Credit Cardholders' Bill Of Rights Act Of 2009
Floor Speech
BREAK IN TRANSCRIPT
Mr. GRASSLEY. Madam President, for the benefit of my colleagues, I will only be speaking about 11 minutes or so. I will proceed.
Yesterday--no, it was not yesterday, 2 days ago--the Medicare trustees announced that Medicare's Part A hospital trust fund will be insolvent in 2017. That is 2 years sooner than last year's estimate. This announcement shines a spotlight on an issue Congress cannot ignore. Our largest Federal health program is on an unsustainable course.
Medicare, according to the trustees, is going broke. We have all heard the reasons over and over: People are living longer, health care costs are increasing, and most seniors are developing chronic and very costly conditions.
All this leaves the Federal Government with a $35 trillion unfunded liability over the next 75 years because the trustees always look ahead 75 years. That is updated annually.
Some in Congress recognize the financial black hole that is looming before us. I hope my colleagues know I am working with Senator Baucus and other members of the Finance Committee to reform the way the Government pays for health care.
Our options for delivery reform will bring the Medicare Program into the 21st century by improving quality and reducing costs. We desperately need to retake control of the costs of the Medicare Program, obviously, so it can be around for future generations. Yet in the face of that reality, some people think the best way to accomplish health care reform is to create another entitlement program.
In the face of Medicare's pending insolvency, some people want to create a new public program, a government-run health insurance program. I am one of the most vocal supporters of health care reform. We need to improve quality, access, and affordability. But we need to understand by adding another unsustainable government-run health insurance plan into our health care system, it cannot be the answer.
We cannot afford what we already have, so let's add more. Put that against the commonsense test. It does not make much sense. As the saying goes: History is a vast early warning system. Today, debate over health care reform is eerily similar to the debate in 1965, before Medicare was created.
Let's look at that history. Before the bill became law, doctors, hospitals, and other health care providers were concerned about this new government-run health care program that was passed back then. We call it Medicare.
Much like today, way back then, they were worried the Government would use this program to ration care and cut payments. To deal with these concerns, Congress and the President actually promised back then to doctors and others that they would continue to be paid, as the law says, the usual and customary rates.
That is why, to this very date, the Medicare legislation still states this:
Nothing in this title shall authorize any Federal officer or employee to exercise any supervision or control over the practice of medicine or compensation of any person providing health care services.
That was written in 1965. It is still in the law. But--and a big ``but''--we all know that the cost and the political pressure has increased.
As a result, this section that I quoted, written in 1965, has become meaningless. Time and time again, Congress has intervened in medical decisions and cut reimbursement rates. Legislation in the late 1980s placed limits on what doctors could charge and put in place a government-mandated fee schedule.
One American Medical Association trustee recounted the AMA's original concern about Medicare by stating it this way: ``Many of the things we feared have come to pass.'' Surprise. Surprise. Despite the promise to pay ``reasonable rates'' when Medicare was created, today the Government pays between 60 and 70 percent of what private insurers pay.
By setting payment rates well below costs, it is becoming more and more difficult for seniors to find a doctor who accepts Medicare. Access issues for Medicaid, as we all know, are even worse. But some say we can avoid these problems by putting the government-run plan on a level playing field with private insurers.
They say Congress could set up a system so the government-run health insurance plan has to follow the same rules as private insurers. They say it would have to pay the same rates, form networks, be independently solvent, all sounding good. My question is this: When this new government-run health insurance plan starts to cost too much, then following the pattern since 1965 with Medicare, is Congress going to start breaking its promises? Will it change the rules?
A recent Wall Street Journal article tried to answer this question this way:
Any policy guardrails built this year can be dismantled once the basic public option architecture is in place ..... That is what has always--
And ``always'' is emphasized--That is what has always happened with Government health programs.
Maybe at first Congress somehow repeals the requirement that the government-run plan has to form a network. Next, Congress might allow the Government plan to start paying lower rates than private insurers, just like we have done with Medicare and Medicaid. At that point, Congress might let the government-run plan dip into the Treasury from time to time to keep the Government plan solvent.
This, of course, would increase costs for everyone. As the Government takes more and more control over the plan, providers would get paid less and taxpayers would end up paying more. Rates for government-run health insurance plans would be lower than private insurers because Government can impose lower rates by law, also known--can you believe it--as price fixing.
This is a common talking point for supporters of the government-run plan. They say the Government can use its numbers to lower costs. But as the Government cuts payments to providers, costs will go up for everyone who is left in the private market. Slowly but surely the Government plan takes over the market. Eventually, all the promises about creating a level playing field have been broken, and we would be left with a single-payer, government-run health insurance plan, such as Canada.
Canada brags about having a single plan. But Canada does not have just a single plan. There is a second plan, and it is called the United States of America. So if you do not want to wait around 3 months for an MRI in Canada, you can come to the United States, if you have the money to do it and the time to do it, and get it right away.
But what happens if you have such a plan in America? Where do Americans go for what the plan does not provide for our people when you have delay? Well, we will not go to Mexico, surely. Eventually, all the promises about creating a level playing field will have been broken, and we would be left with a single-payer, government-run health insurance plan.
The simple truth is, supporters of a government plan absolutely intend for this to be the outcome. Independent analysis by the Lewin Group agrees. According to Lewin's work, 119 million people would lose their private insurance. In other words, they would be crowded out. They would end up where? On the Government plan.
It also breaks one of the most important promises that President Obama made during his campaign, and I agree with this promise. What is it? If you like what you have now in the way of health insurance, you can keep it.
Independent analysis has shown that a government-run insurance plan will drive up prices in the private market and force employees and employers to drop that coverage. So the President does not get his plan or his promise during the campaign kept.
This, of course, will make our emergency rooms more crowded than they are today. It will limit access to high-quality care through rationing and price fixing. It will increase waiting time for lab results and lifesaving and life-enhancing procedures. It will add hundreds of billions of dollars of new Government spending.
This is not the kind of change the American people are looking for. Instead of creating a government-run plan and making a bunch of promises Congress cannot keep, let's create stronger rules and regulations for the private insurance market.
For instance, we should prohibit health plans from denying coverage to people with preexisting conditions and provide tax credits to people who cannot afford coverage.
Instead of introducing a government-run health insurance plan that would cost too much, limit choices, and lower quality, let's clean up the private market. Instead of introducing a government plan, let's help President Obama keep his promise that if you like what you have in the way of health insurance, you can keep it.
I yield the floor, and I suggest the absence of a quorum.
BREAK IN TRANSCRIPT
Source