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GOP Doctors Caucus: Medicare Seniors and Obamacare

Floor Speech

Location: Washington, DC

Mr. FLEMING. Thank you, Mr. Speaker.

I come before this House tonight to talk about a very important issue--it's been important for years, and it's going to be increasingly important and increasingly a part of the debate--and that is health care, and particularly health care for our seniors. We've got lots going on. ObamaCare, of course, was passed in 2010, and we're running into all sorts of problems. Of course, I and my Republican colleagues here tonight voted against it.

I'm joined tonight, by the way, by two of my colleagues, Dr. Phil Roe, an obstetrician from the great State of Tennessee, and Dr. Scott DesJarlais, who is, like me, a family physician.

I thought I would just give a brief introduction about Medicare and how that fits into the budget. I know that Dr. Roe is going to talk in more detail about that.

No speaker would be complete without a chart, and I have several tonight. This is one I think that's important for everybody to understand. This pie chart breaks up spending for the Federal budget. If you will notice, the vast majority of this pie is in what we call permanent mandatory or so-called entitlement spending and interest. What makes up a large part of mandatory spending is Social Security, Medicare, and Medicaid. The size of this pie, this section of the pie, is growing. In fact, if you recall, back in the nineties we actually balanced the budget. The last time we balanced it, I think was in the late nineties. It was a lot easier to do back then because entitlement spending, permanent spending, was not in place to the extent that it is today. It was growing, but not as big.

What is the difference between mandatory spending and discretionary spending, which is the other two pieces of this pie? Mandatory means that if you qualify for a certain type of service or payment, whether you're on Medicare, Medicaid, whether you earned it or not, if you qualify for it, the government must pay. No matter who shows up or how many people show up, the government must pay. So, therefore, the government cannot per se control that cost.

Discretionary cost, on the other hand, is split into two: defense, which is around $600 billion to $700 billion a year; and nondefense discretionary, which is what we run the government on. That we can adjust, although we've not done a good job in controlling this. In fact, that's increased probably 25 percent just in the last 2 years under President Obama.

But I want to illustrate for you what the problem is, and that is that the entitlement spending, which we don't control, with an aging population and the fact that it's dependent on government spending, is growing at a much faster rate than our revenues and inflation.

This is a chart that outlines where we are today with Social Security, Medicaid and Medicare, the part of entitlement spending. Now, let me say, first of all, Social Security is down here in the purple, and you notice that it slants upward and then it flattens out. Social Security is not our problem. Let me repeat that: Social Security is not our problem.

And people who are on it or will be on it, in my opinion, have nothing to worry about. Now, we may have to tweak it, we may have to adjust it, but you'll notice that the cost really rises relatively slowly, and that's just a matter of demographics. And we can adjust this, as we have in the past, and make this sustainable. There are other ways to do it, in terms of allowing Social Security recipients to invest some of their money and so forth, but that's beyond the scope of discussion tonight.

The next group in green is Medicaid and other health care. You'll notice it's going up faster. And Medicaid is health care for the poor. And then finally in red you see Medicare, and you see how that explodes and it goes up continuously. Medicare alone will completely displace all the budgetary spending eventually if we don't bring that under control. And that would mean we'd have to give up on government itself, we'd have to give up on a national defense--everything--unless we begin to control that.

Now, at the rate things are going, Medicare will run out of money, become insolvent by 2020. And that is straight from the CBO, the Congressional Budget Office. Another way to look at it is that our spending is now equal to 15 percent of the total Federal spending is Medicare, blowing out of control. What has made this worse is ObamaCare actually cut $500 billion, that is, half a trillion dollars, out of Medicare to use for subsidies for middle class health care plans.

So let me repeat: Medicare is running out of money; it's exploding through the roof. And what does ObamaCare do, the Members who voted for it, it actually cuts money out of it and depletes it of money in the future so that it becomes insolvent. And here's where the cuts are: $135 billion for Medicare Advantage, which is the private health care version of Medicare, $112 billion, which was taken from hospitals, $39.7 billion from home health, $14.6 billion from nursing homes, and $6.8 billion from hospice care. These are very real cuts.

And the only explanation that the other side gave us, our Democrat friends, is that somehow we'll cut out fraud, waste and abuse. Well, let me warn you, any time a politician tells you he's capable of doing that, watch out, because I've never seen it done and I don't expect to see it done in the future. Because, you see, in order to cut out the massive fraud, waste and abuse, you have to spend even more money to find all the bad actors. The best way to do away with fraud, waste and abuse is to make the system much smaller, perhaps even privatize it, and make the system accountable rather than a Big Government bureaucracy, which wastes money, whether we're talking about the Department of Defense or Medicare. So that should give you kind of a beginning of where we are with Medicare.

Let me just close my opening remarks by saying that there's basically two options when it comes to making Medicare again solvent and available for us in the future. There is a Republican plan, which would allow you, if you are currently on Medicare or 10 years from becoming on Medicare, to keep Medicare as it is. And it is sustainable, as far as the CBO tells us, indefinitely.

However, we would have to reform that for younger adults today who will be senior citizens by opening up the insurance system, creating a marketplace for seniors to buy insurance, and then let government help them with what we call ``premium support,'' and allowing competition in private care to drive the cost down and raise the level of service. In fact, what we in Congress have today is the very same thing.

The Democrats, their plan is this: goose egg, no plan whatsoever. Under their plan--or non-plan--Medicare runs out of money in 8 years. And they've failed to present an idea, much less a bill, as we have, that would even solve that. Well, that gives you an idea of some of our opening discussion.

First tonight, I want to introduce my good friend, Phil Roe. Dr. Phil Roe, as I said, is an obstetrician. I think he has some comments about the financing of Medicare and other things as well.


Mr. FLEMING. Absolutely. I thank you for the wisdom of your experience, Dr. DesJarlais.

I'd like to turn to Dr. Gingrey here. He's joined us and, of course, has conducted a number--I can't even count the number that I've participated in with Dr. Gingrey with respect to Special Orders that we've had.

And before doing that, just to follow up on what Dr. DesJarlais said about the 100,000 in, 300,000 back, I can recall one day in my own practice sitting there and thinking about the three patients that I just saw. In Room 1, I saw a little lady who's on Medicare who could barely scrape by by the end of the month, and she's on Medicare and getting the benefits of Medicare, and God bless her, she was getting them. And then I thought about the second room where there was a gentleman who's a multimillionaire. But you know what? My charge to both of them and what Medicare did for both of them was precisely the same.

I just couldn't quite understand that, especially when I thought about the little mother in Room 3 who's on private insurance, two-paycheck family, baby, barely scraping by, paying far more in their premiums than someone in Medicare and having to raise children. It was her insurance premiums that were subsidizing both the little old lady who was poor and the multimillionaire.

We're going to have to do something about that to make the economics of this system work. It is unsustainable, as we know.

Dr. Gingrey, I would like to ask you if you could give us a few words, sage wisdom on what your perspective of where we are with health care, ObamaCare, Medicare, and all the other cares that we're talking about.


Mr. FLEMING. I thank the gentleman. Dr. Gingrey serves on the House Energy and Commerce Committee, a committee that has oversight and jurisdiction in this area, very important, looking at a lot of legislation.

Next, I want to turn to another of our freshmen. We've had a wonderful cadre of freshmen we appreciate so much and a wealth of physicians and dentists as well bringing in their years of experience, training, and education.

Next I would like to recognize Dr. Hayworth, Nan Hayworth from New York, and would be very interested to hear what you have to say this evening.


Mr. FLEMING. I thank the gentleman from Michigan.

Again, we're getting a world of experience here tonight, all the way from OB-GYNs, ophthalmologists, family physicians, nurses, so much in the way of words of wisdom, and we have so much on our side of the aisle with Republicans, as my friend points out, a dearth of available physicians, health care workers on the other side of the aisle. It seems a shame that we were completely closed out of the creation of and passage of the health care reform act, which certainly suggests that we need to go back and do it.

We also are joined tonight by our colleague from Arizona, Dr. Gosar, who is a dentist and a very valued member, as well, of the conference. I would love to hear from you this evening.


Mr. FLEMING. I thank the gentleman, Dr. Gosar. I'm just going to make a couple of closing comments; and in the few moments we have left, I'm going to allow some of our other physicians to give closing comments.

One of the important things we have learned here tonight is under ObamaCare, $575 billion was cut out of Medicare. Medicare is going broke, becoming insolvent, according to the actuary in 8 years. The Republicans passed a budget earlier this year that would have fixed that for good. And the Democrats have yet to even talk about it or even acknowledge that it exists. But they do know it. So I want to be sure that we leave here tonight with an understanding of the seriousness of the challenges that we have before us.

Now I would like to recognize Dr. Roe for some parting comments.


Mr. FLEMING. I thank the gentleman. Before I recognize another Member in the last minute or two that we have, I would just like to say that we are going to be having a lot more of these sessions. So we've just started. We've just scratched the surface. We're running out of time, so just to wrap things up, we have just barely scratched the surface. And these are not all the physicians or health care workers we have on our side. There are others here who could have been here, but had some other commitment tonight, but will be here next time.

I would love to talk more on IPAB. Even many Democrats see that was a very big mistake. It will be one way that you can get the door closed on your health care and getting the right sort of care in the future.

I thank everyone for being here tonight, and I look forward to doing it again very soon. God bless you all.

I yield back the balance of my time.


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