Mr. Speaker, I yield myself such time as I may consume, and I too am delighted to be here to debate with the gentleman from Florida the motion to instruct which he offered. Mr. Speaker, I think there is a consensus in this body that we do…
Mr. Speaker, I yield myself such time as I may consume, and I too am delighted to be here to debate with the gentleman from Florida the motion to instruct which he offered.
Mr. Speaker, I think there is a consensus in this body that we do something to save the Medicare program. All of us know the demographics, all of us know the health of the system itself is in jeopardy, and we must do something to reform the program to ensure its financial health and longevity.
It is interesting, Mr. Speaker, the gentleman from Florida insisted that we ought not go the route of market-based competition and we ought not allow the competition of private sector plans to come into play to give seniors a choice of how they want their health care delivered. But I heard no ideas come forth from the gentleman. Where is his solution?
I think it is fairly indicative that there is no solution coming from the other side, and that they probably, I do not want to put words in the gentleman's mouth, are satisfied with the status quo. But we cannot be satisfied with the status quo. We must reform the system. We must modernize it, and we must update it so that seniors can have a choice and seniors can have access to a prescription drug benefit.
So if we call premium support, as the gentleman said, a voucher, I think it is a characterization that perhaps may not adequately or accurately reflect what the House bill does. And let us start back from the very beginning when a bipartisan commission on the future of Medicare studied this. It concluded that the best way to reform Medicare was to provide beneficiaries with a choice of plans similar to the choice available to Members of Congress, the FEHBP plan, which we all have access to. And certainly I would think we would want to share that same type of health care with the millions of seniors out there who may not currently enjoy the same type of options under the plan.
But to talk to the gentleman's allegations that the House bill would only squeeze out the unhealthy seniors and would deny them access is simply not true. Absolutely not true. At 2010, when competition sets in, the rates that are set at that point are not just the average rates.
And since we are talking about the facts, and the gentleman says he hopes we can agree on the facts, the facts are that in the House bill the average rates are a blended rate, a blended rate of the then- private plan rates as well as the government rate that was used as a benchmark up until that point. And at that point we will then have market forces coming to bear, and we will enable plans to compete for business. And if plans can come in under that benchmark or that blended rate, then there will be a benefit for seniors to choose those plans because they, as well as the government, will be able to share in the savings in the costs of those premiums.
But to speak to the gentleman's conclusion, that if we have competition we will ultimately deny seniors health care, that is just preposterous. There are provisions, if he would look at the facts in the House bill, there are provisions which allow for an adjustment in premiums of the government program. No one ever said that there would not be an option in the government program. Nothing changes a senior's entitlement to Medicare. There is no change in entitlement.
And if, as the gentleman suggests, that perhaps there is a disproportionate number of the population of ill or more sick seniors that are in the government program, there is a provision in the bill which allows there to be an adjustment in the premium so as to avoid the exact problem the gentleman points out. Those are the facts.
And to conclude, Mr. Speaker, again, we have got to do something about Medicare. Medicare and the demographics supporting that program do not bode well given the current state of affairs. I do not hear a single solution coming from the other side, which seems to suggest that there perhaps may be an obstructionist plan not to allow Congress to pass a prescription drug benefit plan this year, but that is what America's seniors wants and that is what we must do.
The bill that passed the House offers us a way to reform the system, to achieve savings, to allow seniors to have choice in their health care, and choice just as we here in Congress enjoy in the FEHBP program.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I yield myself such time as I may consume.
Just to respond to the gentleman from New Jersey's statements, first of all about the need for us to reverse the trend toward giving people and businesses back more of their hard-earned money, so they can invest that money creating opportunity, so we can actually grow this economy the way we are seeing it grow as a result of the Bush tax cuts that we have passed in this Congress. And setting that aside, Part A is funded by the trust fund, and Part A has a surplus in it. But Members know the demographics. Just like the Social Security situation, the demographics in this country are betting against us because as more and more people retire, less money will be paid into the program and more people will be on the back side benefiting from the program. That is the problem with Part A.
Part B is funded by general revenues. As we continue to put money into Part B, and we continue to see rising health care costs, estimates are that a third of people's income will be used in the next 20 or 30 years to fund the Medicare program. I do not think any of us want to see our children and grandchildren saddled with that kind of debt off into the future. That is why we have to act now. That is why we have to reform this program, we have to afford ourselves efficiencies, we have to save money, and we have at the end to provide seniors with a health care plan that affords them choices.
I will also tell the gentleman, I am having difficulty following the argument about the blended rate and about the fact that we are going to have a blended rate that reflects both private rates, as well as the rate in the government program. That is the beginning. That is the transition into the formula which after 5 years will then reflect basically the rates that are out there in the marketplace for the predominance of the public, the seniors who are in the private plans. And the gentleman just said the private plans will be cheaper, so if the private plans are cheaper, then the government plan and the fee to get into the government plan will reflect the costs offered by the private plan. I am having trouble with the sort of circular argument that you cannot have these private plans succeed because only the nonsick will enter them and will leave all of the sick people in the government-run program which we already said there are provisions in the bill to address that.
Also, we are talking about doing something to reform and better the program. We are talking about updating and modernizing the program. I hear nothing from the other side of the aisle which even suggests that we should go forward to offer seniors a real choice in health care just as we have as Members of Congress.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, first I would like to call to the attention of the other side of the aisle, in H.R. 1 on page 260, line 18, in very bold print it says, ``No change in Medicare's defined benefit package. Nothing in this part or the amendments made by this part shall be construed as changing the entitlement to defined benefits under parts A and B of the act.''
Again, nothing is going to change the entitlement for seniors to these benefits, as we said earlier in the House bill.
I would also, Mr. Speaker, at this time like to point out, the gentleman from Ohio says that Republicans do not like Medicare. It is interesting that we on the Republican side are the only ones, once we took majority in this House, who put preventive benefits into the Medicare package. We now have as current law colorectal cancer screening which seniors are entitled to, mammograms, pap smears, prostate screening. In the current bill that we have before us that is in the conference committee, there is an initial physical that will be offered to seniors. There is screening for diabetes, screening for cardiovascular disease provided to all seniors. All seniors. That is what the bill provides for.
As the gentleman also knows, there has been much discussion and much work on the part of the gentlewoman from Connecticut (Mrs. Johnson) in the area of chronic disease management. Together with these screening provisions and these benefits that are going to be offered to seniors, we will be able to address some of the potential for these diseases early on, thus saving an awful lot of money and lengthening seniors' lives. I find it hard to even digest the gentleman's suggestion that Republicans do not like Medicare.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I yield myself such time as I may consume.
I would just like to respond, number one, the gentleman from New Jersey suggests that the best way that we can control the escalation in cost in health care is essentially for the government to fix the price and for the government to be the player. That is essentially what we have got now in Medicare. We have got a one-size-fits-all government plan determining benchmarks, government determining reimbursement rates. I would just ask the gentleman whether he really believes that we have done anything to really control costs. I am not yielding to him right now. He can respond on his own time. Does he really believe that the costs have come under control and that we are facing a deflationary trend in the cost of health care?
Then I would like to also say that in terms of the accusations that we in some way through passing the House bill are forcing people into HMOs, there is no provision which forces anyone into an HMO. In fact, the bill takes great strides toward creating regional provider networks, so that individual Medicare beneficiaries will have the ability to go and seek care within the network. They can go outside the network. No one is forcing anyone into an HMO, which again goes back to the central point of what we are trying to do and that is to afford seniors a choice. Not everyone wants the same type of health care. And certainly I would suggest that no one wants a Canadian-style health care. No one wants to see a nationalized health care. It is almost like the other side calls for Hillary-care. No one wants that.
As far as the gentleman from Ohio in his discussion on the pharmaceutical end, I thought that the motion to instruct on the part of the gentleman from Florida related to part C, not part D.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I yield myself such time as I may consume. I just want to respond to the gentleman's remarks about discriminating against seniors and thereby denying them access. I think the gentleman will agree, again we are talking about facts, that current law already provides that under Medicare there can be no discrimination based upon age or based upon one's health. And in this bill there is a requirement that the plans that participate and opt to participate in the Medicare program must have uniform pricing and uniform premiums. There are safeguards. And so all this doomsday prediction that the gentleman offers is not going to occur because there are safeguards provided in the bill for that.
I would also like to point out to the gentleman that studies have shown that the poor that are existing now under the Medicare program, they by far are opting for the Medicare+Choice plans versus the standard Medicare program because they are, frankly, more affordable. Again, this is the marketplace at work. I think it brings us back full circle to the fundamental difference between the parties here. We believe that seniors are individuals and they deserve to have a choice and we should bring in the same type of choice that we all have as Members of Congress in the FEHBP, that seniors should also have that and with the safeguards that we have spoken about, seniors can have that choice just as we do, and not be suffering under a one-size-fits- all government-run program that, frankly, is going to run out of money. So we have got to do something.
The gentleman says he is only in a position to offer a motion to instruct. I have heard no solutions being offered by the gentleman or any of the speakers on the other side of the aisle other than some notion of recreating Hillary-care.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, will the gentleman yield?
Mr. Speaker, I will be glad to respond to the question, because, again, we are talking about the philosophy. Do you want the government out there fixing prices? Do you want the government out there coming up with the formulary? That is what you are talking about. Many States across the country do that, they come up with a formulary, and we all know how difficult it is to get anything through this Congress.
So as the drug industry comes up with more and more miraculous lifesaving and life-lengthening drugs, we will be stuck and mired in the bureaucratic process of approving a change in the formulary, so it will almost be impossible for that to happen.
Again, I think that the Secretary of Defense and any other agency that negotiates on behalf of its agencies, its employees, has a mission. But we are talking about negotiating on behalf of the public and people out there that have different needs.
We are a market-based country. We are a country where people have the option to choose for themselves. We are not living in a country where I think, one would think, the government can decide which medicine, which prescription drugs you ought to have and which you ought not to have.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, just to follow up on that, again, it goes to the fundamental difference between the two parties here, whether you think the government ought to be in there for you negotiating prices, or whether you ought to let the private sector and the plans that have an incentive to attract customers and attract seniors into the plan to make their formularies more attractive, if we are talking about prescription drugs, to give the market the incentive to do that for seniors. Let the seniors choose which plan is better for them, because if you have got the government doing it, there will be no choice. There will be a one-size-fits-all, government-run plan.
Mr. Speaker, I reserve the balance of my time.
Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I would say to the gentleman and the Members on the other side, I have enjoyed the debate. I think it is always a healthy experience for this body and the country to have an active discussion on very important issues.
I happen to think that the Medicare reform bill that we hopefully will be voting on soon is probably one of the most important things we will do in our careers in this body, because it does affect so many people. It impacts them in an area of their lives in which everybody is concerned, and that is health care. So I appreciate the debate.
I would just like to underscore, once again, the bill that we have in place and that we have passed out of this body is a bill designed to shore up the failing actuarial numbers in Medicare and the fact that we are on a road to ultimate bankruptcy of the system if we do not do something to reform it and if we do not do something to allow seniors to continue to enjoy that benefit.
The way that this House has spoken, the way we will do that, hopefully, is through inviting in competition from the private sector, allowing seniors to choose health plans that best fit their own family and their own health care needs.
We also, as we have discussed, have in this H.R. 1 provisions which protect seniors and which ensure that they will have access to quality health care, and, at the same time, protection that there is never going to be any denying of the entitlement of Medicare to seniors.
Mr. Speaker, I yield back the balance of my time.