Energy and Water Development and Related Agencies Appropriations Act, 2012

Floor Speech

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Mr. COBURN. Mr. President, myself and Senator Barrasso are two of the three doctors in the Senate. Both of us have practiced for over 25 years. We have put out several reports. Every year, Medicare recipients receive a message from Medicare, called ``Medicare and You.'' What we thought we would do is come to the floor and tell our colleagues, as well as the American people, that we also put out a ``Medicare and You'' report. There is a lot that wasn't in the ``Medicare and You'' report this year.

I ask unanimous consent to have a colloquy between myself and the Senator from Wyoming, Dr. Barrasso, as to what we are reporting in our Medicare and You statement.

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Mr. COBURN. This booklet, which will be available on coburn.senate.gov and barrasso.senate.gov to every Medicare patient out there, explains what has actually happened to Medicare in the last year and a half. It explains that $530 billion has been cut out of Medicare. It explains the physician reimbursement cuts were not addressed when we addressed health care and, consequently, a 27-percent cut is coming if Congress doesn't change that.

It explains that Medicare Advantage--both the options and the number of people eligible for that--has been taken away by the Affordable Care Act. It explains that the CLASS Act was put in to save money, but it won't, and it has now been abandoned by the administration. The fact is there is an independent payment advisory board, whose sole purpose is to cut payments for Medicare procedures and supplies and drugs to save money--even when that will instigate the loss of available drugs.

Finally, it creates a $10 billion trust fund for an innovation center that is a smokescreen for a rationing board very similar to the IPAB.

I want Dr. Barrasso to go over the Medicare cuts now, if he will.

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Mr. COBURN. The other thing Medicare recipients should recognize is that under the laws as previously set, the reimbursement for your physician in January is scheduled to decline 27 percent. When I talk to seniors in the State of Oklahoma, one of the No. 1 problems that somebody turning 65 has is now finding that physician who will care for them under the Medicare payment guidelines. What was never spoken of was the fact that there was no fix in the health care bill for the very real need to attract more physicians into caring for seniors.

As we have seen, Congress may or may not fix that--it is $300 billion to fix that. That is the cost of it. Whether we fix it or not, the fact is we are playing with the access of Medicare patients to care. Denied access is denied care.

If you live in a community much like mine where no new doctors have been coming in because there is a shortage of primary care doctors, and those who do come in will not take the lower reimbursement for Medicare because they cannot afford to, it may mean that you have to drive 70 miles to get that care. That is not access, and it is not health care. It means you don't have available health care because the government run the program so poorly.

Let me finish up, since we don't want to go over our time. The other thing I want to talk about for a minute is this innovation center. In the health care law, we set aside a $10 billion slush fund for innovation in payment and procedures for Medicare patients. We are going to be spending $10 billion to figure out how to pay for it more cheaply and limit the combinations, or increase the combinations of combining these things so that the reimbursements are less.

First of all, I don't understand why it is going to take $10 billion, but it is a slush fund. No. 2 is that if you don't like the results of that, there is nothing we can do about it except reverse the Affordable Care Act, Obamacare. No. 2, you can't sue. You have no injunctive relief. You have no opportunity to express your desire in a court of

law or through an administrative procedure to challenge their elimination of paying for certain procedures that may in fact save the country money but may in fact also hurt the very patients who are on Medicare.

We have this fund that we cannot find out anything about; no rules have been put out on it, and we cannot find the details of it. Yet, we know what the purpose of the fund is. It is like the IPAB fund. It is designed to ration the care that seniors need to control the cost of Medicare.

What do we know about Medicare? One dollar of every three dollars spent on Medicare doesn't help anybody get well and doesn't keep anybody from getting sick. The reason it doesn't work is because of the government's mandate--we have all these stories about shortages of drugs. The reason there are shortages of drugs in our country is because Medicare has mandated prices 90 percent of the time so low that we only have one supplier. Some of them either have a technical problem or have decided to stop making a drug that is critical to our seniors because we have a price control bureaucracy.

There are large problems with the Medicare law. They need to be recognized and addressed. They need to be fixed, and the last thing we ought to do is spend $10 billion figuring out how not to get somebody treatment, or lessen the availability of treatment through the innovation council.

I yield the rest of my time to the Senator from Wyoming.

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Mr. COBURN. If the Senator will yield for a moment, one of the reasons our cancer cure rates are a third better than England is because we don't have an IPAB and they do. The No. 1 reason survival rates from cancer in England are lower is because treatments are denied by their IPAB for the best treatments, which will save more people's lives at the best price. That is something that should not be discounted.

I yield the floor.

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