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[Congressional Record Volume 141, Number 83 (Thursday, May 18, 1995)]
[Senate]
[Pages S6844-S6845]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

 MAJORITY'S BUDGET PROPOSALS FOR MEDICARE AND VETERAN'S ADMINISTRATION 
                          HEALTH CARE PROGRAMS

  Mr. AKAKA. Mr. President, I want to say good morning to my friend who 
is now presiding, Senator Inhofe, from Oklahoma, and wish him a good 
day.
  I am here to express some of my concerns about some parts of the 
budget, and particularly Medicare and Veterans' Administration health 
care programs.
  Mr. President, earlier this week the Republican-controlled Budget 
Committees unveiled their 7-year budget resolutions. The House 
resolution provides a generous tax cut for wealthy Americans. The 
Senate resolution would allow not one, but two tax cut proposals. The 
first would be $170 billion in tax cuts once the Congressional Budget 
Office certifies that the savings from cutting Medicare, education, VA 
health care, and the other programs targeted for reductions are, in 
fact, achieved.
  Further tax cuts would be permitted if the budget is reduced by an 
amount that is greater than the reductions already proposed by the 
Senate budget resolution. We can clearly see that Republicans in the 
House and Senate have laid the foundation for implementing the tax 
proposals outlined in the Contract With America. To pay for their tax 
cuts they must reduce programs that help working families and the 
elderly.
  The Senate budget resolution proposes a $256 billion cut in Medicare 
spending over 7 years, but provides no guidelines on how these savings 
will be achieved. This will be the largest Medicare cut in history, and 
the impact on beneficiaries and providers will be very painful.
  If Medicare cuts of this magnitude are approved, the Department of 
Health and Human Services estimates that senior citizen's out-of-pocket 
expenses will increase by $900 a year, or a total of $3,500 over the 7 
years. Eighty-three percent of Medicare benefits go to beneficiaries 
with incomes under $25,000.
  It is obvious who will be hurt by these cuts. Our Nation's low-income 
elderly, who can least afford it, will bear the brunt of the Medicare 
cuts.
  In addition, cuts to providers will have serious ramifications on 
health care costs since they are passed along to other health care 
consumers. Provider cuts could have a devastating impact on urban 
hospitals which already bear a disproportionate share of the Nation's 
growing burden of uncompensated care. Reductions in Medicare payments 
will also endanger access to care in rural areas. Nearly 10 million 
Medicare beneficiaries--25 percent of the total Medicare population--
live in rural areas. There is often only a single hospital in their 
county. Significant cuts in Medicare may force rural hospitals to close 
or cause more providers to refuse to treat Medicare beneficiaries.
  The Senate Budget Committee was given the opportunity to restore the 
cuts in Medicare funding. Two amendments were offered to scrap the tax 
cut for the rich in order to fund Medicare. Unfortunately, they were 
rejected on party-line
 votes. This massive cut in Medicare funding would not be necessary if 
the majority abandoned their tax cut for the wealthy.

  Under the Republican plan, the wealthy will gain while our elderly 
population suffers more pain. Instead of cutting Medicare, we must work 
to ensure that any effort to maintain the solvency of the Medicare 
trust fund does not put Medicare beneficiaries at risk. And, we must 
protect the program for future enrollees. This problem can and should 
be solved in the context of health care reform.
  I recognize the critical need to ensure long-term stability in the 
Medicare Program and I support efforts to balance our budget. However, 
I am opposed to arbitrarily cutting Medicare to finance a tax break for 
wealthy Americans. I look forward to working with my colleagues on 
addressing these important issues.
  Just as health care benefits are being cut for our senior citizens 
dependent on Medicare, the freeze proposed on veterans health care 
programs would be equally devastating for our elderly veterans.
  At first glance, the majority budget seems to have little impact on 
veterans health care programs. The chairman's mark shields the Veterans 
Health Administration from cuts, and freezes funding at the 1995 level. 
However, if you examine the long-term impact of the proposal, you find 
that the proposed freeze will have a debilitating effect on health care 
provided to our Nation's veterans.
  The budget resolution contains only half of the annual cost-of-living 
adjustments [COLA], so the Veterans' Administration must absorb the 
remainder of the increase from a budget that is already being held 
flat. This will mean that fewer resources will be available to veterans 
seeking access to veteran health care programs.
  In fiscal year 1996, the majority's proposal will cut $640 million 
from the Veterans Health Administration's budget compared to the 
President's budget request. The options to cope with this cut include 
the elimination of 8,200 health care providers and support staff or 
closing Veterans Administration Medical Centers [VAMC] to achieve a 
total reduction of 1,500 patient beds. In terms of direct care 
services, 57,000 inpatient and 1,300,000 outpatient visits for 142,000 
patients would be foregone in fiscal year 1996 under the Republican 
proposal.
  Under their proposal, by the year 2002, 53,000 full-time-equivalent 
positions would be eliminated or 35 Veterans' Administration medical 
centers would have to be closed. Over a 7-year period, one-fourth of 
the current medical care positions would have to be eliminated and 35 
of the 159 Veterans' Administration medical centers currently serving 
veterans across the country would be closed if the Republican proposal 
is implemented.
  Health care facilities and personnel are not the only areas which 
will be affected by the majority's proposal. Medical research within 
the Veterans' Administration would also be frozen at the fiscal year 
1995 appropriation level. This will significantly impact the 
specialized services the Veterans' Administration provides, including 
spinal cord and prosthetics research. In fiscal year 1996, over 150 
projects would have to be terminated to meet the budget constraints 
imposed by the majority.
  The cumulative impact for Veterans Health Administration services 
over 7 years would decimate the Veterans' Administration health care 
system as we know it. By the year 2002, the Veterans Health 
Administration budget would have lost $20.6 billion over 7 years. Over 
1.5 million inpatient and 34 [[Page S6845]] million outpatient visits 
for 3.7 million patients would have been denied under the majority's 
budget blueprint, and we will have turned our backs on the majority of 
those who so valiantly served this Nation.
  Mr. President, this has been our findings in reading through the 
budget proposal that will be presented today to the Senate. The 
majority's budget proposals for cuts to Medicare and freezing Veterans' 
Administration health care programs are simply, in my eyes and in my 
heart, unacceptable. You cannot single out health care for one segment 
of the population for cuts without serious consequences. The senior 
citizens of today, the veterans of today, should not have the rugs 
pulled out from under them. So, therefore, I urge my colleagues to 
reject these unwise proposals.
  I yield the remainder of my time.
  

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