May 3, 1995 CONGRESSIONAL RECORD—HOUSE H 4527

to take the medicine. The first issue

that I thought was so interesting was

the Hill newspaper, which said, guess

what,

The Republicans are having trouble with

their own appointed head of the Congressional Budget Office.

Luckily, the Congressional Budget

Office is there. When the Democrats

appointed the head of the Budget Office, we had trouble. Mr. Reischauer

pointed out that we had underestimated the cost of the health care proposals that were out there. Thank

goodness he did that, because I think

he brought real reality.

Now they are very angry because the

new head that they appointed is telling

them their Medicare stuff does not add

up, that they have put in all sorts of

little amendments, and they want to

tinker a little bit with it, and it is

going to be a whole lot more costly

than they thought. That is not the

news they want to hear, but Americans

want to hear what is really going to

happen to the budget, so I am glad that

both under Republicans and Democrats

that Budget Office has worked to be

nonpartisan and look at the numbers,

not poll numbers, but budget numbers.

This budget fight goes on and on and

on because, as you see in the other

newspaper, you see both Republican

leaders out pleading with the President

to join them in the rescue of Medicare.

They want the President to join them

in the rescue of Medicare after they

have proceeded to raid Medicare. What

a deal. They get to raid it, we get to

rescue it. There is something wrong

with that picture.

The President and his administration

were very responsible in the last 2

years. They have dealt with Medicare

in our last budget. We bailed it out for

the next 3 years, added solvency to it.

We did it without one Republican vote.

We have been talking about how not

only Medicare but all health care

should be looked at, because of the rising costs. We have had many proposals.

Guess what, we didn’t get a lot of bipartisan help.

In this last election people went out

and said, ‘‘It is so easy. Those silly

Democrats, they just mess everything

up. Just give it to us. We can do tax

cuts, we can balance the budget, and

we can increase defense.’’ I guess people forgot they had heard that once before in 1981. It didn’t work then, and we

see it isn’t working now.

I really hope we get on with business,

we get a budget out here. The No. 1

issue people want is doing something

about that deficit, doing something

about that deficit as rapidly as possible. All the other stuff was frill. We

got the frill out of the way. We still

don’t have the main course, the budget.

I hope we don’t see politicization of the

budget office.

We saw earlier this year the Speaker

taking on his own budget nominee,

saying he didn’t like the way that they

were responding. They are supposed to

respond neutrally and according to real

numbers. That is the way it should be.

I salute Director O’Neill for continuing

that tradition, and I must say, let’s

stop whining about that and let’s get

on with the real budget. Just do it.

Let’s stop whining about how the

President should rescue them from

their own raids that they made to do

tax cuts for the wealthy. Hey, they

gave it away, now they have got to figure out how they pay. I don’t think

they should blame it on the President.

He didn’t get the credit for giving it all

away.

Let’s get on with it, let’s see that

budget, and let’s get on with the real

hard tasks of government.

Mr. DURBIN. Mr. Speaker, will the

gentlewoman yield?

Mrs. SCHROEDER. I am delighted to

yield to the gentleman from Illinois.

Mr. DURBIN. I think I have heard

some speculation that the Republicans

want to cut somewhere in the neighborhood of $350 billion out of Medicare

spending, which would mean, of course,

that there would either be higher payments by senior citizens, or lower reimbursement to hospitals and doctors

and clinics and the like.

What I find curious about this is that

$350 billion figure is very close to the

figure that we hear will be the cost of

the tax cut bill, which was part of the

Republican Contract With America. So

this tax cut that took the money out of

the Treasury is obviously being

plugged with some cuts in Medicare.

Maybe I have missed something here,

but the two figures are very similar.

Mrs. SCHROEDER. The gentleman

from Illinois listened very properly and

very correctly. That is exactly right.

They raided it, they gave it away, and

now they are screaming to the President, ‘‘Rescue us, rescue us from our

own craziness.’’ If you remember, when

these tax cuts went into effect, the

Speaker attacked the same budget director who came out with this analysis

on what those tax cuts were going to

cost: ‘‘Did you write the numbers the

same,’’ and said it looked like she had

socialists doing the analysis. Really.

That is why I think the rhetoric has

gotten too high on this, and the gentleman has gotten right to the core of

the problem, as he usually does.

fb 1215

MEDICARE AND THE BUDGET

The SPEAKER pro tempore (Mr.

REGULA). Under a previous order of the

House, the gentleman from California

[Mr. MILLER] is recognized for 5 minutes.

Mr. MILLER of California. Mr.

Speaker, many of our colleagues on

this side of the aisle have raised the

question about exactly what is going

on with the Republican budget process

where we are now a month late in

meeting the deadline, a deadline that

we have not missed over the last 4

years.

I guess the answer is in the daily

press. That is, that the Republican

leadership is having a terrible time

with now trying to figure out how to

connect all of the dots in what they

have promised in their budget to the

American public. That is, that they

would provide a huge tax cut to the

wealthiest people in this Nation, they

would balance the budget, they would

add money to the military, and they

would not touch Social Security.

Of course, what we now find out is

that they cannot meet those targets

without touching Social Security, and

they plan to do more than just touch

Social Security. The speculation runs

from cuts of somewhere around $200

billion over the next 7 years to Senators estimating as high as $400 billion.

What that means, if you just take an

average, if you just save $250 billion,

you are talking over that 7-year period

of asking senior citizens to pay somewhere between $3,000 and $3,700 more

for their health care.

The problem is that many, many of

these senior citizens simply have no

way to replace that income. They have

no way to replace the money that they

would have to pay out for the additional cost of Medicare. They have no

ability to go back to work. They cannot get a job. They cannot lean on

their children any harder. So those

cuts are immediately translated to the

declining assets and the financial wellbeing of the senior citizens.

The Republican leadership has run

around the last couple of days trying

to explain that this is really about

their saving Medicare, this is about reforming Medicare. But it is interesting,

as each objective observer who has

looked at this says that this continues

to translate into cuts to Medicare that

must be made up by the beneficiaries of

that plan, the senior citizens of this

country, the $3,000 that I just talked

about.

It is also interesting to note that

when you get into a discussion of rural

hospitals, we find out that there are 10

million Medicare beneficiaries who live

in rural America, where often there is

only a single hospital available to service that population and the rest of the

community, and that these kinds of

cuts, the hospital association tells us,

translate into a serious threat of these

hospitals closing, and not only the senior citizens losing access to that hospital but the entire community losing

access to that hospital.

We also know that these rural residents very often are more likely than

urban residents to be uninsured. So the

ability to offset these cuts would then

be shifted in rural areas, perhaps to

those who have less access to insurance.

It is interesting also to note that the

plan of just cutting across the board in

Medicare is resisted by the National

Association of Manufacturers, companies like Eastman Kodak that say if

you do that, once again you are taking
H 4528 CONGRESSIONAL RECORD—HOUSE May 3, 1995

the cost of Medicare and you are shifting it onto the backs of working people

who are already paying very substantial premiums for current Medicare recipients and for their future cost.

This kind of leads you to what happened yesterday when Senator DOLE

and Speaker GINGRICH called a news

conference to explain all this, and as

they found that they could not explain

it to the press, they finally just simply

walked out of the news conference.

They just walked off stage.

They called the news conference,

they said, ‘‘We want the news conference to explain to the American people how we are saving Medicare,’’ and

when they got into the news conference

a few minutes, they found out that

they could not explain it because the

numbers do not add up. They cannot

protect Social Security under their

plan or they cannot protect the balanced budget under their plan or they

cannot protect the tax cut under their

plan. So they simply in a huff walked

out of the room and said they would

get back to everyone later.

That is what the fear is about in the

country today, is that they will get

back to us later. I guess the new date

for the budget is on May 17, and at that

point then we will, I guess, be able to

unravel the puzzle here on how they

are going to meet the goal of the balanced budget which almost everybody

in the country believes should happen,

the goal of the tax cut which most of

the country thinks is kind of a luxury

when you are running a deficit of $250

to $300 billion a year, a $4 trillion national debt, to now borrow money to

give people a tax cut or borrow money

from the Social Security recipients to

give the people a tax cut.

This just no longer makes any kind

of economic sense, and looks very bad

both for the deficit, for Social Security

recipients, and eventually for low-income people who rely on the programs

that have already been cut.

I will be happy to yield to the gentlewoman from California.

Ms. PELOSI. I thank the gentleman

for yielding.

I wanted to focus on one point you

had made about the Republicans saying

they would not touch Social Security,

but what these Medicare cuts will do.

It would reduce half of the Social Security cost-of-living adjustment for millions and millions of our senior citizens. In fact, 2 million Medicare beneficiaries will have all or most of their

cost of living adjustments consumed by

the Republican beneficiary cost increases.

Mr. MILLER of California. So in fact

what you are saying is when they get a

COLA increase, the vast amount of

that COLA will simply be absorbed in

additional Medicare costs to the Social

Security recipient?

Ms. PELOSI. Yes. It is a back door

way of cutting Social Security.

MORE ON MEDICARE

The SPEAKER pro tempore. Under a

previous order of the House, the gentleman from Illinois [Mr. DURBIN] is

recognized for 5 minutes.

Mr. DURBIN. Mr. Speaker, I would

like to follow up on the earlier discussion by the gentleman and the gentlewoman from California about Medicare.

I think it is critically important for

us to focus on the fact that when we

are talking about Medicare, we are not

necessarily just confining our interest

to the health care of our parents and

grandparents. Some of us who are advancing in age look to Medicare just a

few years down the line to take care of

them, too.

But the bottom line is that Medicare

and Medicaid, the other Government

health care program, are major sources

of funding for hospitals across the

United States. In my small-town district in Illinois, I have many, many

hospitals, and I find that 60 percent to

80 percent of the revenue coming into

those hospitals comes from those two

Government programs, Medicare and

Medicaid.

So when I hear suggestions made, as

I have from some Republican leaders

who are trying to come up with a budget, that they want to make cuts of billions of dollars in Medicare funds in

out years, it not only should cause concern among seniors and people soon to

be seniors as to whether they will have

to pay more out of pocket, it also

raises a serious question as to whether

or not these hospitals will receive

enough revenue to keep their doors

open.

Those who visit with the hospital administrators and boards know that

there have been dramatic changes in

these hospitals in rural and small town

America over the last 10 years. Most of

them have downsized, there are fewer

patient beds, there is more outpatient

service, and they depend dramatically

on Medicare and Medicaid to continue

to keep their doors open.

We just finished last week in Ames,

IA, a rural conference with President

Clinton and Vice President Gore talking about the future of small-town

America. A lot of concentration was

put on bringing new jobs and keeping

businesses in rural America. What we

found is that when the Chamber of

Commerce or the local boosters want

to bring in a business or keep one, they

have to answer some basic questions.

The first question is: Do you have a

hospital? How many doctors do you

have?

So when we talk about changing a

Federal program for medical care, reducing the expenditure and literally

threatening the bottom line of rural

and small-town hospitals, the ripple effect goes far beyond the jobs at that

hospital. It goes far beyond whether or

not that ambulance has to drive 5 minutes or 50 minutes with a patient who

is in critical need. It goes to the question of whether or not the community

survives.

Members of Congress fight battles

day in and day out to keep Federal facilities open in small towns. We know

how important they are. There is nothing more important than a hospital.

Absolutely nothing. In rural America,

it is critically important because we

have an older population. Many of

them are in farming, the most dangerous occupation in America, and a

lot of them get involved in automobile

accidents in rural areas at higher

speeds with more injuries.

So all these debates that we hear on

Capitol Hill about budget resolutions

and the future of Medicare have dramatic importance to people living in

small town America. They had better

tune in.

Let me tell you, also, as I listen to

this debate, I am really troubled. The

Republicans yesterday, Mr. DOLE, Mr.

GINGRICH, tossed down the gauntlet and

said, ‘‘President Clinton, why haven’t

you told us anything about health care

reform?’’

Excuse me? This President was here 2

years ago with a proposal on health

care reform. It was one that was detailed. Perhaps it was overly bureaucratic, maybe it was too large in its

scope, but he accepted the challenge

long before they issued it. He came to

us and said, ‘‘Let’s look at the integrated health care system of America

and how we can help Medicare, Medicaid, uninsured people, and the private

sector,’’ and it fell on deaf ears.

The insurance industry ran over him

like a steamroller, and that was the

end of the debate. Now the Republican

leaders have discovered the issue again

because the problem is still there. The

problem is there in terms of human

terms and in terms of budget terms.

I sincerely hope that we can come to

some sort of bipartisan dialog on this.

But I think honestly before that occurs

that the Republican leaders, particularly those in the House, are going to

have to basically admit the reality

that they cannot have a tax cut package which adds more to our Nation’s

deficit at the time that they are talking about cutting a program as critical

as Medicare.

I think if they drop that whole Republican tax bill and then say, ‘‘Let’s

come to the table,’’ we have got a real

opportunity for bipartisanship. But

why in the world should my senior citizens, should my small towns and

should my neighbors lose a community

hospital critical for the future of that

community in order to give tax breaks

to the wealthiest people in America

under the Republican Contract With

America? That does not compute. You

cannot give a tax credit large enough

to a family to make up for the loss of

a hospital when there is serious need,

when that family needs that medical

care.

I yield to the gentlewoman from

California.