. The Senator from Michigan sees this differently than I do. There are people who would tell you that the bill offered to us that night would have gutted the Medicare Advantage Program. Medicare Advantage offers seniors a choice between regular Medicare and traditional insurance in the form of Medicare Advantage. These insurers offer the same services as traditional Medicare, but in addition, they offer options Medicare does not. In Mississippi, this means seniors may choose to have increased coverage of things such as diabetes management, increased cancer screening, or lower cost-sharing in the form of lower premiums and copays.

Admittedly, Medicare Advantage is not a perfect program. I believe there is a certain bipartisan consensus that we should take a look at the plan's enrollment and billing practices. Physicians back home in my State of Mississippi tell me this, and I want to work with them. The amount of payments to these plans is also an issue that needs to be looked at.

But the Medicare bill that the majority leader would have forced upon us on that Thursday night of June 26, 2008, would have included provisions that did not enjoy bipartisan support. If that bill had passed, American seniors and Mississippi seniors would have lost their choices. They would have been told: Take it or leave it.

Fewer choices and less competition are not good for America's seniors and certainly not good for our health care system. If Medicare Advantage needs adjusting, we should consider stand-alone Medicare Advantage legislation.

The PRESIDING OFFICER. The junior Senator from Mississippi must know that his time has expired.

Mr. WICKER. I wonder if I may have an additional 2 minutes, Mr. President. I don't see anyone here at this moment. I wonder if I may have an additional 2 minutes to wrap up.

The PRESIDING OFFICER. Without objection, it is so ordered.

Mr. WICKER. I thank the Chair.

There is overwhelming support for fixing the sustainable growth rate. Doctors deserve better than to be involuntarily paired with a poison pill provision that cannot pass this Congress on its own merits. I repeat, there is not a single Member of this Senate who wants these cuts to go into effect.

The issue of Medicare Advantage is so important because of the competition. If we are ever going to solve the future of funding on the issue of Medicare as a whole, if we are going to have that goal that the AMA wants of 18 months to look at a permanent fix to this issue, if we are going to prevent the train wreck that looms a few short years from now on the funding of Medicare as a whole, then we are going to have to inject competition. But let's not use it as a political football. Let's not adopt offsets on which there have been no hearings. Let's not change basic Medicare policy in the form of a pay-for for a temporary fix.

What we are looking at is two vastly different approaches to health care reform: the traditional Medicare, one size fits all, take it or leave it, that would lead us to a Canadian-style, single-payer type plan for the entire United States of America, or injecting this little bit of competition to see if we can help control the cost of the Medicare Program. That is what we are making this stand about, and that is why I hope eventually we will adopt the unanimous consent request Senator Cochran has made and move to a bipartisan plan we can all support and prevent these doctor cuts from going into effect.

I yield the floor. I thank the Chair for indulging me on the time.

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