I thank the gentlelady from Illinois for reserving this time to take the message out. For a moment, let me speak to the 103,000 Medicare beneficiaries in the 12th Congressional District in New Jersey, more than 100,000. This legislation…
I thank the gentlelady from Illinois for reserving this time to take the message out. For a moment, let me speak to the 103,000 Medicare beneficiaries in the 12th Congressional District in New Jersey, more than 100,000. This legislation would improve their benefits. It would provide free preventive and wellness care. It would improve the primary care and better coordination of care, not just so there is more efficiency and less waste, although there would be, but so that patients don't get the runaround. It does not help their health to have unnecessary or counterproductive tests or procedures. It would enhance nursing home care. And it would strengthen the Medicare Trust Fund, extending solvency for another 8 or 9 years. That is real.
You had spoken earlier about the doughnut hole. I always hesitate to talk about the doughnut hole. I think of it as a cliff. Depending on how expensive your monthly medication is, along about August or September or October, you have exceeded the expenditure limit on Medicare, the way things stand now, and you fall off the cliff. And if you want to keep taking the medicines, you have got to pay out of pocket.
Under the bill, the beneficiaries not only would receive in 2010 a $250 rebate and 50 percent discounts on brand-name drugs beginning in the coming year, but also complete closure of this doughnut hole, or better yet, filling in this cliff in the years to come. A typical beneficiary who enters the so-called doughnut hole, again, that is too benign a term, who falls off the cliff, will see savings of over $700 in the coming year and over $3,000 in coming years. So this is something that, yes, it helps small businesses. Yes, it helps young adults trying to get a start after college. Yes, it helps people who find themselves between jobs or people who want to start small businesses. It helps employees of large businesses. It helps anybody who has a health insurance policy now. But tonight, we are talking about how it will help senior Americans.
I thank the gentlelady for reserving this time. Let me turn it back to you, and I will add some comments as we go along if I may.
I thank Representative Schakowsky, my good friend. This is something that has been one of the great accomplishments, not just of the Democratic Party, but of the United States. Medicare has been a success. It has been medically a success. It has been socially a success. This legislation before us will only strengthen Medicare.
And to underscore a point that you were making, Ms. Schakowsky: By getting better coordination among doctors, by having more primary care doctors, by covering preventive care, by making sure that beneficiaries have access to medicine, we not only get efficiencies, but each patient gets better care.
We begin to shift more attention toward the outcome, the health of the patient.
Having extra procedures or having to go to a specialist when you don't need to go to a specialist but only because you don't have a primary care physician available is not only costly but it is not healthful. It does not produce the best outcome, and it leaves the patient frustrated and getting the runaround.
So people ask me, well, in this health care bill, how can you claim to cut costs and not cut our benefits? How can you claim to cut costs and not give us worse care? Well, in fact that is the point exactly. By having primary care physicians, by paying for the medical education of those physicians to have more of them available, to have better coordinated care among doctors, the patients will get better care. So it is not just a matter of efficiency, but it is that also.
And to continue on your point. The debate that we are having right now strongly echoes the debate of the 1960s over Medicare. ``Inefficient and costly government.'' ``Putting the government between the doctor and the patient.'' ``Socialized medicine.'' Yes, we have heard all of those phrases this week, in fact tonight here, previously, from the other side of the aisle. Those are quotes from the 1960s.
Now, few people today would call for a repeal of Medicare given its success for seniors, yet it was very controversial back then. The same arguments were made against health care reform then as are being made now.
Some leaders, from Ronald Reagan to Bob Dole to Gerald Ford, fought the program and voted against its creation. Since then, some opponents of Medicare have tried to cut, or cut, Medicare. Former Speaker of the House Gingrich spoke of cutting back Medicare so that it could, quote, wither on the vine.
Does anybody really think that Democrats, who are so proud of the accomplishments of Medicare, would for a moment consider cutting back on Medicare? Does anybody reasonably think that?
This is a successful program that has taken us from 1965, when 44 percent of seniors were uninsured. They had no place to go except maybe the emergency room if they got really sick. It has taken us to a point where barely 1 percent of seniors today have no coverage. Seniors had limited choices back then. They could deplete their savings or seek assistance from their children or look for charity care, or, as was so often the case, forego medical care entirely. Within 11 months after President Johnson signed Medicare into law, almost 20 million Americans had enrolled in the program, and it has virtually eliminated uninsurance among older Americans. Today, about 1 percent of those 65 and older lack health care coverage.
So ask any of the 45 million beneficiaries if they would trade their Medicare. You will have a hard time finding any.
If the gentleman will yield. And these are not lies of ignorance. These are people who know better.
They know that Medicare has an overhead of about 2 percent.
So if I may make a small correction on what the gentleman has said. There is waste and fraud in Medicare. I think the gentleman said a lot; actually, it is a little. But when there are 44 million beneficiaries, almost 45 million beneficiaries, a little bit of error, a little bit of fraud can add up to a lot of money. But the program itself, if you count administrative costs as well as waste, fraud, and abuse, it is a couple of percent. In other words, almost all of the money in Medicare goes to providing health care.
On a percentage basis, it is a small amount. When you have 45 million beneficiaries, that adds up to a lot.
Let's be very clear. They are saying in this health care bill, You want to cut Medicare. No. That's the point. We've been saying over and over again, we're strengthening Medicare. What they want to do is do away with Medicare, replace it with vouchers, or another term that has been used in the past is ``privatizing.'' In other words, to say, Well, you can take care of your health care. We'll even give you a coupon. Now, the coupon is going to be of declining value over time, but you're smart enough. You will have saved for your golden years and you will be okay. That is what they propose to do.
The best estimate is 9.
I wanted to address another point that I hear from folks in central New Jersey about a lot. They get letters from their insurance companies saying Medicare is going to be cut. Again, it's misrepresentation, and we want to clear that up.
Let me give a little history about Medicare Advantage. A number of years back the insurance companies came to the then-Republican majority in Congress and said, You know, the government is really inefficient. We, the insurance companies, can provide the benefits of Medicare a lot more efficiently than the government can. In fact, if you give us 95 cents on the dollar, we will provide benefits to Medicare beneficiaries.
Right. We're so good and so eager to move services into the private sector--in other words, to privatize Medicare. The then- congressional majority said, Fine. Well, it didn't take more than a couple of years before the insurance companies came back, tears in their eyes, hat in their hands saying, Well, we can't really do it for 95 cents on a dollar. It's actually about $1.15 on the dollar. And those who liked privatization said, Hey, that's still a great deal. So right now we find ourselves where 20 percent of Medicare beneficiaries are getting Medicare benefits, and we are paying insurance companies a 15 percent premium to provide those benefits.
All taxpayers and the other Medicare beneficiaries. So yes, those insurance companies, under this health care legislation, are not going to get paid for doing no more than the Federal Government does at a dollar on the dollar. We're not doing away with Medicare Advantage. We're just saying, It's not going to be a giveaway for the insurance companies. So they'll get a dollar's worth of payment for a dollar's worth of services rendered.
Ask your seniors. About 20 percent of the Americans on Medicare are a part of this Medicare Advantage program. Ask them how many letters they have gotten from their insurance company saying that the sky is falling and that if Congress goes through with this health care reform, it will be curtains. Well, what it means is that there will be fairness, once again, restored to the Medicare program. And the Medicare beneficiaries will get a dollar's worth of services and benefits for a dollar's worth of expenditures. That's the way it should be.
And it's based on a fallacy.
Because Medicare has low administrative overhead. It is an efficiently run program.
It's a couple of percent.
And Medicare's costs grow at a slower rate--at least they have over the past 5 years--than the private health insurance for the same benefits. So it's just another indication of the efficiency of Medicare. Every year the government makes some changes. You know, ever since 1965, there have been changes made from time to time about Medicare to make it a more efficient program and to make it more directed toward healthy outcomes for the seniors.