Steve Buyer

Mr. BUYER

Mr. BUYER. Mr. Chairman, I thank the gentleman from South Carolina (Mr. Spence) for yielding the balance of his time. Mr. Chairman, I do not believe that any of the Members who have spoken here today or those of whom served dutifully on the Committee on Armed Services can claim the cornerstone of fulfilling the promise, because I believe in fact we are all working in that direction. I also will concur with the gentleman from Missouri (Mr. Skelton) in that we are all charged to do our best, honor the commitment. Those are all the words that all of us will use, but let us be very careful. I am always extra cautious not to create unrealistic expectancies among populations, and here in particular the military retiree. Let us say that today we even voted to make Medicare subvention permanent. Okay. Let us do a hypothetical. We vote to make it permanent right now. None of us can go back to our districts, pound the chest and say we have now fulfilled the promise and all the military retirees are taken care of. The reason I drew out the pie and tried to show the map is the total eligibility of military retirees next to the medical treatment facilities is about 350,000. Of that 350,000, because of the limited capacity, we can only do about 69,000, which means out of 1.4 million military retirees we are only talking about 69,000. So let us be very honest with ourselves about what we are doing here today. It is a pilot program that is flawed at the moment. It is running a deficit to the Department of Defense of $100 million. One says, well, money does not matter. Oh, really? Go back home and say that again. Money does matter. We have to make sure that we make the right decision, and what we have done is laid forth the methodology to deliver the care. In 2002, when we get that report from the independent advisory council, Congress will work with OMB, work with the Department of Defense; in 2002, put together the program, make sure the $9 billion to $10 billion will be in the budget; it comes over here; in October of 2003, this question is done. It is done, but what we have done is made sure that what we do is the right thing. We do not have the capacity today to say, well, I already know the answer; we are going to do it; we are just going to make Medicare subvention permanent. Permanent when it only addresses a small minority of individuals who are located next to a medical treatment facility? Let us do the right thing. Let us take the time and do the analysis.

Mr. BUYER. Mr. Chairman, I demand a recorded vote.

Mr. BUYER. Mr. Chairman, I thank the chairman for the leadership that he has given me as I put this together and also worked with the gentleman from Hawaii (Mr. Abercrombie). I needed to address several points earlier when I talked about making sure our advocacy is very correct. Let me address, number one, with regard to the comments of the gentleman from North Carolina (Mr. Jones) that this will only cost $250 million. The actual scoring from CBO is that it is $285 million. I just want to be very accurate. The other is that what worries me is that if we are at six sites and it is costing DOD $100 million when, in fact, it was supposed to be cost neutral, and then we are going to expand nationwide, over 40 sites nationwide, it boggles my mind the impact that is going have upon DOD that has not even been budgeted. With regard to my colleague, who I have great respect for and have been in Oklahoma with him in saying that whether it is cost effective or not does not matter, I believe that being cost effective in the efficiencies of governmental operations does matter. In this bill, for example, we even said, for every claim that TRICARE files, we have learned that it costs $78 per claim. For Medicare, I say to the gentleman from Oklahoma (Mr. Coburn), when he goes back to Oklahoma and does his Medicare, it costs 85 cents to a dollar to file it. So we are forcing TRICARE to do best business practices and on-line billing. We are going to save over $500 million over 5 years. That is like a touchdown and extra point for the American taxpayer. Asking government systems to exercise business practices and principles should not be a radical concept of the Federal Government. I understand the gentleman saying these are men and women who put on the uniform who were not only willing to risk their life but their earning power, also. Should we meet the commitment and obligation? Absolutely. How we get there with the right method is what this debate is all about. So I have to stand here, as hard as it is, to agree to disagree with my colleague the gentleman from Mississippi (Mr. Taylor). We should not be going to as permanent a system, not yet. I do not want to, but I will bring my opinion into the matter. My opinion is that I do not believe something magically should happen to a military retiree when they turn 65. When they retire from the military at age 46 or 42 or 50, whatever it is, or they are in TRICARE Senior Prime or Standard, nothing magically should happen when they turn 65. Keep them in the same system. It works for all. I say to the gentleman from Connecticut (Mr. Larson) that is comprehensive. To say that what is being offered is comprehensive I would respectfully disagree, because Medicare Subvention is only going to apply to 20 percent of the 50 percent that live next to a military medical treatment facility.

Mr. BUYER. Mr. Chairman, I yield the balance of my time, 3\1/2\ minutes, to the gentleman from California (Mr. Thomas). (Mr. THOMAS asked and was given permission to revise and extend his remarks.)

Mr. BUYER. Mr. Chairman, I yield myself 30 seconds to respond. I enjoyed working with the gentleman from Hawaii (Mr. Abercrombie), and I would say that in the letter from the Air Force Chief of Staff, it also reads, ``I urge that we heed the lessons already learned from the Medicare subvention demonstration projects. The current TRICARE Senior Prime demonstration, though popular with retirees, is not fiscally sustainable over the long term.'' The real difficulty I say to the gentleman from Hawaii (Mr. Abercrombie) between these two proposals is that the gentleman from Mississippi (Mr. Taylor) seeks permanency of a crippled program. Mr. Chairman, I reserve the balance of my time.

Mr. BUYER. Mr. Chairman, I yield 3 minutes to the gentleman from Texas (Mr. Thornberry).

Mr. BUYER. I yield to the gentleman from California.

Mr. BUYER. Mr. Chairman, I yield myself such time as I may consume. Mr. Chairman, I would change the vocabulary a bit, I say to my friend, the gentleman from Mississippi (Mr. Taylor). I seek to improve the amendment, not gut it. To improve the amendment, what I mean is what we have done in the base text of this bill is stop the rhetoric. By speech, it is 101, any Member can go to the well and give a great speech and throw their arms around the military veteran. It is the easiest speech to give. It is 101 in speech. Delivering the right preparation on the commitment and obligation of the retiree is a little more difficult. I will never, ever create an unreal expectancy. I caution Members who will speak on this issue, because I will be quick on my feet. I want truth in advocacy. When it comes to ``the Medicare subvention,'' let me bring the stark reality into question. If we were to draw a pie of the 1.4 million military retirees, half of that pie, they live next to medical treatment facilities all around the country. Then, of that pie, I take 20 percent of the half, and that is all that could ever be treated in Medicare subvention. Why? Because there is a capacity question, capacity. So be very cautious and tempered in words to say, and I throw this warning out in the debate, that Medicare subvention, if we make it permanent, delivers on the promise, because it does not. The painful reality to the military retirees came into being not in the 1960s, when we created Medicare as a program, and we then triggered the retiree into the Medicare system, to be treated like everyone else in the country, senior citizens who had never worn the uniform. The painful reality really came when we went through the BRAC process and closed a lot of military bases, to include those base hospitals. Congress responded in search of an answer. The reason this is so difficult, and it is a complex health system, is that the purpose of the military health systems are to treat combat casualties and accidents, and those active duty service personnel who are sick. Second comes the dependents and retirees. The real purpose is combat casualties, so military medical readiness is set up a little bit differently. So when Congress is in search of ``the answer'' of how we take care of the commitment to the military retiree, we created some demo programs. We created Medicare subvention, whether it is the FEHBP, we have BRAC pharmacies, we have many different things. What we do in the base text of this bill, which I compliment the bipartisan support of, that came out of the Committee on Armed Services, is, and it is supported by the administration, we put our arms around all of these demonstration projects. We expand them, and then we end them on December 31 of 2003. Why do we end them? Because we want to analyze all these programs and say, all right, what is best to deliver the care to the military retiree? I would say that we do not have the competency to make that judgment today, so we create a methodology that says, all right, we create an independent advisory board, nominated by the Secretary of Defense. They will examine these. They have a report due to Congress in July of 2002. We will have our ideas. The advisory group has theirs. DOD has theirs. The Senate will have theirs. OMB I am sure is a player. Then what we do is we come in and then make a judgment in the fall of 2002 of what is the best to deliver. In the meantime, what can we do? Because that is the spirit of what my colleague, the gentleman from Mississippi (Mr. Taylor), is trying to say: In the meantime, what can we do? I have been a good listener to him. I will have an amendment that comes up that says that we will expand the scope to the major medical centers, but it is not timely for us to make permanent Medicare subvention. Why? Because it is a crippled program. It was meant to be cost-neutral when it was negotiated with the Committee on Ways and Means and the Committee on Commerce. Today it is costing over $100 million to DOD, in excess of $3,000 per beneficiary. Mr. Chairman, if we have a pilot program that is crippled fiscally, is it the right thing to do by the taxpayers to say, well, we will just go ahead and make it permanent? I believe that is not the proper and prudent thing for us to do. Let us follow the methodology. Let us do what is right for the military retiree. In the meantime, we can do something. I will agree, I concur with the gentleman, we will extend the scope. We will work with HCFA and DOD to renegotiate these reimbursement rates. We will work on the utilization question. One glorious thing we did do in this bill is we said to the military retiree, we said, we will create a pharmacy benefit, a pharmacy benefit that is so rich that it is not going to be treated like Grandma and Grandpa that never had served in the military. We are going to say to the military retiree, you are entitled to this pharmacy benefit. So there are some things that we can do while we are waiting for the methodology, the analytical process of the data. Then we step forward, working with the next administration, for the cost of this program.

Mr. BUYER. Mr. Chairman, I rise in opposition to the gentleman's amendment.

Mr. BUYER. Mr. Chairman, I thank the gentleman from South Carolina (Mr. Spence) for yielding me this time. Mr. Chairman, I also would agree it is important to keep the record clean. When the former Governor of Puerto Rico stands in the well and says that this land was taken by condemnation, that is completely false and I believe he knows that. The land was purchased at fair value between 1941 and 1950 for the use as a live-firing range. So I want the record clean. Mr. Chairman, I rise in strong opposition to this amendment offered by Mr. Skelton. The agreement on Vieques range that the administration has reached with the Government of Puerto Rico, I believe, is fundamentally flawed in several respects, including the terrible precedent that the President's provision for a referendum sets. Allowing the local communities to vote on the type of training that can be conducted at a military range endangers our military's access to other critical facilities both in the United States and overseas. Even more importantly, the agreement permits the Navy and the Marine Corps to return to Vieques but only using inert munitions, which do not provide the type of combat arms training that our Navy and Marine Corps teams require. The Commandant of the Marine Corps, James Jones, whose name is being thrown around a lot here today, and I would say to the gentleman from Missouri (Mr. Skelton) I will also read from part of his quotes, he said, ``Inert training cannot replace the experience gained from training with live-fire ordnance. Employing live ordnance will allow us to train as we intend to fight.'' He goes on to say that the curtailment of training operations would have, quote, a significant detrimental effect on Navy and Marine Corps readiness. When asked what the impact on Navy readiness would be if the Vieques range is restricted to inert ordnance only, the Chief of Naval Operations, Admiral Jay Johnson stated, ``The proficiency obtained by the personnel involved would be less than optimum.'' Significant detrimental effect on readiness and less than optimum? What these statements mean are longer, more costly wars and pictures on CNN of flag-draped coffins at Dover Air Force Base. Is that what America really expects of us, those of us here in Congress that have the ultimate responsibility to ensure that the men and women who serve in the Nation's military are adequately trained? I think not. Vote down the Skelton amendment.

Mr. BUYER. Mr. Chairman, I yield 1 minute to the gentleman from California (Mr. Hunter), the chairman of the Subcommittee on Military Procurement of the House Committee on Armed Services.

Mr. BUYER. Mr. Chairman, I reserve the right to close.

Mr. BUYER. Mr. Chairman, I yield 2 minutes to the well-respected gentleman from Illinois (Mr. Hyde). (Mr. HYDE asked and was given permission to revise and extend his remarks.)

Mr. BUYER. Mr. Chairman, I yield 1\1/2\ minutes to the gentleman from Pennsylvania (Mr. Pitts).

Mr. BUYER. Mr. Chairman, I demand a recorded vote.

Mr. BUYER. Mr. Chairman, I yield myself the remainder of my time. Mr. Chairman, I have heard the words fairness, double standard, discrimination, narrow-minded. I mean, we could go down the list. I suppose to articulate debates one can choose these types of words. One thing that is real that one cannot get away from is the Supreme Court over there permits Congress to set the rules for the military, and we discriminate all the time: How tall one can be; how short; how heavy; how light; one cannot even be color blind. We discriminate all the time, so that argument is rather foolish. Narrow-minded? Guilty. So narrow that the interests for which we seek to protect are twofold. Number one, life. If we in this country cannot be the defenders of life, then what are we as a society? If that is narrow-minded, guilty.

Mr. BUYER. Mr. Chairman, I would first, by the way of opening, say that we need a little truth in advocacy. It is very easy to create a strawman in advocacy that we then get to knock down. So the allegations of those of us who oppose the Skelton amendment that making some form of allegation that those of whom only support inert and support the President are less patriotic was one of the allegations, that is false. As a matter of fact, I have great pride and I believe every Member of Congress has great pride in the contribution of the citizens of Puerto Rico to freedom, and some of the Puerto Ricans that I served with in the United States Army, they were the sharpest dressed. They had the best looking shoes, the best looking brass, and I would stand side by side with them at any time, because I know they would be with me, or if they told me go left, I know that they would cover me. So stop creating this false advocacy that we have in here, let us have a little truth in advocacy.

Mr. BUYER. Mr. Chairman, I wondered how long it would take before we get a little politics involved in the issue. I thank the gentleman from Mississippi (Mr. Taylor). Mr. Chairman, I yield 1 minute to the gentleman from Texas (Mr. Sam Johnson), one of our true American heroes. (Mr. SAM JOHNSON of Texas asked and was given permission to revise and extend his remarks.)

Mr. BUYER. Reclaiming my time, Mr. Chairman, the TRICARE senior pharmacy, what we do is reinstate access. We do not create new entitlements for the military retiree. It is an earned benefit. What we do is we preserve access to the military pharmacies at the medical treatment facilities. We create a mail order pharmacy with an $8 co-pay, so if someone has diabetes or needs a drug that they know that have to have, they can. We also create a network, retail, with a 20 percent co-pay. Then also we have added an out of-network retail with a 25 percent co-pay and a $150 deductible. What we are doing is giving the widest array of choices to that military retiree. I think that is extremely important, because most do not live next to medical treatment facilities.

Mr. BUYER. Reclaiming my time, Mr. Chairman, the key word that I believe the gentleman used is ``options.'' This methodology preserves a wide array of options from which we can then choose. Mr. Chairman, I reserve the balance of my time.

Mr. BUYER

Mr. BUYER. Mr. Chairman, reclaiming my time, I want to thank the gentleman from California (Mr. Hunter) again for working with us. He is absolutely correct with regard to parity. We have enjoyed our working relationship with the Guard and Reserve components. I look forward to working with the gentleman in conference.

Mr. BUYER. I yield to the gentleman from California.

Mr. BUYER. Mr. Chairman, reclaiming my time, as I understand, that is two KC-135 engine kits at $52 million.

Mr. BUYER

Mr. BUYER. Mr. Chairman, it is not as though the House has had this debate. It never had this debate. It seems as though we have had it over the years, and I have great respect for the gentleman from Ohio (Mr. Traficant). I have great respect for his passion and his zeal. Let us apply a little common sense, as the gentleman from Missouri (Mr. Skelton) always likes to teach me. This is also about the Constitution and the prerogatives of the Office of the Presidency. He is the Commander-in-Chief. The Congress, we do not have to stand here and tell the Commander-in-Chief that one of your jobs is to protect the Nation's borders. Constitutionally, it is implied in the powers of the Executive Office of the Presidency. With regard to narcotics, let us be very upfront; 80 percent of the drugs that are coming into this country come through ports of entry. Now, we have 10 percent that are air. We probably have the other 10 percent that come through the transit countries here in particular, whether it is up through central America to Mexico, they shortland the border, and then they end up taking it across the border through mules, to humans, to motorbikes, horseback, that happens; so the gentleman is correct on that. That issue gets addressed by, whether it is INS and DEA and those types of issues, but for the Congress to mandate placing our troops in divisions on the border is not the most prudent way to do this. I agree with the gentleman from Texas (Mr. Reyes) about how it detracts from the unit readiness and those types of things, he is right. I concur with the gentleman's analysis. That is not what we should be doing. I would urge Members to vote against the Traficant amendment, although, I have great respect for his passion.

Mr. BUYER

Mr. BUYER. Mr. Chairman, I have great respect for the gentleman that just spoke, but I extend my even greater admiration to the chairman of the full committee, who extended the ability of this committee to finally put our arms around all of those demo programs. This bill provides the road map actually to extend and remove these barriers and extend that benefit the military retiree is entitled to. Any Member can stand in this well and embrace the military retiree and the Veteran, it is easy. But how do we finally put our arms around all of these demos and actually deliver the right program that is in the best interests? That is what this bill lays out, the road map, and I thank the chairman for giving me the ability to do that.