Recognition Of The Minority Leader
Floor Speech
BREAK IN TRANSCRIPT
Mr. BARRASSO. Well, as the Senator from Arizona knows, I have treated patients in Wyoming, families in Wyoming, for 25 years. The story in the New York Times has a wonderful picture of Bertha Milliard, a 94-year-old lady, who is very similar to many of the patients I have taken care of in families in Wyoming who depend on this care. There is a picture of Bertha dealing with her nurse. Bertha greets the nurse who has come to check her condition and review the medications she takes for chronic pain, for heart failure, and for stroke. Ms. Milliard says those visits have been highly effective, she says, in keeping her out of the hospital.
That is the whole idea: Keep them out of the hospital so they can lower the cost of care. But the home care that she receives could be altered, according to the front page of the New York Times, under the legislation passed by the House and pending on the Senate floor today. The legislation would reduce Medicare spending on home health services, which is a lifeline for homebound Medicare beneficiaries which keeps them out of hospitals as well as out of nursing homes.
So there you have it. What could be better for our seniors than to have the dignity of being in their own homes, to have someone coming into their homes to help them, to make their lives better, and that is going to include skilled nursing care, physical therapy, occupational therapy, sometimes speech and language therapy, and different medical and social services? That is where the care ought to be given, in the home. That is what we want for our seniors: the dignity at home, opportunities at home, to stay in their surroundings. That is what we want for not just all seniors such as Bertha, we want that for our Nation because that will help keep down the cost of care.
This bill does the exact opposite. That is why we have to have this amendment that says don't cut Medicare for our seniors and certainly not to start a whole new program.
In the Wall Street Journal today is an editorial by the dean of Johns Hopkins Medical Center, a wonderful, world class center: ``Health Reform Could Harm Medicaid Patients.''
So we are taking the money from Medicare, hurting Medicare patients, and they are using it in a way that is actually going to make it worse for patients on Medicaid, as they have dumped 15 million people into this program that is absolutely broken.
BREAK IN TRANSCRIPT
Mr. BARRASSO. I agree with the Senator. It is astonishing that the Senator from Montana would read a national organization's letter instead of one from his home State.
In Wyoming, we have 43 different home health care agencies, and some of them are in communities that don't even have hospitals. Therapists drive long distances. We have colleagues from rural States here, and Montana is certainly one of them. Those home health care agencies know they are not even going to get paid enough from Medicare to put gas in the car to drive out to the ranches and the farms where people are who are staying at home, trying to stay out of the hospitals and nursing homes. We have home health agencies throughout the States, and they drive tens of thousands of miles every year, with therapists and nurses and home care aides going out to help people stay at home and therefore give them dignity and allow them to keep down the cost of care for everybody.
BREAK IN TRANSCRIPT
Mr. BARRASSO. This proposal is going to hurt patients in a lot of ways. It is going to hurt patients psychologically. They are in a hospital when they want to be at home. It is going to hurt patients in terms of their health. The better place to be is at home, as long as somebody is coming around to check on them. That is why for so many reasons, doctors have for decades said: Try to help patients get home as quickly as they can. That is the best place for them to heal.
We have heard from the Senator from Georgia a remarkable story about pennies on the dollar, the effectiveness of this program. It is good for folks, and it is good for the whole health care of our Nation if we have people healing at home, not in the hospital.
BREAK IN TRANSCRIPT
Mr. BARRASSO. It has been a privilege to take care of patients in Wyoming for the last 25 years. This bill is going to hurt them. It is going to hurt the future of care. It is going to hurt the future of Medicare in America. You cannot take $464 billion away from Medicare, a program on which the seniors of this country depend, and say it will not affect their care.
It will affect them in the hospitals, it will affect them in the doctors' offices, it will affect them in the home, it will affect them in the final days of their lives in the hospices. That is what I hear about across Wyoming.
I have not met doctors who support this--not at all. I have not met very many patients who support it, and they are also told by others: We don't want this. The townhall meetings have been overwhelming in opposition.
This is a bill that will be bad for our small businesses and bad for people who want to get insurance. It will be bad for people who have insurance because they know their premiums are going to go up. It will be bad for people who pay taxes because those are going to go up. But specifically for home health care, this will be awful. It will affect small communities--in all of the small communities of America, not just in Wyoming. I can't imagine anyone in a small community being for this.
BREAK IN TRANSCRIPT
Mr. BARRASSO. Madam President, you know as well as I that the President promised the American seniors that if they liked the care they had, they could keep it. Nothing could be further from the truth.
Looking through this bill we are debating, there is an incredible amount of cuts to Medicare, which is a program seniors rely upon for their health care: $120 billion of cuts to Medicare Advantage. One in four people in America who depend on Medicare for their health care--11 million Americans--are on Medicare Advantage. The reason they chose it is because it is an advantage. It helps with coordinated care and preventive care. Having practiced medicine for 25 years, I know the people at home get it. That is why they chose that program. It also cuts $135 billion from hospitals and $115 billion from nursing homes.
I want to focus a little bit on the $42 billion cut from our home health agencies. I don't know how anybody on the other side of the aisle can say with a straight face that the legislation before us doesn't cut Medicare and doesn't hurt our seniors because it does.
I will tell you, having taken care of people in hospitals, the services that are provided through home health care is what helps get people out of the hospital sooner, gets them home faster, gets them out of nursing homes, and helps keep down their costs. These services include skilled nursing care, physical therapy, occupational therapy, speech and language therapy, and medical social services.
I have a letter from the director of home health services of Wyoming, the Home Health Care Alliance.
I ask unanimous consent that it be printed in the Record
BREAK IN TRANSCRIPT
Mr. BARRASSO. This letter talks about the devastating impact of the cuts proposed in this bill we are considering today. There are 43 home health agencies in Wyoming and a number of them are in communities--the occupant of the chair is from a State where there are a lot of rural areas. A number of our agencies are in communities that don't even have hospitals. So it helps people stay in their homes, in their home communities, stay out of the hospital, out of the nursing home, and it gives them the dignity and the opportunity and the independence they need to stay at home.
Yet this bill, according to the folks in Wyoming and the folks nationally, is going to make it that much harder for our seniors to stay at home.
Taking $42 billion from home health care, raiding that program to start another program, to spend it on a new government program is going to absolutely impact the ability of home health care providers in this country to offer services. These nurses, therapists, and home care aides all drive hundreds of miles on a daily basis in Wyoming, going from ranch to farm, to help care for people and to help them stay at home. It is all around the country.
There is a front-page story in the New York Times today, a wonderful story of a delightful 94-year-old lady, Bertha Milliard. She lives in Maine. There is a picture of her with her nurse during a home health care visit. Bertha is very worried that they are going to lose this service, which is the service that keeps her out of the hospital.
It just seems, as we look at this, that there is no way home health care agencies around the country are going to be able to sustain these kinds of cuts and continue to remain available to the Medicare patients who depend on home health care.
Even the National Association for Home Care & Hospice said that in a few short years, Medicare will be paying home health agencies less than it costs to even provide the services. We are talking about less than the gas in the cars and the salaries of the folks who drive around. We are not talking about profit. We are talking just about keeping doors open.
As I think about the patients in Wyoming whom I have taken care of over the years who have benefited from home health services, who have been able to receive care from nurses, therapists, home care aides and allow them to stay at home, to be more independent--not totally independent but more independent--I think anything that cuts into this is not good for America.
BREAK IN TRANSCRIPT
Source