Health Care

Floor Speech

BREAK IN TRANSCRIPT

Mr. BARRASSO. Mr. President, my colleague from Arizona is absolutely right. There is a front-page story in USA TODAY. I was reading it as I was coming back from Wyoming yesterday. In Wyoming over the weekend, I visited with a number of seniors on Medicare. I visited with some family physicians who take care of families in Wyoming. I practiced medicine for 25 years in Wyoming taking care of families and have lived under the Medicare rules and regulations.

Here it is: ``Doctors limit new Medicare patients. Surveys point to payment concerns.'' Doctors will tell you the biggest deadbeat when it comes to paying for health care is the Federal Government. It is Washington. More and more of my colleagues are opting out, as the Senator from Arizona said, from taking care of Medicare patients because what they get reimbursed is so limited that it does not keep up with the growing cost of liability insurance, the mandates on them in terms of the expenses of running a business, and they try to provide health care for all their employees.

Item after item, those costs go up. But what the government continues to pay for taking care of patients on Medicare, which is an expanding group of people, is shrinking.

Think about how Washington works and does not get it. Patients around the country on Medicare understand they are having a hard time finding a doctor. The Center for Medicare and Medicaid Services was quoted in yesterday's USA TODAY saying 97 percent of doctors accept Medicare. What is the reality? In North Carolina, since January 1, this article says 117 doctors have opted out of Medicare. In New York, since the beginning of the year, about 1,100 doctors have left Medicare. The president of the State of New York Medical Society is not taking new Medicare patients.

Mr. McCAIN. As well as the Mayo Clinic.

Mr. BARRASSO. Mayo Clinic said: We cannot afford to keep our doors open if we are taking Medicare patients. Specifically in Arizona, where they have a wonderful clinic, the best care in the world in many ways in the sense that early on in the health care debate, President Obama said we should use the Mayo Clinic as a model of what works, they do not want to take Medicare patients. They do not want to take Medicaid patients. But this health care law is cramming 16 million more Americans on to Medicaid. What the President is proposing for the American people is something less than what he has previously said is the best in care.

One of the other promises the President made is, if you like the health care you have, you can keep it. As a matter of fact, he gave a speech about a year ago at the American Medical Association meeting:

If you like your health care plan, you will be able to keep your health care plan. Period.

He went on to say:

No one will take it away. Period. No matter what. Period.

Now the White House has come out with new rules and regulations about
who really will be able to keep their health care plans. In the analysis that has come out from the administration, over 100 pages--I had it on the Senate floor last week--what they have shown is, over the next few years more and more Americans who have health care right now through their jobs that they like, they understand, they know how to use--and as a doctor I have worked with these patients. I know what it means to them to have a health care plan they are comfortable with, that they understand, that they use, that all of the work has been done with the doctor's office, hospital, and the patient, they understand the whole thing. To have that change is very distressing for people. It is unsettling. But yet this government report out from the administration says within the next couple of years, for people who have their insurance through small business plans, almost four out of five of them may lose the coverage they have.

Mr. McCAIN. May I ask, is that because of a minor change in the insurance policy they now have that then forces them out of the policy, even though there is a minor change? Maybe Dr. Barrasso can give us some of those examples of how minor they are, how they basically force them out of the policy they have into the ``exchanges.'' Is that what happens?

Mr. BARRASSO. I agree with my colleague completely. What is happening is any sort of a change to a policy, whether they change the deductible, change the copay or any of those things, then that policy is disallowed as something you can keep.

Mr. McCAIN. Some of those changes would simply be driven by pure economics and the escalating cost of health care on which clearly this legislation has no effect.

Mr. BARRASSO. Let's say you change your job. Let's say you move from one employment situation to another. You may change your insurance. Most people do because most people get their insurance through their work. We will have a situation where over the next couple of years, a promise that the President made to the American people--another promise that the President made to the American people will be broken.

We have not just seen it with regular insurance. My colleague from Arizona is in a State with many people who are seniors, a number of them on Medicare Advantage, a special program that speaks specifically to preventive care, coordinated care. People signed up for Medicare Advantage because there are advantages to being on Medicare Advantage. Yet this health care law that was crammed through this Senate is going to cut massively from Medicare Advantage.

One out of four people on Medicare is on Medicare Advantage, and they know why they have signed up for it. It is because of the advantages to them.

Mr. McCAIN. May I ask one more question of my friend? This is kind of a hometown issue, but 330,000 Arizona citizens who are enrolled in Medicare, who paid into Medicare all their working lives and have enrolled in this Medicare Advantage program which gives them choices are now going to have that severely impaired or eliminated. How does that happen? How is it when a program is offered to people who have paid into the system all their lives and they have chosen that Medicare Advantage program, and now it is going to be taken away from them. How does that work?

Mr. BARRASSO. It works when a Senate and a House of Representatives and a President think they know more than the American people. They say: We know what is best for you. We don't care what you think. That is what has happened.

Mr. McCAIN. They have pledged basically to dismantle the Medicare Advantage program?

Mr. BARRASSO. Cut the funding so people on Medicare Advantage--who like it, who like the preventive medicine activities of it--are going to lose those opportunities.

Just since 2003, the number of seniors on Medicare Advantage grew from a little over 4 million to 11 million. That is because the seniors talk to one another, and they know what the best deal is for them, for their money, and for their health.

The seniors I know in Wyoming who signed up for this program said they want to make sure they have a number of these preventive services. Once they lose this, they are going to lose preventive services. They will have to pay more. The cost for people will go up, in spite of the promise made by the President that he was going to get down the cost of care.

Experts who have looked at this said: No, I am sorry, it is not going to work that way.

Mr. McCAIN. May I ask the Senator one more question. Did he have a chance to examine the $14 million--I believe it was $14 million, $18 million----

Mr. BARRASSO. The mailer.

Mr. McCAIN. The mailer. I was trying to find a polite word--the mailer that was sent out to all Medicare enrollees and what conclusions he drew from that infomercial?

Mr. BARRASSO. To my colleague from Arizona, I did. I had a chance to look at that mailer sent out by the Secretary of Health and Human Services. I found it very misleading. Some have described it even as being a piece of propaganda.

The sad part is, it was paid for by the American taxpayers. The estimates for the cost have been $16 to $20 million of taxpayers' money to send out this piece of mail that essentially misleads, or tries to mislead--as my colleague from Arizona knows, the American people are too smart to be misled by this--it tries to mislead them into saying that this whole health care law is actually going to strengthen Medicare.

The seniors of this country clearly understand, as I know they do in Wyoming and Arizona, if you cut $500 billion--a $ 1/2 trillion--out of Medicare, not to save Medicare, not to save the program that is there for our seniors but to start a whole new government program, that is not going to improve Medicare. That is money seniors planned for, know it is in their system, and it is being taken from Medicare to start a whole new government program. It is not for them. It is not going to improve Medicare. It is not going to strengthen Medicare.

That is why from the beginning, to my colleague from Arizona, I said this bill, now the law for 90 days, is bad for patients, bad for payers--the American taxpayers who are going to end up stuck with the bill--and bad for the providers--the nurses and doctors who are trying to take care of these people.

Mr. McCAIN. Mr. President, I thank Dr. Barrasso for his leadership on this issue. Those who are interested in his Web site, which is titled ``Second Opinion,'' might be interested in gaining more information from that Web site. My colleagues might be interested in that.

I thank Dr. Barrasso for his leadership on this issue, for his in depth knowledge of it. I noted the luncheon we had with the President of the United States. I applaud Dr. Barrasso's attempts to inform the President on this issue. I am not sure how receptive the audience was to it, but what he had to say made a lot of sense to me.

I know Dr. Barrasso shares my view that we are not going to quit on this issue. We are not going to quit on this issue. It is going to be repealed and replaced because we are not going to do this to the American people.

Still the overwhelming majority of the American people disapprove of this proposal. As the Speaker of the House said, we have to pass the bill so we can find out what is in it. As they are finding out what is in it, more and more Americans dislike it.

Mr. President, I yield the floor. I suggest the absence of a quorum.

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