The Ongoing Health Care Debate

Floor Speech

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Mr. GRIFFIN of Arkansas. Mr. Speaker, I've come here to the floor tonight with my colleague from Wisconsin, Representative Duffy, to talk about the crisis Medicare faces and to talk about the Independent Payment Advisory Board. Some call it the IPAB. It's a part of the President's health care law, and this House is going to address it this week.

But I want to start out by talking a little bit about the crisis that we're facing in this country over Medicare and what it means to our seniors. My mother is 71, and she's a Medicare recipient. She counts on Medicare. She paid into it and is now using it to take care of herself. And we've got to make sure that future generations are able to rely on, count on Medicare.

This first chart here, Mr. Speaker, shows what a significant portion of the Federal budget Medicare consumes. We have it here, $555 billion, and that is per year. This is a yearly budget for the Federal Government.

It is widely agreed upon by Democrats and Republicans that Medicare is going bankrupt. Some estimate it's 7 years, 8 years, 10 years, but most everyone agrees, having looked at the numbers, that Medicare is going bankrupt.

I've got a quote here from Senator Lieberman, who addresses a criticism that we hear a lot about the Republican reform plan on Medicare:

We can agree that Medicare is going bankrupt. We then have to ask ourselves, what are we going to do about it?

What are we doing about it? Well, the House has acted to reform Medicare. We acted last year, in 2011, as part of our budget to reform Medicare to save it. The only reason we proposed reforms to Medicare is because we want to save it. We want it to be there for the next generation.

I've heard a lot of criticism: You want to change Medicare as we know it. I say: No, Medicare, as we know it, goes bankrupt on its own. We have to act to save Medicare, Mr. Speaker.

And in this quote of Senator Lieberman, he says:

The truth is that we cannot save Medicare as we know it. We can save Medicare only if we change it.

Now, like House Republicans, I think it's fair to say, Senator Lieberman is talking about what we must do for the next generation. Like our proposal, I think a lot of us agree that we can make changes to Medicare for the next generation, and for those, for example, 55 and over, leave it as it is. Why? Because people have counted on a particular way the program works, and we won't have to change that to start saving. We can just change it for the next generation.

I have another quote here I want to share with you that shows that President Obama, at least in his words, understands that we have a problem with Medicare.

If you look at the numbers, Medicare, in particular, will run out of money, and we will not be able to sustain that program, no matter how much taxes go up.

This is the President.

He continues:

I mean, it's not an option for us to just sit by and do nothing.

Unfortunately, those are just words because that is precisely what the President has done, sit by and do nothing. It's what the Senate has done. The House has acted to reform to save Medicare.

Now, the President's health care law has a provision in it, the IPAB that I referred to earlier, that impacts Medicare, but it doesn't save Medicare. It rations Medicare.

How does that work? Well, this is an unelected board, it's an unelected board that will make decisions on where Medicare is cut. So the President has had an opportunity to propose reforms to the way Medicare works, so that we can innovate and change it to save it for future generations--reform it, upgrade it, do things better. But instead, the President's approach is simply to cut the levels of spending but leave the overall functioning of Medicare the same. So no innovation, no new approach, no reform, just cut when we run out of money.

Well, what does that result in? It results in seniors not getting the care they need, and not just because services are reduced but because a lot of doctors won't take Medicare patients. This is already a problem today. Today there are seniors looking for a doctor to help them with their particular problem, and doctor after doctor says, I'm sorry; we don't take Medicare. That problem is only going to get worse if the IPAB, the Independent Payment Advisory Board that's in the President's health care law, if it does what it is scheduled to do.

Now, what are we doing about it here in the House? Well, we certainly voted to repeal the President's health care law. That passed the House, did not pass the Senate. But we've tried a lot of other ways to get at the problem, and one that we're going to do this week is to repeal the IPAB, repeal the Independent Payment Advisory Board.

I yield to the gentleman from Wisconsin.

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Mr. GRIFFIN of Arkansas. What really scares me is that this restricted access to health care, to Medicare that you're talking about, it already exists. The IPAB, the Independent Payment Advisory Board, that's in ObamaCare that will cut the amount of reimbursement to doctors when it gets going, it's not even cutting yet and we already have a problem with seniors getting the doctor that they want because so many doctors have said, I'm just not going to take Medicare any more.

Before I yield back, I just wanted to mention an email that I got in my office this week.

There's a constituent of mine, John Pollett. He's the program administrator for the Arkansas Senior Medicare Patrol. He goes around and he talks with seniors about Medicare and how to recognize fraud in Medicare.

He was at the Sherwood Senior Center this past week, this week, in my district, and he was giving a presentation teaching Arkansas seniors about Medicare fraud. A lady, a senior, who's on Medicare, an angry senior, said to him--she wasn't angry at him--but she said with passion, I don't understand why I'm forced to pay my Medicare premium but can't find a doctor who will take me because I'm on Medicare.

So we already have a problem with access to Medicare because more and more doctors are saying, I'm not going to take Medicare. There are a host of reasons: the reimbursement rate, the administrative hassle, what have you.

But IPAB, I hear the gentleman from Wisconsin saying, the Independent Payment Advisory Board that's in ObamaCare is only going to make the problem worse because while some of us are interested in reforming the way Medicare works so that we get more service for our dollar, the President is only interested in saving money by just reducing and cutting without reforming.

We all understand the need to reach solvency; but those of us who back Medicare reform want to do it through innovative, creative, cost-saving approaches that avoid rationing, whereas the President simply wants to cut through an unelected board.

I'm going to yield back now to the gentleman from Wisconsin. I just thought it would be helpful to give you a real-life example of a senior in my district who's been impacted by that.

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Mr. GRIFFIN of Arkansas. I thank the gentleman from Arizona.

I wanted to just point out that 70 House Democrats opposed IPAB when it was being debated in the President's health care law. Before I ever got to Congress, there were 70. In fact, it wasn't in the House version. I'm hopeful that some of the Democrats who have come out against IPAB will join us in repealing it so we can move on to truly reforming Medicare to save it.

We're lucky and fortunate to have some physicians, many physicians, serving with us here in the House of Representatives; and they bring an expertise in this area that really helps us when we're working on solutions to the problems with Medicare and Medicaid. One of them has joined us here on the floor tonight. I would like to yield to my friend from Tennessee.

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Mr. GRIFFIN of Arkansas. I just want to make sure I understand what the gentleman is saying. What you are saying--correct me if I am wrong, but what you are saying is the House has a plan to reform Medicare to save it. As far as I know, I haven't seen any other plan to save Medicare pass the Senate. I haven't seen the President propose a plan to save Medicare. There is only one. Now the President has a plan for Medicare, but it's not to save it, and it really doesn't reduce cost through innovation and what have you; it just cuts. And the cuts are decided upon by unelected bureaucrats who are on this IPAB, the Independent Payment Advisory Board.

You mentioned the television ads. I had television ads run back in my district. They talked about how I and others want to change Medicare as we know it. Well, I quoted Senator Lieberman earlier, who said we can't save Medicare as we know it because it's going bankrupt. So what I say to folks is we have to reform it. And I'm happy to have a discussion and debate and compare this reform with that reform. I'm happy to do that.

What is intellectually dishonest, though, is to compare reforms that I advocate or you advocate, to compare those to the way it is now. That's intellectually dishonest. It's actually deception.

Why is that deception?

Because the way things are now is not going to be that way in 7, 8, 9, 10 years. It's unsustainable, the path we're on with regard to Medicare. So if someone says your reform changes Medicare as we know it, if that is presented to demagogue, that, in and of itself, is intellectually dishonest, because Medicare as we know it goes bankrupt and changes itself.

So I am happy to have a conversation to compare this reform with that reform. I certainly do not have a monopoly on wisdom in this area. I think we ought to be having a free and open debate of reform ideas that save Medicare for seniors. But what we can't do, what we can't do, is mislead people, mislead seniors into believing that Medicare, as it currently functions, is sustainable. That's not true. That's not true.

Folks who continue to talk about Medicare as we know it need to point out that Medicare as we know it ends on its own by itself. The Congress of the United States could do nothing on this for 10, 20, 30 years, whatever, and Medicare would go bankrupt with no congressional action.

So our job, as I see it, is to take affirmative steps to save Medicare, to maintain the quality, to maintain the quality so that doctors still want to take Medicare patients, and reform it to save it for people, seniors like my mother. But we've got to start with the fundamental idea that we could debate reforms. But comparing reform to an unsustainable status quo is intellectually dishonest.

I yield back to the gentleman.

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Mr. GRIFFIN of Arkansas. Even a bipartisan discussion, I welcome it. In fact, I was proud to see that a Democrat from the Senate joined with a Republican in the House on a Medicare reform plan. And I'm happy to debate all these different plans as long as they have the ability to save Medicare and guarantee quality care for seniors.

If we end up debating reforms on the one hand versus the status quo, the way things are now, Medicare as we know it on the other hand, we can't have that debate because the whole point is that Medicare as we know it, the status quo, Medicare as it is now, it's going bankrupt. So any discussion of the options has to be between the different options that save Medicare.

The problem is there is only one plan that saves Medicare that has passed the House or the Senate or that has been proposed by the President, and that is the House budget plan from last year. And we will, I am confident, have a plan this year that we will vote on shortly that will propose changes to save Medicare.

I want to thank the gentleman for joining us here tonight.

Do you have anything else you want to add?

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Mr. GRIFFIN of Arkansas. I think ultimately the IPAB seeks to save money by simply cutting blindly without regard to innovation, without regard to structural reform, simply having a board of unelected bureaucrats ration care by making decisions on what Medicare will cover, won't cover, and by how much.

Yes, we need to do what is fiscally right, but we need to keep our promise to our seniors; and the way that you do both is to reform Medicare structurally, not to blindly cut, leaving all the rules the same, just reducing what you are paying doctors.

That's not the path. That's not the path. That is, in effect, rationing, and that will continue to exacerbate the problem of Medicare recipients being unable to find doctors who will take them. The answer is to take Medicare that has been so good to so many seniors and reform it and innovate and make changes that won't just cut costs by reducing the money paid but will actually change the rules so that we are able to get more value and more services for our dollar. And that's the approach we have to take.

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I would like to thank the gentleman for leading this hour on such an important topic.

Mr. GRIFFIN of Arkansas. I thank the gentleman from Tennessee for his service here in the Congress and as a physician. I thank him for joining me here tonight. And I just want to reiterate what you said. Whatever solution we come up with has got to be patient-centered and respect the doctor-patient relationship. Patient-Centered, not government bureaucracy-centered--patient-centered.

I thank the gentleman for joining me. I thank all of my colleagues for joining us here tonight.

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