Small Business Additional Temporary Extension Act of 2011

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Mr. BARRASSO. Mr. President, as you well know, I come to the floor each week with a doctor's second opinion, and it specifically relates to the health care law, the law that was passed now over a year ago, with many promises made by the President, one of which was that if you like your coverage, you can keep it. We now know that is not the case, as he had promised. He also talked about this driving down the cost of health care. We have seen the cost of health care going up.

Last week, I came to the Senate floor and talked about something that is not known very well. It is a part of this law. It is called the so-called Independent Payment Advisory Board. I gave five specifics as to problems with this board. So today I wish to give another five specifics, and I think these are things every single American needs to know about the mandates that are part of this health care law and what is going to happen to them as more and more components and parts of this health care law are implemented.

People refer to this board as ``IPAB''--not ``iPod'' but ``IPAB''--and it stands for the so-called Independent Payment Advisory Board. But I will tell you, this is a Washington board. It is not independent. I believe it is going to be very harmful in terms of the health of the American people.

This board often goes unnoticed, and one of the reasons is it actually does not become operational until after the 2012 elections, until 2013. But it is an extremely powerful and extremely dangerous part of the President's health care law. It is a Washington board. It empowers 15 unelected and unaccountable bureaucrats, 15 full-time Washington bureaucrats, who will decide how Medicare's dollars are spent. These Washington bureaucrats will use basically price controls, and they will use price controls to ration medical care and services all across the country.

You remember, Mr. President, when then-Speaker of the House Nancy Pelosi said first you had to pass the bill before you got to find out what was in it? Well, now, as more and more Americans learn about this rationing board, they will again voice their opposition to the President's health care law.

I will tell you, I want to pick up today where I left off last week. I want to share with the American people an additional five things they need to know about this board.

The No. 1 thing today is the President wants to keep this board under the radar. He and his administration simply want to disguise the long-term impact this board's price controls will have on our seniors on Medicare. If he does so successfully, the patients on Medicare will be the big losers.

He wants to promise the American people that the board will achieve great Medicare savings, but he does not want to explain to the American people exactly what those Medicare cuts will do and how the American people will ultimately pay the price in their health care.

The President and Washington Democrats have historically supported policies giving government the power to set health care prices. Make no mistake, the President is using this Washington board as a Trojan horse to accomplish that goal. This is exactly why this board is not going to be set up until after the 2012 elections. The American people will not face the true impact of this board and the cuts it is going to have on their loved ones until after the Presidential election next year. The President's plan depends entirely on keeping the true purpose of this rationing board well below the radar.

Here is a second concern; that is, the opposition to the President's payment advisory board, interestingly enough, is bipartisan. Even members of the President's own Party know that creating a Washington board to cut Medicare payments and ration medical services is bad policy when it comes to our seniors.

Even Representative Pete Stark of California, the ranking member of the House Ways and Means Health Subcommittee, said in an April 19, 2011, New York Times article:

In its effort to limit the growth of Medicare spending, the board is likely to set inadequate payment rates for health care providers, which could endanger patient care.

There you have a statement by a member with ranking stature of the Democratic Party in the House.

Now let's take a look at what someone else said. She announced her support for legislation which would repeal the President's Payment Advisory Board. This is Representative Allyson Schwartz of Pennsylvania. Actually, she is a strong champion for the health care law. She is also vice chairman of the New Democrat Coalition. She had a statement that came out on April 15, 2011--income tax day--saying:

Congress is a representative body and must assume responsibility for legislating sound health care policy for Medicare beneficiaries, including those policies related to payment systems. Abdicating this responsibility ..... undermines our ability to represent our constituents. ..... I cannot condone the implementation of a flawed policy that will risk beneficiary access to care.

Third, the President's payment advisory board sets prices and it gives Washington more power, not patients. In most cases, Medicare payments to doctors--and Members of the Senate from both parties understand this--are already well below market rates. That is why doctors often limit the number of Medicare patients they see. In more severe cases, doctors stop treating new Medicare patients.

Allowing a rationing board unlimited power to control Medicare prices is only going to drive Medicare payments lower, and it is going to drive more doctors away from seeing Medicare patients. My concern is the prices are going to be driven so low by this rationing board that the government will force doctors, hospitals, and other medical providers to stop offering any care to Medicare patients.

Random and punishing cuts to Medicare provider payments will not make this program any more efficient. It will not make people's health care better. But it will reduce the supply of medical care to our seniors on Medicare.

The Washington board's ability to set prices gives it unprecedented control over personal medical decisions, and that is wrong. Those decisions should be left to the patient and his or her doctor alone, without the interference of 15 Washington bureaucrats.

No Washington bureaucrat should ever have the right to stand between a patient and his or her doctor. At its core, the debate about the President's Independent Payment Advisory Board centers around a few questions: Do the American people want a Washington board of unelected people whom they do not know making their personal health care choices for them or do they want to have the freedom and choice to make their own health care decisions? Do they want Members of Congress, the people whom they send to Washington, to be able and to be held accountable--do they want those Members of Congress to explain exactly what spending cuts are being discussed and need to be made to ensure Medicare's solvency?

As we know, we all heard just last week, Medicare is going to be bankrupt even 5 years faster than it had been thought in the past. Interestingly enough--this is No. 4--President Obama doubled down on this, on the President's Independent Payment Advisory Board.

In his April 15 spending speech to the Nation, he doubled down on his commitment to this Washington rationing board. In the speech, he said he actually wants to give the Board more power to slash Medicare payments to providers. Apparently, expanding his rationing board is one of the only tangible proposals that the President has to reform Medicare and reduce the debt.

The American people sent us to confront our financial and fiscal crisis head on and to come up with solutions to solve the problem. They did not send us to cower behind boards and commissions and empty promises. They asked us to come to Washington with the courage, the strength, and the political will--the political will--to make tough spending decisions. Rather than stand up to the challenge, the President chose to go all in, placing his bet on 15 bureaucrats yet to be identified.

He asked the American people to trust him that this rationing board will squeeze out Medicare savings, at the same time, not impacting--he says--our seniors' access to medical care. But I do not think this is a bet our Nation's seniors should take or should be willing to take.

Finally, No. 5, members of my party, the Republicans, are working to repeal the President's Independent Payment Advisory Board. Senate Republicans are taking a stand against this rationing board, against more government control. Senator John Cornyn of Texas has introduced S. 668. It is the Health Care Bureaucrats Elimination Act. This bill repeals the President's Independent Payment Advisory Board, ensuring Medicare patients can get the care they need from the doctor they choose. I am proud to be a cosponsor, an original cosponsor of this piece of legislation.

That is why I come to you again on the floor with a doctor's second opinion, as somebody who, for a quarter of a century in Wyoming, has taken care of patients on Medicare--many patients on Medicare--to provide a doctor's second opinion that this health care law is bad for those patients. It is bad for providers, the nurses, and doctors who take care of those patients, and it is bad for the taxpayers.

I yield the floor.

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