FISA Amendments Act of 2008 - Motion to Proceed
Floor Speech
FISA AMENDMENTS ACT OF 2008--MOTION TO PROCEED -- (Senate - June 26, 2008)
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Ms. STABENOW. Thank you, Mr. President.
MEDICARE IMPROVEMENTS FOR PATIENTS AND PROVIDERS ACT
We are at a critical point today for 44 million Medicare beneficiaries--seniors, people with disabilities--and the physicians, the health care providers, who serve them. We are at a critical point.
I am very hopeful we are not going to see this number go up--the number of filibusters that have been done on the other side of the aisle. I am very hopeful this number is not going to go from 78 to 79 over the Medicare legislation that is in front of us.
We have already seen a filibuster in a successful effort to stop the Medicare bill that would make sure that the 10-percent cut for physicians does not take place and that other preventative and other access issues are addressed. That is already part of these 78 filibusters. We have already seen the Medicare bill filibustered.
But today we are hopeful, based on the wonderful bipartisan vote of 355 Members of the House of Representatives, that as we come back with their bill that was passed--and I should mention, based on the bill that was crafted by Senator Baucus; and I wish to give him tremendous credit for all the hard work he has done; and I am proud to be a member of the Finance Committee, as the distinguished Presiding Officer is--but the House, based on the work of the Senate, as well, has passed, with 355 votes, on a bipartisan basis, a bill to make sure 44 million seniors and people with disabilities do not find themselves worse off as it relates to being able to get a doctor or being able to get the care they need.
So we are at a crossroads right now. The time is up. As of next Tuesday, July 1, a cut will take effect if we do not act. On top of that, we will not see the other beneficial parts of this bill take effect for our seniors, for people with disabilities, for their families. So we are now at a point where it is decisionmaking time. The House has acted. It is my understanding they will, in fact, be adjourning at the end of today, and we will be in a situation to either act, based on a strong bipartisan vote and a tremendous amount of work that has been done in the Senate, or we will see devastating consequences in the Medicare system.
I do not want to see this number go from 78 to 79 because of a filibuster on a critically important Medicare bill. That is what we are talking about. This legislation itself is good public policy. That is why it received the 355 votes that it did, because it not only stops the cut, the 10-percent cut that is scheduled to take place next Tuesday, July 1--which, by the way, is the result of a fatally flawed sustainable growth rate formula, which I have talked about many times on this floor--we have to change the way what is called the SGR is set up in terms of physician payments--this would not only stop a major cut for physicians that translates into cuts in service for Medicare beneficiaries, but it also does some other very important things that relate to increasing service.
First, let me say that if the cut were to take effect, we are talking about in Michigan alone losing $540 million--$540 million--for the care of seniors and people with disabilities over the next 18 months--only 18 months, $540 million, if we do not act before next Tuesday.
Right now, as to the 20,000 M.D.s and D.O.s in Michigan who provide high-quality care to 1.4 million seniors and people with disabilities and the over 90,000 TRICARE beneficiaries--our men and women in the military--we would see cutbacks in their staffing, in their ability to provide service.
I have heard so many stories from physicians' practices about what all of this means. At a time when more and more people are going into Medicare, as our country is aging, we do not need to see cutbacks that mean there are fewer physicians available to treat our senior citizens and people with disabilities. That is what that means. That is what this will mean if we do not act.
Additionally, the bill provides important and meaningful protections. We are looking at increasing help for low-income seniors, low-income individuals on Medicare who will be able to get additional assistance. It also improves coordination in a number of areas and addresses what we call mental health parity--being able to make sure that mental health services are treated in the same way as public health services. This is something we have gone on record to address in this body in a bipartisan basis on more than one occasion. In this Medicare bill, we address discrepancies between mental health services and physical health services, all of which are the same thing, in my mind. This is a continuum of care in terms of health care. But that is addressed in this bill and has very strong support.
The bill also addresses very important investments in technology for the future--investments that won't take place, such as electronic medical records that will not be developed if, in fact, we see huge cuts in Medicare, rather than investing in the future and investing in technology.
The legislation in front of us would do two things in the area of technology. We would provide additional opportunities for telehealth--more providers, more facilities that would be able to use and be reimbursed for telehealth--and we focus on e-prescribing, which is the first stage of health information technology, bringing it into the 21st century in terms of our health care system and technology.
I am very proud of Michigan. We have been one of the leaders in both of these areas. In telehealth, in the upper peninsula of Michigan, we have had 15 counties that have been connected through the health care system. We have had the opportunity to see how well telemedicine works for all of our seniors, for people with disabilities, for families in general in the UP, as well as in northern Michigan and all around Michigan, including our rural communities, as well as in many of our urban communities. Telehealth is very important and it is expanded in this Medicare bill with more access to care.
We also address the first building block of health information technology, and that is e-prescribing. There are incentives for physicians to use e-prescribing and there is accountability in that arena. This is another area I have to say that I am proud of my State of Michigan for, because we have spent a lot of time and effort, and we have gotten real results for people, in terms of saving lives and saving money as it relates to e-prescribing. We have a group called the Southeastern Michigan E-prescribing Initiative, our auto industry, the United Auto Workers, BlueCross and BlueShield, and many of our businesses and providers have come together and found extraordinary results.
One of the things that I think is so important about e-prescribing is when you have an e-prescribing system, an electronic system where your current medicines can then be compared with any new prescription that the physician wishes to write, they are finding very important safety and quality results. For instance, 423,000 prescriptions that were originally written by physicians were changed or canceled by the doctor once they received very important information about potential allergic reactions or some other interaction with the other medicines their patient was on. So this is very important information that is available. We also know that 39 percent of the time, the physician, given more information, changed the prescription to save the patient and the employer money; being able to offer the option of more generic drugs. So there are huge benefits to e-prescribing. On top of that, you can read the physician's handwriting, and I say that lovingly to all of my physician friends.
But we are in a situation now where we have a bill in front of us that not only stops cuts that would be devastating but looks to the future in terms of electronic e-prescribing, in terms of telehealth, preventive services, helping low-income seniors and people with disabilities, being able to provide mental health parity; a number of areas that while they overall are low in cost are huge in benefit in terms of savings lives. In fact, there are many places in this bill where we are talking about saving dollars at the same time we are saving lives.
I am also very pleased with the fact that the bill addresses a number of health disparities that face those who receive Medicare based on the legislation I have introduced with, in fact, all of the women Members of the Senate--all 16 women Members. We have cosponsored the HEART for Women Act, which begins to gather gender and race data to determine gaps in coverage around heart disease. We are now using similar language in the Medicare bill to collect more data for researchers about disparities around health treatments and so on.
The bottom line is this is a must-pass bill, and we need to pass it now. Time is running out. In fact, in my mind, time has run out. It is now time to act today. When our leader, Senator Reid, who is very committed to this legislation, committed to Medicare, came to the floor and asked for unanimous consent to be able to take up the Medicare bill, there were objections again. I am very concerned that those objections are going to be leading to another filibuster, another filibuster vote coming in the next day or few days.
I hope colleagues are aware that the American Medical Association strongly supports this bill and has been actively involved in promoting the bill and urging all of us to support the bill. The AARP, a leading seniors' organization, has endorsed the House bill as well. I will read a portion of their letter. AARP's letter notes:
Our members have also stressed strong interest in knowing how their elected officials vote on key issues that affect older Americans. Given the importance of the Medicare legislation, we will be informing them how their Senators vote on this legislation when it comes to the Senate floor.
There is great concern among people around the country watching and waiting. People are asking what is taking us so long and why haven't we acted. We have legislation that we worked through on a bipartisan basis here in the Senate, and it has now passed by 355 votes in the House of Representatives. You can't get much better than that vote. This bill has now come over to us and it is time for us to act.
I thank again Chairman Baucus for his leadership and his hard work. I also thank my good friends in the House, Chairman Rangel and Chairman Dingell, for their work on behalf of Medicare beneficiaries and physicians. I stand squarely behind this bill. I was proud to introduce legislation a number of months back to address the question of physician payment and the need to change the process and the way this is done fundamentally. I am so pleased that the bill in front of us mirrors the 18-month bill I introduced and adds to it some critically important changes, critically important incentives to modernize the system with telehealth and more access to health care, modernize the system as it relates to electronic prescribing, and does more to make sure our low-income seniors receive the help they need, and makes sure that we are, in fact, providing a more equitable system where mental health and physical health payments and services are looked at in the same kind of way. This is very important. Focusing more on prevention is very important.
The bottom line is we have 44 million Americans who rely on Medicare every day. Medicare is a great American success story. It passed in 1965. It is a great American success story that has brought healthier lives through better medical care as well as opportunities for longer lives for millions and millions of Americans. Access to those services is jeopardized seriously if we do not pass this bill. The ability to expand on services and prevention is also in jeopardy if we do not pass this bill.
I am hopeful we will come together, as our House colleagues have done, and stand on a bipartisan basis in support of our providers, our health care providers and, most importantly, those men and women who are counting on us to keep the Medicare system strong for the future. I am hopeful we will not see another filibuster stopping us from addressing the important issues of Medicare. This needs to be done today.
Mr. President, I yield the floor and suggest the absence of a quorum.
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