May 22, 1995 CONGRESSIONAL RECORD — SENATE S7071

billion. We have difficult choices to

make, but this budget fails. It is time

to try again.

We can balance the Federal budget,

but we have to set some priorities here.

We cannot, indeed must not, balance

the budget on the backs of children and

the elderly. It is not right and it is not

the American way. This amendment

seeks to reduce the burden of this

budget on those who need it most. I

offer my wholehearted support.

REPUBLICAN BUDGET PLANS AND

Thank you Mr. President.

MEDICARE CUTS

fMr. LEAHY. Mr. President, I believe

the current debate in Congress on the

budget is the most important action

Congress will take this year. The Republican budget proposals are indeed

monumental. The debate over how we

balance our Federal budget will have

repercussions to State and local governments for years to come.

I agree with several things in the Republican budget plans. I agree we need

to continue to reduce the deficit and

achieve a balanced budget. The Federal

deficit and its resulting interest payments on the growing national debt

put a heavy drag on our economy. In

1990 and 1993, I cast politically unpopular votes that cut about $1 trillion

from the projected deficit. Since 1992,

the deficit has been reduced from $290

to $176 billion this year—a drop of onethird. And more savings must be made.

But as Ross Perot would say: ‘‘The

devil is in the details.’’ How we balance

the Federal budget is just as important

as balancing it.

I am extremely disappointed that the

Republican budget would reduce Medicare spending by the largest amount in

history—$256 billion in the Senate version and $288 billion in the House.

These numbers are big, but what do

they really mean to Vermonters?

Under the Senate Republican budget

proposal, the average Medicare spending per Vermont beneficiary would be

reduced from today’s level by over

$4,000 over the next 7 years.

Over the next 7 years, Vermont will

lose $339 million in Medicare funding,

$79 million in the year 2002 alone. If

this loss of funds is split 50–50 between

Medicare recipients and providers, in

the year 2002 Medicare beneficiaries

will be paying about $500 in increased

copayments, premiums, and

deductibles. Hospitals, doctors, and

other health care provides will be receiving $500 less from each Medicare recipient.

These reductions result from slowing

the projected growth of Medicare to 7

percent a year instead of the projected

increase of 10 percent a year. Some

claim that these reductions are not

really cuts. I fail to understand that

logic.

For the 83,000 Vermonters on Medicare and in particular the 12 percent of

Vermont seniors who live below the

poverty level, does it make any difference what we call these reductions?

Over the next 7 years, Vermont seniors,

or the hospital, or the doctor will have

to come up with over $4,000 to maintain

their current level of benefits.

Ask the elderly couple that is retired

and living on a fixed income if they can

afford this slowing of growth? Ask the

family down the road that has a grandparent who was just diagnosed with

Alzehiemers whether they will be able

to afford this slowing of growth? Ask

the rural doctor who is already having

trouble covering costs whether he or

she can afford this slowing of growth?

Ask the typical rural hospital that

currently receives only 91.5 cents on

the dollar for the cost of each Medicare

participant whether it can afford this

slowing of growth. Ask the Vermonter

with private health insurance that is

currently paying that remaining 8.5

cents on every dollar on hospital costs

alone due to cost shifting whether they

can afford this slowing of growth?

The scariest part about the Senate

Republican budget resolution is that it

ignores the fact that it is not just Medicare costs that are rising. All health

care costs are rising. And by just cutting Medicare—and Medicaid for that

matter—a huge cost-shift of medical

expenses will result and make sure

that all Vermonters pay more for

health care.

Vermonters need to realize that the

magic number of $256 billion in the

Senate and $288 billion in the House

will do nothing for the long-term solvency of the Medicare trust fund. It extends the trust fund’s life another 3

years from the current projection of it

going broke in 2002. Since the first

trustees’ report in 1970, there always

has been a date certain for the trust

fund’s insolvency. It is interesting to

note that last year the insolvency date

was projected at 2001, yet Republicans

at that time saw no such urgency in

shoring up the trust fund or dealing

with the real problem of overall health

care costs.

The Republican Medicare cuts are

short-sighted. Simply cutting Medicare

does not make its problems go away.

To reduce Medicare costs, we must reduce health care costs throughout the

system, which can only be achieved by

true health care reform. But the Republicans have no plan to curb Medicare costs except to cut the program.

I hope in the coming months that

Members from both sides of the aisle

hammer out a plan to deal with the

issue of comprehensive health care reform. But in the meantime, simply cutting Medicare is not the answer.

Mr. BIDEN. Mr. President, this Republican budget sets the wrong priorities. The goal is right—steady movement toward a balanced budget—but

how the Republicans propose to get

there is wrong. More than half of all

the cuts in this budget come from just

two programs—Medicare and Medicaid.

Specifically, the Republican budget

would cut $256 billion from Medicare

over the next 7 years and another $175

billion from Medicaid, about $58 billion

of which would come from long-term

care for the elderly. This would be,

without a doubt, the largest Medicare

cut in history—three times larger than

any previous cut.

This was not part of the Republican

Contract With America. In fact, some

have forgotten about an earlier contract—the contract we made with the

senior citizens of America—those who

worked hard and played by the rules.

Cutting health care for those who are

at an age when they need health care

the most is simply wrong. To cut Medicare as much as the Republicans are

proposing violates the long-standing

contract with America’s seniors.

And, why? So that the wealthy can

be guaranteed a tax cut and so that

rich billionaires can continue to renounce their U.S. citizenship in order

to avoid paying taxes.

I believe we should have a tax cut—

one that is targeted to middle-class

families for the cost of education. And,

I will discuss that issue in more detail

later. But, the Republicans in the

House have already passed their tax

cut. Families making less than $30,000

would get a tax cut of $124—less than 50

cents a day—while families making

over $200,000 would get a tax cut of over

$11,000.

I am not saying we should raise taxes

on the wealthy. And I am not saying

that we should give a tax cut to everyone but the wealthy. But, Mr. President, do our richest 1 percent, or 5 percent, need a tax cut more than our retirees on a fixed income need protection against skyrocketing health care

costs. I do not think so. I do not think

we should provide a tax cut for guys

like me—and I am the poorest one

around this place—while we are increasing my mother’s health care

costs. And, I certainly do not believe

that billionaires who renounce their

American citizenship should have priority over the seniors who gave so

much to this country.

I know what the Republicans are saying. They are claiming that they are

not cutting Medicare and Medicaid—

only reducing the rate of increase.

Technically, true. But, for those seniors whose costs go up because Medicare pays for less, is that not a cut?

For those seniors who have less access

to health care services because Medicare providers refuse to take new Medicare patients, is that not a cut? For

those seniors who may no longer qualify for Medicaid nursing home care because Medicaid payments to States are

restricted, is that not a cut? Call it

what you want. The fact is, seniors will

pay more—much, much more.

Assuming that half of the Medicare

cuts will come from seniors themselves, this Republican budget means

that the average senior citizen will pay

between $800 and $900 more in out-ofpocket costs—premiums, deductibles,

and copayments—in 2002 than they

would otherwise pay. Over the course

of the next 7 years, the elderly would
S7072 CONGRESSIONAL RECORD — SENATE May 22, 1995

have to pay a total of about $3,200 more

in out-of-pocket costs. That is on top

of the average senior already expecting

to pay about $25,000 in premiums,

copayments, and deductibles for Medicare between now and 2002. The Republican budget would result in a 13-percent increase in out-of-pocket Medicare payments by America’s seniors.

And, on average, seniors already pay 21

percent of their income on health

costs.

I know what else the Republicans are

saying. They are claiming that we need

to cut Medicare in order to save it.

They argue that Medicare will go bankrupt in 2002, and they just want to protect the program for posterity. Mr.

President, this budget does not reform

Medicare; it cuts Medicare. Not one

single proposal has been offered to save

Medicare. Instead, the budget establishes an arbitrary number of $256 billion and says that is how much is going

to be cut regardless of the actual cost

of medical services or the total number

of people who qualify. Between now

and the year 2002, the number of seniors eligible for Medicare will increase

by 4 million—15,000 in my State of

Delaware. The Medicare funds will not

keep pace. Someone gets cut.

If the Republicans were interested in

saving Medicare, they would attack the

causes of why Medicare is going bankrupt. But, they do not. If the Republicans were interested in saving Medicare, they would come to the table

with the goal of saving Medicare. Instead, they want Democrats to come to

the table after they have pulled an arbitrary number out of thin air.

And, where have the Republicans

been? We have known since 1985 that

the Medicare trust fund would become

insolvent near the turn of the century.

And, yet, for 7 years, Republican Presidents Reagan and Bush never proposed

saving Medicare from bankruptcy. In

1993, not one single Republican in either the House or the Senate voted for

President Clinton’s proposal to shore

up the Medicare trust fund. And, last

fall, Republicans were so concerned

about saving Medicare that they forgot

to include it as part of the Contract

With America.

Let us stop the charade. Republicans

are cutting Medicare to balance the

budget and to provide tax cuts to the

wealthy. That is their priority. They

are wrong. Democrats have alternatives that will achieve the same

goal—a balanced budget in 2002—without taking this much from Medicare.

For example, Senators ROCKEFELLER

and LAUTENBERG have an amendment

to return part of any economic dividend that results from a balanced

budget back to the Medicare and Medicaid Programs. We ought to adopt the

Democratic amendments and fulfill the

original Contract With America—the

contract with America’s seniors.

Mr. BINGAMAN. Mr. President, I rise

in support of the amendment offered by

my distinguished colleague from West

Virginia, Senator ROCKEFELLER, to restore $100 billion of the $426 billion proposed cuts in the Medicare and Medicaid programs over the next 7 years.

Mr. President, virtually everyone—

Members of Congress, the President,

program administrators and even current beneficiaries of the Medicare and

Medicaid Programs—agree that

changes, including slower spending,

need to be made to the current system.

The cost of health care is growing too

fast and too high. Medicare, for example, currently is expanding by more

than 10 percent per year, or three times

CPI. These escalating costs simply are

unsustainable.

President Clinton and many of us

here in Congress spent 2 years trying

to deal with this problem in a responsible, comprehensive way. Had we been

successful, the Medicare Program

would be more secure and access to affordable health care would have been a

reality for all Americans, young and

old alike. But at the time, my colleagues on the other side of the aisle

were not interested in working with us

to help make the Medicare Program secure. We heard repeatedly that there

was no crisis, no need for Congress to

act.

So here we are, with the Medicare

Program in real trouble and the chairman of the Senate Budget Committee

proposing to save it by cutting the program $256 billion over 7 years. Along

with the Medicare cuts are $170 billion

in cuts to the Medicaid program, which

often serves as a long-term care safety

net for seniors and the disabled.

My first question is ‘‘What do cuts of

this magnitude mean to my homestate

of New Mexico?’’ Unfortunately, Mr.

President, States like New Mexico are

going to be hit especially hard. This is

due to a combination of factors:

First, New Mexico has a growing senior population.

Second, New Mexico has a high poverty rate; a high rate of seniors living

in or near poverty; and low per capita

income level.

Third, New Mexico’s hospitals and

providers are heavily dependent on

Medicare and Medicaid revenue, more

so than most other States.

SENIOR POPULATION—DEPENDENCY ON

MEDICARE

In New Mexico, more than 212,000

seniors, disabled children, and disabled

adults currently depend on Medicare.

By 2002, more than 257,000 New Mexicans are anticipated to be eligible for

the program. Looking at seniors alone,

New Mexico’s over-65 population grew

by 37.8 percent between 1980 and 1990.

The senior population is expected to

grow by another 11 percent by 2000—to

204,000—and by more than 21 percent by

2010—to 247,000. Our over-65 growth

rate, which is currently at 11 percent,

is one of the highest in the country.

What do the proposed cuts mean to

these seniors? According to an AARP

study, to the average Medicare beneficiary in New Mexico it means $3,237

more in out-of-pocket expenses over

the next 7 years, or $462 per person per

year. This is $462 per person more in

higher premiums, higher deductibles,

higher copays, and more services not

covered.

SENIORS IN POVERTY—TIE BETWEEN MEDICARE

AND MEDICAID

A cost shift of this type is especially

tough on New Mexico’s seniors and

their families because so many in my

State are living at or near poverty. In

fact, at 22.4 percent, New Mexico has

one of the highest poverty rates in the

country. One in every five New Mexicans—including about 26,000 seniors—

lives in poverty.

Mr. President, the majority of my

constituents are barely making ends

meet today. And then along comes the

majority in Congress with an significant increase in the obligation of beneficiaries—all beneficiaries, regardless

of income level—to pay more out-ofpocket for their health care. How can

poor, elder New Mexicans possibly

come up with an additional $3,200 for

their health care? The simple answer is

that they will not be able to.

Through the Medicaid Program, the

State typically would pick up the extra

cost. But to do so, the State must raise

additional revenue, either by cutting

services elsewhere or by raising taxes.

Under the budget plan before us today,

the situation is even more grim for the

States: before even beginning to address the new costs they will face,

States must first come up with revenue

to cover the initial shortfall they will

face from the $170 billion in proposed

cuts to the Medicaid Program itself.

If New Mexico or any other State will

not or cannot raise the revenue needed

to keep the safety net in place without

Federal assistance, the results will be

tragically clear: hundreds of seniors

will have to go without health care;

and hundreds of families will be forced

to shoulder even more of the costs and

burdens of providing long-term care for

an elderly parent or relative. Those

least able to afford it and most vulnerable among us—the very poor, frail elderly—will be hurt most.

The very bad news does not end

there, however. I want to turn for a

moment to the situation facing seniors

with income levels above the poverty

line. In New Mexico, our per capita income is $14,709, or more than $5,000

below the national average. Per capita

income for New Mexico’s seniors is

even lower, estimated at around $12,000

per year by AARP, with between 20–25

percent being spent on health care.

If Senator ROCKEFELLER’s amendment does not pass, the message to

New Mexico’s seniors will be that they

will have to spend even more on their

health care. The Senate will be telling

New Mexico’s seniors that they must

spend more of their $12,000 to $14,000

annual income on health care. To

many, this will simply be impossible.

I have just described the impact of

the proposed Medicare cuts on New

Mexico’s Medicare beneficiaries. The

adverse impact on our State does not

stop there. Just as the cuts hurt New
May 22, 1995 CONGRESSIONAL RECORD — SENATE S7073

Mexico seniors more than seniors in

many other States—because many of

our seniors are living at or near poverty and our per capita income level is

low—the cuts will also hit New Mexico’s hospitals and health care providers

harder than hospitals and providers in

other States.

NEW MEXICO’S HOSPITALS AND PROVIDERS

The proposed Medicare and Medicaid

cuts will be tough on our hospitals and

providers, particularly in rural areas,

because they are disproportionately dependent on Medicare and Medicaid for

their revenue. Most NM hospitals/providers depend on the programs for 70 to

80 percent or more of their revenue.

Nationally, 60 percent or less of all revenue comes from Medicare and Medicaid.

A hospital with a 60 percent or lower

Medicare revenue share can compensate for lost Medicare-Medicaid dollars by cost-shifting to private insurers. NM hospitals and providers cannot.

They depend on reimbursement from

Medicare and Medicaid. Even a slight

cut to rural providers could represent a

serious financial threat to the providers and a very real threat to health

care for rural New Mexicans.

Mr. President, I believe we can find a

more equitable way to achieve the kind

of savings and fiscal accountability we

need. We can agree, for example, that

we can develop ways for fairly changing many variables contributing to

higher health care costs. Fraud, waste,

and inefficiency can all be identified,

targeted, and changed. We can improve

case management, increase use of costeffective, quality managed care where

appropriate, and focus more on prevention and early detection.

I believe the amendment put forth by

Senator ROCKEFELLER represents a

more equitable, more reasonable approach to the challenges we face. I will

support it, and I urge my colleagues to

do likewise.

Mr. KENNEDY. Mr. President, in

crafting this budget resolution, the Republican majority has made a great

show of its pledge to protect Social Security. But when the American people

look behind the rhetoric, they will find

that the Republican budget plan is a

sneak attack on Social Security, and a

violation of our Government’s compact

with its citizens.

As every senior citizen knows, the

Medicare part B premium is deducted

directly from their Social Security

check. When that premium goes up, Social Security benefits go down. The Republican budget will raise those premiums and reduce Social Security

checks by more than $1,750 per senior

over the life of this budget plan. For an

elderly couple, the reduction in the Social Security check will be $3,500. Next

year alone, as a result of this Republican budget, seniors will see a premium increase of $134 compared to current law. In effect, that will eliminate

more than half the average COLA increase of $237. Lower income seniors

will lose 83 percent of their COLA.

Senior citizens rely on their annual

cost of living adjustments to pay for

the increased costs of food, housing,

fuel, and clothing that they face every

year. But under this Republican budget, the majority of that COLA will be

stolen to pay for tax cuts for the

wealthy. The last time the Republicans

tried to cut the Social Security COLA

they were forced to back down. Now

they are trying to do it by stealth—but

it is not going to work.

It is not only through the increase in

the Medicare premium that the Republicans are attacking Social Security.

In the House budget, the Republicans

have arbitrarily assumed an unprecedented, unilateral reduction of the CPI

of .6 percent. That change is designed

to cut Social Security COLA’s by another $23 billion over the next 7 years.

At the most basic level, the harsh

cuts in Medicare contained in this

budget resolution are a repudiation of

our historic commitment to Social Security, because the distinction between

Medicare and Social Security is a false

one. Medicare is part of the same compact between the Government and the

people as Social Security. That compact says ‘‘Contribute during your

working years, and we will guarantee

basic income and health security in

your retirement years.’’

Any senior citizen who has been hospitalized or who suffers from a serious

chronic illness knows that there is no

retirement security without Medicare;

the cost of illness is too high. A week

in an intensive care unit can cost more

than the total yearly income of many

senior citizens.

It is the low- and moderate-income

elderly who will suffer most from these

Medicare cuts. Eighty-three percent of

all Medicare spending is for older

Americans with annual incomes below

$25,000; two-thirds is for those with incomes below $15,000.

How can any budget plan that

purports to be part of a Contract With

America break America’s contract

with the elderly? It is bad enough to

propose these deep cuts in Medicare at

all. It is even worse to make these cuts

in order to pay for an undeserved and

unneeded tax cut for the wealthiest

Americans.

The cuts in Medicare are unprecedented—$256 billion over the next 7

years. By the time the plan is fully

phased in, the average senior citizen is

likely to pay $900 more a year in Medicare premiums and out-of-pocket costs.

An elderly couple would have to pay

$1,800. Over the life of this budget, they

have to pay $6,400 in additional costs.

The part B deductible could double

under this Republican plan, raising the

amount a senior citizen would have to

pay before they can see a doctor by an

additional $100.

A typical senior citizen needing home

health services could have to pay an

additional $1,200. Anyone who is sick

enough to need the full home care benefit could have to pay $3,200.

Seniors could lose the freedom to select their own doctor, or face

unaffordable costs if they refuse to give

up their family physician.

The fundamental unfairness of this

proposal is plain. Because of gaps in

Medicare, senior citizens already pay

too much for the health care they need.

Average elderly Americans pay an astounding one-fifth of their income to

purchase health care—more than they

paid before Medicare was even enacted

30 years ago. And the reason we enacted Medicare then was because the

elderly faced a health care crisis then.

Lower income, older seniors pay even

more than a fifth of their income for

health care. Medicare doesn’t cover

prescription drugs. Its coverage of

home health care and nursing home

care is limited.

Unlike private insurance policies,

Medicare doesn’t have a cap on out-ofpocket costs. It doesn’t cover eye care

or foot care or dental care. Yet this

budget plan piles additional medical

costs on every senior citizen—while the

Republican tax bill that has already

passed the House gives a tax break of

$20,000 to people making more than

$350,000 a year.

It is interesting to compare the generous benefits that the authors of this

resolution enjoy under the FEHBP plan

available to every Member of Congress

to the much less adequate benefits provided by Medicare to senior citizens.

Medicare has no coverage at all for

outpatient prescription drugs, but they

are fully covered under Blue Cross-Blue

Shield Standard, the most popular

FEHBP plan. The combined deductible

for doctor and hospital services under

Blue Cross/Blue Shield is $350. For Medicare, the combined deductible is $816.

Blue Cross/Blue Shield covers unlimited hospital days with no co-payments. Under Medicare, seniors face a

$179 per day copayment after 60 days

and $358 after 90 days. After 150 days,

Medicare pays nothing at all. Medicare

covers a few preventive services, but it

does not cover screening for heart disease, colorectal cancer, and prostate

cancer—all FEHBP benefits. Dental

services are covered for Members of

Congress—but not for senior citizens.

Members of Congress are protected

against skyrocketing out-of-pocket

costs by a cap on their total liability,

but there is no cap on how much a senior citizen has to pay for Medicare copayments on deductibles.

Members of Congress earn $133,600 a

year. The average senior’s income is

$17,750. For the limited Medicare benefits they receive, seniors pay $46.10 a

month, but for their comprehensive insurance coverage Members of Congress

pay a grand total of $44.05 a month—

$2.00 less than seniors must pay out of

incomes one-eighth as large.

The Republican sponsors of this resolution do not seem to understand that

the average senior citizen has an income of only $17,750 a year. Because of

this budget, millions of elderly Americans will be forced to go without the

health care they need. Millions more

will have to choose between food on the
S7074 CONGRESSIONAL RECORD — SENATE May 22, 1995

table, adequate heat in the winter, paying the rent, and paying for medical

care. These proposals are cruel—and

they are unjust. Senior citizens have

earned their Medicare benefits, they

have paid for them, and they deserve

them. Yet our Republican friends

would deny them.

How do they explain this to senior

citizens? This is a budget that Marie

Antoinette would love—let them eat

cake.

The Medicare cuts in this resolution

harm more than senior citizens. These

proposals will strike a severe blow to

the quality of American medicine, by

damaging hospitals and other health

care institutions that depend heavily

on Medicare.

These institutions provide essential

health care for Americans of all ages,

not just senior citizens. Progress in

medical research and training of health

professionals depend on the financial

stability of these institutions. Academic health centers, public hospitals,

and rural hospitals will bear an especially heavy burden. As representatives

of the academic health centers that

guarantee our world-renowned excellence in health care said of this budget,

‘‘Every American’s quality of life will

suffer as a result.’’ Health care providers from the American Hospital Association, to the American Medical Association, to the Catholic Health Association have warned of the devastating

effects of these cuts on the quality of

care.

In addition, these massive cuts will

inevitably impose a hidden tax on

workers and businesses, as the National Association of Manufacturers

has warned. The private sector will

face increased costs and higher insurance premiums, as physicians and hospitals shift even more costs to the nonelderly. According to recent statistics,

Medicare now pays only 68 percent of

what the private sector pays for comparable physicians’ services; for hospital care, the figure is 69 percent. The

proposed Republican cuts will widen

this already ominous gap.

During the course of this debate we

have heard a number of arguments that

attempt to defend this fundamentally

indefensible proposal. We heard them

over and over again during the course

of this debate—as if repetition would

somehow make them right.

The first argument is that deep cuts

are needed to save Medicare from

bankruptcy. The hypocrisy of this

claim is astonishing. Just a few weeks

ago—before they began to feel the political heat on Medicare cuts—the Republicans passed a tax bill through the

House that took almost $90 billion in

revenues out of the Medicare hospital

insurance trust fund over the next 10

years—and brought it that much closer

to insolvency. We did not hear a word

then about the impending bankruptcy

of Medicare.

We also did not hear about it when

last year’s Medicare trustee’s report

was issued. Republicans were too busy

last year blocking health reform and

pretending there was no health care

crises at all.

This year’s trustees report actually

shows the Medicare trust fund to be in

a stronger financial position than last

year. The newfound Republican concern for the solvency of the Medicare

trust fund is a sham—a convenient pretext to rob Medicare to pay for tax

breaks for tycoons. Medicare is nowhere near as bankrupt as Republican

priorities.

It is true that the April 3 report of

the Medicare Trustees projects that

the Medicare Hospital Insurance Trust

Fund will run out of money by 2002.

But few if any Republicans would be

talking about Medicare cuts of this

magnitude, absent the need to finance

their tax cuts for the wealthy. As the

Medicare Trustees themselves noted in

their report, modest adjustments can

keep Medicare solvent for an additional decade—plenty of time to find

fair solutions for the longer term.

Similar projections of Medicare insolvency have been made numerous

times in the past, but adjustments enacted by Congress were able to deal

with the problem without jeopardizing

beneficiaries. Now is no different. For

example, an estimated 20 percent of all

Medicare hospitalizations could be

avoided with better preventive services

and more timely primary and outpatient care. As much as 10 percent of

all Medicare expenditures may be due

to fraud, and could be reduced or eliminated by better oversight. A simple

technical change that would shift primary responsibility for home health

services from the Hospital Insurance

Trust Fund to the Supplementary Insurance Fund would keep the Hospital

Insurance Fund solvent until 2008,

without reducing benefits or increasing

Government costs. This single adjustment would actually keep the Trust

Fund solvent a year longer than all the

draconian Republican cuts put together.

Some Republicans have accused

Democrats of attempting to scare

America’s senior citizens. Senior citizens do have reason to fear what this

budget resolution will do to their Medicare benefits. But the real fear-mongers are those who attempt to cloak

their unfair, misguided budget in

phony dire warnings about the bankruptcy of Medicare.

We don’t have to destroy Medicare in

order to save it. Congress will never

allow the Medicare Trust Fund to become bankrupt. I know it. The Members on the other side of the aisle know

it. And the American people know it.

Another false Republican argument

in defense of Medicare cuts is that they

are not really a cut, because the total

amount of Medicare spending will continue to grow. The fact is that the Republican plan calls for spending $250

billion less on Medicare that the Congressional Budget Office says is necessary to maintain the current level of

services to the elderly.

Every household in America knows

that if the cost of your rent, the cost of

your utilities, and the cost of your food

go up—and your income stays the

same—you have taken a real cut in

your living standard.

Only in Washington could someone

contend with a straight face that making senior citizens pay $900 a year more

for their medical needs is not a cut in

their benefits. Every senior citizen understands that.

Republicans speak of a cut in defense, even though defense spending

has stayed stable. Apparently, the

same Republican logic doesn’t apply to

senior citizens that applies to spending

on guns and tanks. Well, I say to

them—a cut is a cut is a cut—whether

it’s in Medicare or Social Security or

national defense.

To try to defend their no cut argument the Republicans have even resorted to quoting President Clinton

speaking in favor of his health reform

plan. This plan included a reduction in

Medicare growth as part of an overall

reform that slowed cost growth

throughout the system. What they

have conveniently ignored is that the

Clinton plan put every dollar taken out

of Medicare back into expanded benefits to senior citizens. This Republican

budget takes money from senior citizens to fund tax cuts for the wealthy.

And under the Republican budget, the

already dangerous gap between what

Medicare pays and the private sector

pays for comparable services will continue to widen, while under the Clinton

plan total Medicare spending would actually have increased at a faster rate

than private sector spending.

The third specious Republican argument is that Medicare costs can be cut

by encouraging senior citizens to join

managed care. True, such care may

help bring Medicare costs under control—in the long run. Enrollment by

senior citizens in managed care is already increasing rapidly. it is up 75

percent since 1990. But no serious analyst believes that increased enrollment

in managed care will substantially reduce Medicare expenditures in the time

frame of the proposed Republican cuts.

In fact, according to the General Accounting Office, Medicare now actually

loses money on managed care, because

the healthiest senior citizens tend to

enroll in managed care and the payment formula is too generous. This

kind of problem can easily be worked

out, and will help to restore the fiscal

stability of the program. But the only

way to save serious money in the

short-term on managed care is to penalize those who refuse to join. This

option has already been suggested by

the Republican health task force in the

House of Representatives.

But I say right now to my Republican

colleagues—it is wrong to force senior

citizens to give up their freedom to

choose their own doctors and hospitals.

It is wrong to penalize them financially

if they refuse to enroll in managed

care.
May 22, 1995 CONGRESSIONAL RECORD — SENATE S7075

The American people will never accept a policy that tells senior citizens

they have no right to go to the hospital

and doctor of their choice, or that puts

unfair financial pressure on senior citizens to give up that right.

The fourth Republican argument is

that deep cuts in Medicare are necessary to balance the budget. That argument refutes itself. All it proves is

that Republican priorities are wrong.

Democrats favor a balanced budget,

and under President Clinton, we had

been making real progress toward that

goal. There is a right way to balance

the budget, and a far-right way. And

unfortunately, the Republicans have

picked the latter.

It is true that we need to bring

health care spending under control.

But that applies to all health spending,

not just Medicare and Medicaid. As

President Clinton told the White House

Conference on Aging last week, 40 percent of the projected increase in Federal spending in coming years will be

caused by escalating health costs.

But what this Republican budget

fails to recognize is that the current

growth in Medicare spending is a symptom of the underlying problems in the

entire health care system—not a defect

in Medicare.

In fact, Medicare has done a better

job than the private sector in restraining costs in recent years. Since 1984,

Medicare costs have risen at an annual

rate that is 24 percent lower than comparable private sector health spending.

As a result, Medicare now pays only 68

percent of what the private sector

charges for comparable physicians’

services; for hospital care, the figure is

69 percent.

Slashing Medicare unilaterally is no

way to balance the budget. It will simply shift costs from the budget of the

Federal Government to the budgets of

senior citizens, their children, and

their grandchildren. That is not a real

saving.

Moreover, senior citizens will also

face greater discrimination from physicians and hospitals less willing to accept them as patients, because Medicare reimbursements are already much

lower than the reimbursements available under private insurance. Previous

cuts in Medicare have already led to

serious cost shifting, as physicians and

hospitals seek to make up their reduced income from Medicare patients

by charging higher fees to other patients. The result has been higher

health costs and health insurance premiums for everyone, as cost shifting

becomes a significant hidden tax on individuals and businesses.

The right way to slow rising Medicare costs in the context of broader

health reforms that will slow health

cost inflation in the economy as a

whole. That is the way to bring Federal

health costs under control, without

cutting benefits of shifting costs to

working families. In the context of

broader reform, the needs of academic

health centers, rural hospitals, and

inner city hospitals can also be met.

Unilateral Medicare cuts alone, by contrast, could reduce the availability and

quality of care for young and old alike.

The President has said that he is

willing to work for bipartisan reform of

the overall health care system, but the

Republicans have said no. The only bipartisanship they seem to be interested

in is the kind that says, ‘‘Join us in

slashing Medicare.’’ That is not the bipartisanship the American people want

or the elderly deserve.

The cuts in Medicaid proposed in this

budget are equally unfair—a total of

$175 billion over 7 years—a devastating

30-percent reduction from the current

spending levels. The double whammy of

huge Medicare cuts and huge Medicaid

cuts will hit hospitals and other health

care providers even harder than Medicare cuts alone. Struggling State governments and State and local taxpayers will also face heavy burdens.

Massachusetts would lose $4.4 billion in

Federal matching funds over the next 7

years. By the year 2002, we would need

to increase State spending by 26 percent to maintain current program levels.

Other States with higher Federal

matching rates would be hit even harder. New Mexico would lose $1.3 billion,

and would have to increase program

spending by a massive 87 percent. Nationally, State and local taxpayers

would have to increase program spending by 35 percent by the year 2002 to

maintain program levels.

States cannot afford these huge increases. And the impact of these arbitrary cuts on real people is even more

disturbing. Medicaid is a key part of

the safety net for senior citizens, the

disabled, and children. Two-thirds of

all Medicaid spending is for senior citizens and the disabled. If an elderly

American becomes sick enough to need

long-term nursing home care, Medicaid

is the only source of funding after personal savings are exhausted. Cuts in

Medicaid will mean that needed care

for senior citizens is denied. Heavy additional burdens will be imposed on

their children and grandchildren.

Children also depend on Medicaid.

Eighteen million children—more than

a quarter of all children in our country—receive health care under Medicaid. More than half of these children

are members of working families. Their

parents work hard—most of them 8

hours a day, 40 hours a week, 52 weeks

a year. Without Medicaid’s help, all

their hard work will not buy their children the health care they need.

We often hear that the reason to balance the budget is for America’s children. A budget that denies health care

to millions of children is the wrong

way to express concern for their future.

The recent V-E Day ceremonies reminded us that today’s senior citizens

have stood by America in war and

peace. America must stand by them

now. Senior citizens have worked hard.

They’ve played by the rules. They contributed to Medicare. They have earned

their Medicare benefits, and they deserve to have them. Yet this Republican budget proposes to take those

benefits away.

The amendment we are offering will

restore a large part of these unfair

cuts. I urge the Senate to adopt it.

Mr. DODD. Mr. President, I hope all

of my colleagues will take a step back

from this debate and examine what

these cuts in Medicare and long-term

care would mean in real terms for real

people. I believe that these reductions

are simply wrong. They violate our

American values of fairness.

These are not just numbers on a

page. We are talking about injecting

fear into the lives of people who deserve to spend their retirement years

in peace. The cuts seem all the more

callous given that they are being made

to finance tax cuts for the most affluent Americans.

Let us talk about people, not programs, for a moment. The people we

are discussing fought the wars, paid

the taxes and built the wealth that all

of us here have enjoyed. We just

marked the 50-year anniversary of V-E

Day. Many of the people who won that

war for us are now on Medicare. The

least they deserve is to live their last

years in dignity. In their twilight

years, they deserve better than this

budget gives them.

There is no way these cuts would not

hit people of modest means. Medicare

is not a program for the rich. Today,

Medicare serves 35 million seniors, who

have a median income of $17,000. Seventy-eight percent earn less than

$25,000 a year. The typical senior already spends 21 percent of his or her income on out-of-pocket health costs.

That compares to 8 percent for nonseniors. Should we really be jacking up

those out-of-pocket costs to pay for a

$20,000 tax cut for people making over

$350,000 a year?

CUTS WOULD BE PAINFUL

Despite all the rhetoric on the other

side of the aisle, these cuts would be

painful. This is what Robert

Reischauer, the highly respected

former director of the CBO, had to say

about the reductions:

There’s no way to do this without imposing

real sacrifice and real pain, and both beneficiaries and providers will feel it. The notion that this can be squeezed out of the system with greater efficiencies is wishful

thinking.

Taking a hacksaw to medicare, as

this budget proposes, would be devastating. Recipients of care would pay

$3200 more over the next seven years.

That is an enormous hardship for seniors living on modest, fixed incomes.

Businesses and workers who have private insurance would be hurt, too.

Without overall reform, cutting medicare would not necessarily cut the actual cost of visiting a doctor or hospital. So doctors and hospitals would in

all likelihood try to shift costs of $40 to

$50 billion from medicare patients to

privately insured businesses and workers. That is nothing but a hidden tax
S7076 CONGRESSIONAL RECORD — SENATE May 22, 1995

that private businesses and their employees neither deserve nor can afford.

LONG-TERM CARE

The cuts in this budget resolution

would also decimate the long-term care

protection that Medicaid provides seniors. Working families with a parent

who needs long-term care would face

nursing home bills of an average of

$38,000 a year without Medicaid’s longterm care protection. Where will our

seniors who have spent down all their

savings and now rely on Medicaid to

pay for their nursing home care go

without such protection?

IMPACT ON HOSPITALS

These cuts would particularly hit

rural and innercity hospitals with

large concentrations of elderly and

low-income patients. In my own state

of Connecticut, home to many urban

hospitals, Medicare makes up 40 percent of all hospital revenue. Half of the

hospitals in Connecticut are teaching

hospitals, which rely heavily on Medicare to train tomorrow’s physicians.

Many of these hospitals already operate on the edge: some may have to

close their doors if such an important

source of financing is slashed. Nearly

10 million Medicare recipients live in

rural America, where there is often

only one hospital serving a county.

Draconian Medicare cuts like those

proposed by the Republicans could

force many of those rural hospitals out

of business.

A DIFFERENT COURSE

We must do something to control

Medicare spending, but we cannot do it

in isolation. The problems of Medicare

are the same problems facing the entire health care system. To focus only

on Medicare puts its recipients at risk

and would have unintended consequences for the rest of the health

care system.

We need honest, thorough health care

reform, and I invite our Republican

colleagues to begin a dialogue with us

on this important subject. But I also

ask them to step back from the draconian cuts in Medicare and long-term

care. I hope my colleagues will support

the pending amendment.

Mr. BRADLEY. Mr. President, I come

to the floor today to express my very

serious concerns about the cuts to

Medicare and Medicaid which are contained in the budget resolution.

Mr. President, my colleagues across

the aisle have stated repeatedly that

they are not touching Social Security.

But at the same time over a third of

the cuts which they have proposed, including over 40 percent of the cuts in

the year 2002, come from Medicare and

Medicaid. Mr. President, I would like

to spend a few minutes discussing what

the proposed Medicare and Medicaid

cuts will mean to our most vulnerable

citizens. As I discuss these impacts, I

would like my colleagues to ask themselves how they can credibly claim

that this budget does not reduce these

people’s security.

Let me start with Medicare. This

budget cuts spending for the Medicare

program by $256 billion over 7 years. I

would like to spend a minute discussing what these numbers mean in

human terms. They mean that seniors

will have to find an average of $3,447

more to pay for their health care over

the next 7 years. In my home State of

New Jersey, seniors will have to come

up with an additional $932 in the year

2002 alone just to pay for the additional

Medicare costs which this budget imposes on them. For many seniors

across the country, these new costs

will be extremely difficult to bear. In

1992, the median income of seniors in

this country was only about $17,000 a

year, and about a quarter of elderly

households had incomes under $10,000.

Of these incomes, seniors already spend

more than one of every five dollars on

medical costs. For the millions of seniors across the country who live on

fixed incomes, finding an additional

$3,447 over 7 years will mean having to

give up something else which is important to them. It is estimated that there

are already nearly 8 million seniors nationwide who are forced to choose each

month between paying for their medications and paying for food. I can’t

help wondering how many millions

more seniors will be faced with this

horrible choice once the proposed cuts

go into place.

An increased financial burden on seniors is only one of the negative consequences which will result from the

proposed Medicare cuts. Along with

having to pay more, seniors will likely

find that their ability to choose their

own doctor is restricted—perhaps not

explicitly, but because financial limitations leave them with no choice but

to join a managed care plan. Also, doctors, hospitals, and others providers

are all likely to face reduced payments. They already receive far lower

payments from Medicare than from

private insurers, and if Medicare rates

are reduced much further some may

find that they can no longer afford to

take Medicare patients. Those who do

keep accepting Medicare will be forced

to shift even more costs onto their privately insured patients, creating a hidden tax on employers and individuals.

And that’s just Medicare. In addition,

this budget cuts Medicaid by $175 billion. That’s an 18 percent cut, relative

to what spending would be if there

were no change in law. I think it is

very important that we all understand

exactly who these cuts will affect.

Medicaid now insures about one of

every four American children. It pays

for roughly one of every three births in

this country. And it pays for over

three-fifths of the people who need

long-term care services, either in nursing homes or at home. Over half of

Medicaid funds go for persons who are

either elderly, blind, or disabled. Most

elderly recipients of Medicaid are people who spent their whole lives as

members of the middleclass. But when

faced with nursing home costs averaging almost $40,000 a year, it doesn’t

take long for their entire life savings

to disappear. Once they reach this

point, these people have nowhere else

to turn. Thank goodness Medicaid has

been there to provide a safety net for

them.

This resolution caps Federal Medicaid spending at an average annual

growth rate of 5 percent. We all know

that Medicaid spending is expected to

grow much faster than that in the future. By setting a 5 percent cap, the

Federal Government is essentially saying to the States: ‘‘It’s all your problem now. We can’t figure out how to

deal with the growing number of uninsured and the rising costs of health

care, so you do it. We wash our hands

of any responsibility to help you deal

with these critical needs.’’ But, if we

are honest with ourselves, we must

admit that States can’t cope with

these problems alone.

So, Mr. President, let me tell you

what is expected to happen once these

proposed Medicaid cuts go into effect.

By the year 2002, the number of uninsured children in American is predicted

to rise by more than 6 million. By that

same year, there will be an additional

3 million persons who need—but can

not get assistance with—the costs of

long-term care. These will be people

who will be required to leave nursing

homes, or will never be able to enter

one, despite the fact that they need

more care than their family and friends

are able to provide, either financially

or physically. As I stated earlier, many

of these people are now members of the

middle-class, but the astronomical

costs of long-term care will impoverish

them rapidly. For those persons who

are able to enter and remain in nursing

homes the picture is not much brighter. Medicaid now pays significantly

less than the private sector for longterm care. When Medicaid cuts these

payments even further—as it will have

to do in response to the budget cuts—

nursing homes will have to do even

more with less. This means that staff

will be stretched even thinner, and

each resident will receive even less personal attention. The proposed cuts will

mean that the quality of life of nursing

home residents will deteriorate even

further.

Mr. President, I hope that my remarks have helped put a human face on

all the numbers which have been floating around the floor of this chamber

the last few days. I recognize that reducing the deficit will require painful

choices. But in making these choices,

we can not ignore how these decisions,

will impact the persons whom we have

been elected to represent. My colleagues across the aisle claim that

they are concerned about the impact of

deficit reduction on our oldest and

most vulnerable citizens. They have

stated repeatedly that Social Security

is ‘‘off the table’’ — that it has not

been cut. To them I respond: Medicare

and Medicaid are vital parts of our social security system. They provide security at a time when people are most

vulnerable—when they are sick. To
May 22, 1995 CONGRESSIONAL RECORD — SENATE S7077

take over a third of your proposed cuts

out of Medicare and Medicaid is to

deny security when it is most needed.

Mr. SARBANES. Mr. President, I rise

to express my strong support for the

amendment offered by my colleagues,

Senators ROCKEFELLER and LAUTENBERG, to restore critical funding to the

Medicare Program.

In order to provide a significant tax

cut to the very wealthy, Senate Republicans have proposed a budget resolution which includes draconian cuts in

many important programs, including a

substantial cut in Medicare. In my

view, drastic cuts on the spending side,

in order to create room for a tax cut,

are not appropriate and do not reflect

the priorities of this Senator. I oppose

the Senate Republican budget proposal

and feel very strongly that the resolution before us directly threatens the

health and well-being of our Nation’s

seniors citizens.

Over half the people who receive

Medicare are older Americans with incomes below $15,000 a year. The Republican budget with its deep Medicare

cuts lay the basis for tax cuts for the

very wealthy. This is the situation before us.

The proposed Senate Republican

budget resolution would cut Medicare

by $256 billion over the next 7 years. I

know it is asserted that the actual dollar amounts for Medicare will not drop,

but rather will increase gradually over

the next 7 years. However, if the proposed dollar increases are not proportional to increases in Medicare enrollees and increases in the costs of medical care, the end result is massive cost

shifting and cuts in services for beneficiaries.

Mr. President, in my view, it is essential that we recognize that Medicare is not a system unto itself. The

Medicare Program is, instead, a large

component of our Nation’s health care

system and it is illogical to assume

that isolated cuts in Medicare will not

adversely effect all Americans.

First and foremost, these ill-conceived cuts would harm our senior citizens. The Health Care Finance Administration [HCFA] estimates that Medicare payments account for 45 percent

of health care spending by our Nation’s

elderly. Under the GOP budget plan,

out-of-pocket costs to seniors are expected to increase by an average of $900

per person per year by the year 2002.

Over a 7-year period, the typical beneficiary would pay an estimated $3,200 in

additional out-of-pocket costs. While

this might not sound like much to

some, these numbers become more significant when you factor in statistics

which indicate that 60 percent of program spending was incurred on behalf

of those with incomes less than twice

the poverty level, and 83 percent of program spending was on behalf of those

with annual incomes of less than

$25,000.

Clearly, when we talk about Medicare recipients, we are not talking

about our Nation’s wealthiest citizens.

Many seniors live on fixed incomes. In

fact, a large number of Medicare recipients depend on Social Security benefits

for much of their income. According to

HCFA, about 60 percent of the elderly

rely on Social Security benefits for 50

percent or more of their income and 32

percent of the elderly rely on Social

Security for 80 percent or more of their

income. It is also estimated that as

many as 2 million seniors can expect to

see the value of their Social Security

COLA’s decline as increased Medicare

costs consume 40 to 50 percent of Social

Security COLA’s by 2002. Requiring

these individuals to pay more for their

health care will directly undercut their

standard of living. In my view, it is

simply unacceptable to create a situation where more and more seniors will

see their resources stretched to the degree that they will have to choose between food and health care.

As a result of the proposed cuts in

the Republican budget resolution, seniors may also end up paying more for

the services they currently receive.

The number of Medicare recipients is

expected to increase over the next several decades just as the baby boomer

generation reaches retirement age. The

Republican budget proposal fails to account for this projected growth. Therefore, in order to make ends meet, hospitals and other health care centers

will have to shift costs to other payers

or cut valuable services which are supported, in part, by Medicare reimbursements. According to the American Hospital Association, costly but crucial

services like trauma care units, burn

units and intensive care units would

have to be closed in many hospitals.

Teaching hospitals, which receive a

higher rate of reimbursement for Medicare patients than nonteaching hospitals, will suffer losses in revenue certain to impact the fiscal integrity of

these institutions. Reductions in funding to such institutions will result in

less support for services, research, and

education. Such consequences impact

us all and illustrate clearly the danger

of arbitrarily cutting this critical program.

In addition, businesses and working

Americans could see increased health

care costs and higher premiums as

health care providers and institutions

shift a larger portion of costs to the

nonelderly in an attempt to cover rising medical costs and provide quality

services with limited resources. Communities could also see increases in

State and local taxes in order to assist

financially strapped hospitals and

health care providers.

Mr. President, the Medicare Program

does not operate in a vacuum. Cuts of

the magnitude being proposed by the

Republicans will impact us all. I am

not suggesting that the Medicare system does not need to be reformed.

What I am suggesting is that there is a

right way and a wrong way to make

changes in the system and how we go

about doing so provides a clear picture

of what kind of society we are going to

be.

In his 1941 message to Congress,

Franklin Roosevelt articulated a second bill of rights which established a

basic standard of security and prosperity for all Americans. Among these

rights is ‘‘the right to adequate medical care and the opportunity to achieve

and enjoy good health.’’ The proposed

Republican budget resolution seriously

threatens this basic standard and I

urge my colleagues to join me in support of the Rockefeller-Lautenberg

amendment.

The PRESIDING OFFICER. The

question is on agreeing to the amendment.

Are the yeas and nays requested?

Mr. DOMENICI. I ask for the yeas

and nays.

The PRESIDING OFFICER. Is there a

sufficient second?

There is a sufficient second.

The yeas and nays were ordered.

The PRESIDING OFFICER. The

question is on agreeing to amendment

No. 1112. The yeas and nays have been

ordered. The clerk will call the roll.

The assistant legislative clerk called

the roll.

Mr. LOTT. I announce that the Senator from North Carolina [Mr.

FAIRCLOTH] and the Senator from

Texas [Mr. GRAMM] are necessarily absent.

I also announce that the Senator

from North Carolina [Mr. FAIRCLOTH]

would vote ‘‘nay.’’

The PRESIDING OFFICER. Are there

any other Senators in the Chamber

who desire to vote?

The result was announced—yeas 46,

nays 52, as follows:

[Rollcall Vote No. 173 Leg.]

YEAS—46

Akaka

Baucus

Biden

Bingaman

Boxer

Bradley

Breaux

Bryan

Bumpers

Byrd

Conrad

Daschle

Dodd

Dorgan

Exon

Feingold

Feinstein

Ford

Glenn

Graham

Harkin

Heflin

Hollings

Inouye

Jeffords

Johnston

Kennedy

Kerry

Kohl

Lautenberg

Leahy

Levin

Lieberman

Mikulski

Moseley-Braun

Moynihan

Murray

Nunn

Pell

Pryor

Reid

Robb

Rockefeller

Sarbanes

Simon

Wellstone

NAYS—52

Abraham

Ashcroft

Bennett

Bond

Brown

Burns

Campbell

Chafee

Coats

Cochran

Cohen

Coverdell

Craig

D’Amato

DeWine

Dole

Domenici

Frist

Gorton

Grams

Grassley

Gregg

Hatch

Hatfield

Helms

Hutchison

Inhofe

Kassebaum

Kempthorne

Kerrey

Kyl

Lott

Lugar

Mack

McCain

McConnell

Murkowski

Nickles

Packwood

Pressler

Roth

Santorum

Shelby

Simpson

Smith

Snowe

Specter

Stevens

Thomas

Thompson

Thurmond

Warner

NOT VOTING—2

Faircloth Gramm

So the amendment (No. 1112) was rejected.
S7078 CONGRESSIONAL RECORD — SENATE May 22, 1995

Mr. DOLE. Mr. President, I move to

reconsider the vote by which the

amendment was rejected.

Mr. DOMENICI. I move to lay that

motion on the table.

The motion to lay on the table was

agreed to.

DESIGNATING JAMES R. KETCHUM

AS CURATOR EMERITUS OF THE

fU.S. SENATE

Mr. DOLE. Mr. President, I send a

resolution to the desk and ask for its

immediate consideration.

The PRESIDING OFFICER. The

clerk will report.

The bill clerk read as follows:

A resolution (S. Res. 122) designating

James R. Ketchum as Curator Emeritus of

the United States Senate.

The PRESIDING OFFICER. Is there

objection to the immediate consideration of the resolution?

There being no objection, the Senate

proceeded to consider the resolution.

The PRESIDING OFFICER. The

question is on agreeing to the resolution.

The resolution (S. Res. 122) was

agreed to.

The preamble was agreed to.

The resolution, with its preamble, is

as follows:

H.S. RES. 122

Whereas James R. Ketchum will retire

from the United States Senate after 25 years

as Senate Curator, and 35 years of Government service;

Whereas he has dedicated his Senate service to preserving the works of art, history,

and traditions of the Senate;

Whereas he has contributed immeasurably

to the restoration of the Old Senate Chamber, the Old Supreme Court Chamber, the

President’s Room, and other historic rooms

in the Capitol;

Whereas he has developed exhibitions and

educational programs detailing the rich heritage of the Senate for all to enjoy;

Whereas he has upheld the high standards

and traditions of the Senate with abiding devotion; and

Whereas he has earned the respect, affection, and esteem of the United States Senate: Now, therefore, be it

Resolved, That, effective July 1, 1995, as a

token of the appreciation of the Senate for

his long and faithful service, James R.

Ketchum is hereby designated as Curator

Emeritus of the United States Senate.

Mr. DOLE. Mr. President, I move to

reconsider the vote by which the resolution was agreed to, and I move to lay

that motion on the table.

The motion to lay on the table was

agreed to.

RETIREMENT OF GERALD A.

fHACKETT

Mr. DOLE. Mr. President, I send a

resolution to the desk relating to the

retirement of Gerald Hackett and ask

for its immediate consideration.

The PRESIDING OFFICER. The

clerk will report.

The bill clerk read as follows:

A resolution (S. Res. 123) relating to the

retirement of Gerald A. Hackett.

The PRESIDING OFFICER. Is there

objection to the immediate consideration of the resolution?

There being no objection, the Senate

proceeded to consider the resolution.

The PRESIDING OFFICER. The

question is on agreeing to the resolution.

The resolution (S. Res. 123) was

agreed to.

The preamble was agreed to.

The resolution, with its preamble, is

as follows:

S. RES. 123

Whereas Gerald A. Hackett will retire from

the United States Senate after 33 years of

service, the last 29 years as Executive Clerk;

Whereas his dedication to the United

States resulted in the computerization of the

nomination and treaty processes,and the online publishing of the Executive Journal;

Whereas he has performed the duties of his

office with remarkable diligence, perseverance, efficiency, and intelligence;

Whereas he has faithfully performed his

duties serving all Members of the Senate

with great professional integrity and dedication; and

Whereas Gerald A. Hackett has earned the

respect, admiration and esteem of the United

States Senate: Now, therefore, be it

Resolved, That the United States Senate

commends Gerald A. Hackett for his long,

faithful, and exemplary service to his country and to the Senate.

SEC. 2. The Secretary shall transmit a copy

of this resolution to Gerald A. Hackett.

Mr. DOLE. Mr. President, I move to

reconsider the vote by which the resolution was agreed to, and I move to lay

that motion on the table.

The motion to lay on the table was

agreed to.

RETIREMENT OF FREDERICK R.

BROOMFIELD, SR.

fMr. DOLE. Mr. President, I send a

resolution to the desk relating to the

retirement of Frederick R. Broomfield

and ask for its immediate consideration.

The PRESIDING OFFICER. The

clerk will report.

The bill clerk read as follows:

A resolution (S. Res. 124) relating to the

retirement of Frederick R. Broomfield, Sr.

The PRESIDING OFFICER. Is there

objection to the immediate consideration of the resolution?

There being no objection, the Senate

proceeded to consider the resolution.

The PRESIDING OFFICER. The

question is on agreeing to the resolution.

The resolution (S. Res. 124) was

agreed to.

The preamble was agreed to.

The resolution, with its preamble, is

as follows:

S. RES. 124

Whereas on June 30, 1995, Frederick R.

Broomfiled, Sr. will retire from service as a

member of the Department of Office Services

staff within the Office of the Secretary of the

Senate after almost 20 years;

Whereas he has upheld the high standards

and traditions of the Office of the Secretary

of the Senate with abiding devotion; and

Whereas he has gained the trust, confidence, and respect of his associates and the

Members of the United States Senate: Now,

therefore, be it

Resolved, That the United States Senate

expresses its deep appreciate and gratitude

to Frederick R. Broomfield, Sr., for his years

of faithful and exemplary service to his

country and to the United States Senate.

SEC. 2. The Secretary shall transmit a copy

of this resolution to Frederick R. Broomfield, Sr.

Mr. DOLE. Mr. President, I move to

reconsider the vote by which the resolution was agreed to, and I move to lay

that motion on the table.

The motion to lay on the table was

agreed to.

CONCURRENT RESOLUTION ON

THE BUDGET

fThe Senate continued with the consideration of the concurrent resolution.

Mr. COHEN addressed the Chair.

The PRESIDING OFFICER. The Senator from Maine.

AMENDMENT NO. 1116

(Purpose: To express the sense of the Senate

regarding losses of trust funds due to fraud

and abuse in the Medicare program)

Mr. COHEN. Mr. President, I send an

amendment to the desk and ask for its

immediate consideration.

The PRESIDING OFFICER. The

clerk will report.

The assistant legislative clerk read

as follows:

The Senator from Maine [Mr. COHEN] proposes an amendment numbered 1116.

Mr. COHEN. Mr. President, I ask

unanimous consent that reading of the

amendment be dispensed with.

The PRESIDING OFFICER. Without

objection, it is so ordered.

The amendment is as follows:

On page 94, after line 21, add the following

new section:

SEC. . SENSE OF THE SENATE REGARDING

LOSSES OF TRUST FUNDS DUE TO

FRAUD AND ABUSE IN THE MEDICARE PROGRAM.

(a) FINDINGS.—The Senate finds that—

(1) the General Accounting Office estimates that as much as $100,000,000,000 are

wasted each year in the health care system

due to fraud and abuse;

(2) outlays for the medicare program under

title XVIII of the Social Security Act during

fiscal year 1994 were $161,100,000,000, and the

General Accounting Office estimates that up

to 10 percent of those outlays were wasted

because of fraud and abuse;

(3) medicare beneficiaries incur higher outof-pocket costs and copayments due to inflated billings resulting from fraudulent and

abusive practices perpetrated against the

medicare program; and

(4) funds lost because of fraud and abuse

are contributing to financial crises of the

Federal Hospital Insurance Trust Fund and

the Federal Supplementary Medical Insurance Trust Fund, as identified by the Boards

of Trustees of such trust funds in their 1995

annual reports.

(b) SENSE OF THE SENATE.—It is the sense

of the Senate that as the Committee on Finance of the Senate and, if established, the

Bipartisan Commission on the Solvency of