Date: 2010-06-24
Speaker: BILL CASSIDY (republican)
Chamber: H

psychology. the specialty of TIM MURPHY. cardiothoracic surgery. the specialty of Dr. CHARLES BOUSTANY. OBGYN. again the specialty of MIKE BURGESS and PHIL ROE. orthopedic surgery. the specialty of my colleague from Georgia. TOM PRICE. family practice. indeed. housecall medicine. the specialty of my colleague again from Georgia. Dr. PAUL BROUN. I could go on and on. These are Members on our side of the aisle who were just begging. calling. writing letters to the White House: let us participate. We know about that sanctity of the doctorpatient relationship. We know what rationing will do and the fear that our seniors have of being rationed because theyre too old to have taxpayer dollars spent on their hip replacement. So you just say. no. take a couple of Advil and well buy you a walker. maybe even a wheelchair. although thats debatable as well. And. Mr. Speaker. to compound this problem. ObamaCare. now our President has named the new director of CMS. Centers for Medicare and Medicaid Services. Dr. Donald Berwick. Dr. Berwick may be a fine human being. Im sure he is. I dont know him personally. but I have read quotes and I know that hes written a book. And one of those quotes. and Im not going to be able to give it verbatim. but basically. Mr. Speaker. says. its not if we need to ration. its that we need to ration with our eyes wide open. Its not if we need to ration care. but that we ration with our eyes wide open. Im looking forward. as a member of the Energy and Commerce Committee and the Health Subcommittee. to having Dr. Berwick soon after his appointment as director of CMS to come before the committee and explain to us just what he means by that. So that the seniors who are relying on Medicare. like my mom. my 92yearold mom. is she going to be able to. as she did last year. to have her knee operated on? Or is she just going to get a walker and a bottle of Advil and told. youre just too old? We cant afford it. Were going to ration care. Again. this is what people are concerned about. Mr. Speaker. when half of the payfor. the trillion dollars. to be able to get an additional 15 or 20 million people into some kind of health care coverage. whether its these State exchanges. or eventually Im convinced that the real plan is to go to a U.K.type system. Canadiantype system and have national health insurance. the Federal Government to take over onesixth of our economy. onesixth of our entire gross domestic product. $2.5 trillion a year. the Federal Government controlling this. lock. stock and barrel. Madam Speaker. the American people dont want that. The American people didnt want the Federal Government to completely take over the student loan industry. but they did. This President did. This majority did. Madam Speaker. The American people dont want a capandtrade bill. an energy bill. that results in a $1.500ayear minimum increase in the cost of electricity in this country. The American people dont want that. The American people want our borders secured. Madam Speakerask any of themand not just the people in Arizona. Ask the people in Georgia. Ask the people in Michigan. They want our borders secured. They dont want amnesty. That was tried in 1986. and I think something likeI dont know6 million. maybe. were granted amnesty. and now weve got 12 million to 14 million illegals in our country. So it is just a fact. as I said. Madam Speaker. Its not that people dont want to have more affordable health care. lower insurance premiums. and better coverage. They want thatof course they want thatbut they dont want the Federal Government to take it all over and to literally come between a doctor and her patient in an exam room: No. no. Doctor. You cant do that. It says here in the manual that bureaucrat No. 128 of the 131 new ones is over that. and you cant order that test because there is a cheaper way to do it. The doctor says. Well. yeah. but you know. for this patient. I know this medication will work. We tried the other. and it didnt work for my patient. In fact. she had a bad reaction to it. Well. youre going to have to get a waiver then. Doctor. But. Madam Bureaucrat. the patient needs care today. Well. you know. well probably have an answer for you in a week or two. That is the kind of stuff that we are talking about. So Im going to tell you this. Madam Speaker. That is the reason there are physicians all across this country. on both sides of the aisle. who are seeking the nomination of their party to come join us. to become one of the 435 or one of the 100 in the other body. Ive never seen so many running for office. giving up. you know. more lucrative careers financially than what you earn as a Member of Congress. They want to make a difference. They want to make a change. They are. Im sure. pretty frustrated and disgusted about their lot. about their wonderful medical profession that many of them devoted 25. 30 years of their lives to. They probably didnt even get started until they were in their early thirties and had $200.000 worth of student loans to pay off. They went through all of that. and now were going to come along and say. Well. you doctors work for us now. You work for the President. You work for Ms. Sebelius. You work for Dr. Barwick. We are going to call the shots. Not only are we going to set your salaryand. indeed. until today. you were facing a 21 percent cut. a 21 percent cut over last year in what we reimbursed you for anything: seeing a patient. doing a consultation in your office. making a diagnosis. taking out an appendix. delivering a baby. seeing someone at 2 oclock in the morning in the emergency roombut. if they are Medicare. we are going to pay you 21 percent less. Actually. Madam Speaker and my colleagues. that went into effect last Friday. So. for any claims that Medicare was holding. the doctors will be reimbursed. Now. yeah. okay. In this bill we passed today. they will be able to hire. I guess. a new employee who will spend the next several months resubmitting those claims. Maybe. within a year. they will get that 21 percent cut back. Though. do you know what we did here today? Its amazing. We should have done this months ago. We certainly should have done it last Thursday so that this effect. this cut. this 21 percent cut. would not have been allowed to go into effect. Madam Speaker wanted to hold that up so that these other things could get done and could be attached to it. In other words. kind of using this as an incentive to pass some other things thatyes. you guessed itinvolved more government spending. more deficit. and more debt. Thank goodness our colleagues on the other side of the aisle. and especially our Republican colleagues. said. no. we will not vote for that. We are $13 trillion in debt. and our deficit for the year is $1.6 trillion. If you look at it over a 10year period. it is going to average to about $850 billion worth of red ink each and every year over the next 10 years. We are not going to spend another dime on whatever you want to call itStimulus I. Stimulus II. Stimulus III. The first one hasnt worked. Yet our Speaker wanted to hold out for the passage of that and. really. figuratively. wanted to hold a gun to the heads of the doctors. Well. we finally did pass it. as a standalone measure. to mitigate those cuts. but do you know what? Colleagues. you know what. Of course you do. We mitigate it until the end of Novemberbarely 6 months. Then. all of a sudden. they are hit with it again. If we dont permanently fix this problem. then next year the cut will be 25 percent. With ObamaCare. with the Patient Protection and Affordable Care Act. we had an opportunity. and the President promised the doctors at the convention of the American Medical Association in Chicago. his hometown. that tort reform would be in there. that payment reform would be in there-"in there." the bill. the Patient Protection and Affordable Care Actbut. oh. no. it was stripped out because it cost too much. Yet we gutted Medicare of $500 billion. and $130 billion of it was taken from the Medicare Advantage program. Fully a fourth of our seniors on Medicare get their care from a Medicare Advantage plan. Why? Because screening procedures are offered and paid for. Annual physical examinations are offered and paid for. Nurses call the patients to make sure that they are taking their medicationsand the medications are paid for. Yes. it costs a little bit more. and our majority party said. Well. you know. we shouldnt be paying more for those programs. but look how much more youre getting if you believe in wellness rather than in just treating episodes of illness? Thats why you came up with this program. for goodness sakes. Thats why we passed Medicare part D. the prescription drug part. This was when you criticized us so severely back in 2003 and said. Oh. youre not paying for that. Its going to cost another $450 billion on the Medicare program to provide these seniors with coverage for their prescriptions. Well. Madam Speaker and my colleagues. you know that many of these seniorsI know. Im one of themare taking four. five or six medications a day to lower their cholesterol. to lower their blood pressure. or to get their blood sugar in line to make sure they dont end up on renal dialysis. to make sure they dont end up having their coronary arteries bypassed or stented. In the long run. this cost of Medicare part D will be a savings because we wont be spending as much money paying cardiothoracic surgeons to crack peoples chests. we wont be paying nursing homes for all these folks that couldnt take medication for the blood pressure that end up with massive strokes and. God bless them. they didnt die and they are in a nursing home for the rest of their lives. which may be another 20 years. So in the long run. that bill was a good bill. and we will save money because we will shift costs from Medicare part A and part B to part D. the prescription drug part. And isnt it a more compassionate way to treat a human being? Madam Speaker. Id like to suggest that we have a lot of good ideas that were ignored. But it aint over. It aint over. Ive got a couple of posters here I wanted to show my colleagues. I dont know how much more time I have. Maybe I will ask the Speaker how much longer we have.