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Public Statements

Medicare

Floor Speech

By:
Date:
Location: Washington, DC

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Mr. BLUMENAUER. I want to thank my colleague from California for being here this evening, for sharing the time, allowing me to speak with him. And I must say how excited I was that a friend who actually had a rewarding career was willing to jump into the political fray, which has been difficult at times, particularly as we've had the contentious issues surrounding health care, and that you would be willing to bring your expertise, time, and energy when you had other choices with your life and career. We really appreciate it. Because the experience you have had in the medical profession, the years of study, the actual experience with real-life people adds a dimension that is helpful here in ways that I don't know that you fully appreciate, but I certainly do. I also appreciate focusing on the critical nature of Medicare and where we're going in the world of health care reform.

I just spent last week dealing with my Republican friends' approach to the budget. It can only be described as an exercise in fantasy.

They start with the notion that somehow they're going to eliminate ObamaCare entirely; and they seek to transfer the burden of Medicare and Medicaid from the government onto the shoulders of some of America's most vulnerable poor and disabled, and our senior citizens. I really appreciate your focusing on the importance of Medicare in providing dignity and stability to millions of Americans.

Now, I think there have been, between the House and the Senate, about 50 efforts or more to repeal the health care reform. I must say I hope that finally people get it out of their system. I was surprised that we went in this direction, to turn Medicare into a voucher, a block grant for Medicaid, and put this burden on our senior citizens and some of our poor and disabled Americans, because this was the centerpiece of their campaign for the last 6 months. This was part of what our friend Paul Ryan and Governor Romney preached from coast to coast, advertised, campaigned; and all of a sudden it was rejected by the American public overwhelmingly. The President was comfortably reelected. In fact, there were more Democratic Senators added who support this effort. In the House of Representatives, not only did we gain seats, but more than a million voters--more voted for Democrats than Republicans.

So you would think that this canard would be put to rest; but it is important for people to know that it is still a viable option as far as our Republican friends are concerned. It's unfortunate because we are making some progress in reforming the health care system--not by turning our back on Medicare, not by transferring the risk and responsibility to seniors and the most vulnerable, but by making it more efficient, by taking some of the experiments that we've done in my home State of Oregon--and as you well know there are some health care systems in California that have already found ways to reward value over volume, to be able to extend care, and do so more efficiently, and squeeze the approximately one-third to 40 percent or more of our health care spending that is wasted.

We can do a better job. We start, I think, by protecting Medicare. We start by recognizing that a voucher--or premium support, or whatever they call it--that caps the investment does nothing to reform health care; but, instead, it puts seniors and our most vulnerable citizens out navigating the health care maze with fewer resources and more responsibility and actually making it harder. Because that's why we have Medicare in the first place. The private market did a terrible job meeting the needs of America's oldest and least healthy population.

I am hopeful that we're going to be able to continue this effort that you're spearheading here tonight, for people to understand the opportunities to continue reform, to note that we are actually seeing a gradual stabilization of health care spending right now, and that there are things in the hopper that we can do going forward without taking advantage of people who deserve the security of a solid, reformed health care system, not one that the Federal Government vouchers and turns their back.

I would yield back to the gentleman if there are comments. I look forward to hearing what you have to say, and perhaps there may be a little more interaction if it's useful.

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Mr. BLUMENAUER. Thank you, Dr. Bera.

I appreciate your focus on this and pointing out that this is something that shouldn't be a partisan issue, doesn't have to be a partisan issue, and it is in fact a success story that has made a huge difference in the lives of seniors from coast to coast. It's helped, in many cases, stabilize what's happened in terms of local health care economics.

The pattern that we have seen in escalating health care costs for the last 40 years, yes, there are concerns about health care as it relates to Medicare; but if you compare the rate of increase of private health insurance versus the rate of increase in Medicare, Medicare spending has not gone up as rapidly as what's happened with the private insurance sector.

No senior citizen under Medicare needs to go bankrupt because of medical costs. The security that you mentioned, I find it embarrassing and shameful that the United States is the only major country in the world where there are still people going bankrupt for health care costs. Half of all bankruptcies are a result of health care emergencies. It doesn't have to be this way, and it is not that way for American seniors.

But if we're going to change our health care commitment to our senior citizens, taking away the guarantee of Medicare, flinging people into an uncertain private market that failed them in the past, which is why we had Medicare in the first place, that guarantee is not certain to be there.

No one thinks that we shouldn't have a health care system with a Medicare that is flexible going forward. We're open to reforms, absolutely. We want to reward value instead of volume. We want to be able to deal with the pattern of unnecessary medical readmissions for Medicare patients after they've been in the hospital. It's too high still.

But we are working on mechanisms in Medicare and with the hospitals to be able to reward keeping them out of the hospital with preventable conditions that require readmission.

We're in the process of looking at Medicare Advantage, which is growing dramatically. I come from the district that has probably the highest penetration of Medicare Advantage in the entire country, and it serves in many cases my constituencies pretty well, but there are wide variations across the country in Medicare Advantage. Not all Medicare Advantage programs are created equal.

Again, part of what we've done with the Affordable Care Act is not to turn our backs on potential opportunities to improve it, but to dive in and find ways to reward the most efficient and effective Medicare Advantage programs and, frankly, reduce the support for programs that aren't measuring up. That's what we should be doing.

We are moving in this direction. We don't have to take away the commitment that we have made to America's seniors to improve Medicare, Medicare Advantage, to be able to get even more value out of the system--not just tax dollar savings--but better quality care for our senior citizens, which should be our objective.

I know, Doctor, that is something you've practiced both as an elected official and as a professional; and I deeply appreciate it.

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