Bob Corker

Mr. CORKER

Mr. CORKER. Last weekend, the New York Times talked about many physicians prescribing antipsychotic drugs to young people because they don't want to deal with them on Medicaid. So half this reform is people going into this type of program and half the money is coming from Medicare, which is insolvent. We have spent all this time, all kinds of bipartisan meetings. I know you spoke about the issue of partisanship. I know the good chairman is here. We, early on, said we wanted to join in health care reform. We just didn't want to take money from Medicare, which was an insolvent program, to fund it. What was the major building block of this program? Taking $464 billion from Medicare to fund reform. We were, in essence, blocked out on the front end saying something we thought was the wrong type of principle to build upon.

Mr. CORKER. I was listening to the Senator from Oklahoma. I know he cares deeply about his patients and continues to treat patients as he serves in the Senate. What he has done is pointed out the fact that there will be much interruption, changes in the physicians' and patients' relationship. But the big picture is what the Senator is concerned about, too; that is, the tremendous indebtedness this country has by the fact that--the good chairman of the Finance Committee is here today listening patiently, and I know this has to be painful to him--half the reform we are talking about is actually putting people in Medicaid, a program that 40 percent of physicians will not see and 50 percent of specialists will not see.

Mr. CORKER. Will the Senator yield?

Mr. CORKER

Mr. CORKER. The President does not know what is in it.

Mr. CORKER. As you pointed out, in California there was almost an insurrection among students there because of the high cost of tuition, because of the fact that other programs in the State were eating up money. It is the same kind of thing that is going to happen in States across this country. Our Governor, who is a Democrat and who probably knows as much about health care as anybody in the country, is very concerned about what this is going to do--hoping, by the way, that revenues in our State reach 2008 levels by the year 2013. So he is very concerned. I know Senator Johanns from Nebraska has been a Governor. I am sure he has some things to add to this debate.

Mr. CORKER. Mr. President, I read a story this weekend in the New York Times where Medicaid recipients, especially young Medicaid recipients, have huge prescriptions taken out on them for antipsychotic drugs because basically the physicians don't want to take the time to deal with them, and so they are huge users of them. When we speak about physicians, I think it is always important to talk to one. Fortunately, we have one on our side, Senator Barrasso, who I know has treated many Medicaid recipients. I know he has a lot to say on this topic.

Mr. CORKER. Mr. President, it is pretty amazing when you think about it. We have a 2,074-page bill that includes the largest expansion of Medicaid in the history of the program. It would take about 1 page of that 2,074 pages to expand Medicaid and do no reform, and yet that is where 50 percent of the expansion is taking place. Yet, the 2,073 pages remaining don't meet many goals that many--any goals, really, other than access--any goals that Americans would stand behind. I know the Senator from Florida, who has spent a lot of time on this issue, wants to speak on this topic.

Mr. CORKER. Mr. President, I rise today to speak about the health care bill that is before us. One of the major points of contention over the last 2 weeks has been the fact that Medicare savings are being utilized to leverage an entirely different entitlement and not even taking care of the SGR issue that is so important to physicians around our country. The other important stat is the fact that half of the expansion in health care benefits that is occurring under this bill is under Medicaid, probably the worst health care program in America. After a year of discussions among many folks on a bipartisan basis, and ending up with a very partisan bill, the fact that half of the expansion is occurring in one of the worst programs that exist in our country, locking people at 133 percent of poverty into Medicaid, with no other choice, does not seem to me to be true health care reform. I know the Senator from New Hampshire, who has spoken eloquently on this issue, has something to say about that.

Mr. CORKER. Listening to what the Senator just said, I looked on the other side of the aisle and realized there is no one there. This is one of those issues. I know that on Medicare, the other side has been able to argue they are extending the life of Medicare. Yet Senator Gregg so clearly pointed out yesterday on national television that is impossible because they are taking those savings to pay for a new entitlement program. At the end of the day, it really will not be extending the life in any way. We all wonder why those savings are not being utilized now to make Medicare more solvent. I wonder what my friends on the other side of the aisle would argue in favor of the largest expansion of Medicaid. I think that would be a pretty hollow argument. I think everyone knows that it was all about money, that this was the cheapest way to try to meet some goals--by passing it off to States. I would love to hear somebody on the other side argue how health care reform, where 50 percent of the people being added are being thrown into the worst program that exists in America--I would love to hear somebody over there argue how that is good for our country. I know Senator Gregg, myself, and others have signed on to legislation that would give low-income citizens choices among private companies and, with that, vouchers, nonrefundable tax credits, and then to be able to pay for that. That is health care reform. That is something that creates robust competition, and certainly we would not have these low-income individuals locked into the dungeon of the worst health care program that exists simply because it is cheap, making, in essence, the value of their health care less than the value of ours here in the Senate. I would love to hear anybody on the other side of the aisle argue for expanding Medicaid--how that is a good thing for the citizens it covers. I see we have someone from the other side of the aisle here. Mr. President, I don't know if we still have time to talk. I know Senator Johanns has comments to make.

Mr. CORKER. I thank the Senator. That was very good. I am hearing some comments about there being a wink and a nod process taking place which is sort of what we have happening right now with the bill. We don't know what is in it, but I understand there may have been a tilt by leaders of the Democratic Party to say to Governors: If you won't raise much Cain here, we are going to take care of you down the road on this issue. I don't know if I would trust something like that to happen in this body but----

Mr. CORKER. I thank the Senator. I know of nobody who has spoken more eloquently on this topic than the Senator from New Hampshire. Before I hand it off to him, when I was in my 40-something-plus townhall meeting since this debate began, our citizens said to me they wanted the same choices I had as a U.S. Senator. This expansion for the American people is mostly being done in the area of Medicaid. I don't know if the Senator has any comment to that effect or a comment as to whether we Senators ought to be in Medicaid, if this is our idea of health care reform. I certainly hope he will close us out, and I thank him for his tremendous contribution.

Mr. CORKER. I am sure the Senator from Tennessee--if there is time remaining and if nobody is here to claim it--would like to speak. He is always good at explaining the deficiencies of this bill.

Mr. CORKER. So many Senators, so much participation, so little time. I think there is about 6 minutes left. The distinguished Senator from Utah has not yet spoken. The distinguished Senator from Idaho--a former Governor--has not yet spoken. I wondered if the senior Senator from Utah might close us out in the remaining time, just to bring this all to a climactic conclusion.

Mr. CORKER. Not just his representations, but the representations of the President of the United States. As a matter of fact, it is hard to understand any goal that is being achieved other than making sure our country has a huge indebtedness. But the senior Senator from Tennessee has talked about this very subject the Senator is talking about--about Medicaid, in essence, giving people a bus ticket, where there is no bus because of the fact that if we add these people to a system where 40 percent of physicians do not take it, 50 percent of specialists do not take it, in essence, you have people accessing a system where there are not providers to care for them. I do not know if the senior Senator from Tennessee wants to expand on that.

Mr. CORKER. Mr. President, how much time remains?

Mr. CORKER

Mr. CORKER. If the Senator will yield, I was listening to him talk about this bill being fundamentally flawed, which it is. I think back about the comments Senator McConnell said on the floor, and I think Orrin Hatch, from Utah, the other day expanded on it. Anything that is this major, this major of a reform that we are going to live with for generations, should be done in a bipartisan way. I know Senator Hatch talked about the fact that something of this size should have 70 votes, to pass a bill that will stand the test of time. Earlier today I heard a friend on the other side of the aisle talk about the fact that Republicans walked away. I don't look at it that way. But I remember very early on when we saw the basic, fundamental building blocks of this bill, almost every Republican Senator wrote a letter to Senator Reid, our majority leader, and told him if there were going to be Medicare cuts that were used to leverage a whole new entitlement, we could not support the bill. So what did the majority leader and the finance chairman, Max Baucus, do? They used that as one of the fundamental building blocks of this bill. That is paying for 50 percent of this bill--taking Medicare cuts, a program that is insolvent, and using it to leverage a new program. What I would say--and I see the leader here on the floor--I agree a bill of this size has to have bipartisan support. I don't know how you get bipartisan support, though, when almost everyone in our caucus wrote a letter in the very preliminary stages of negotiation to let them know that we considered that to be a fundamental flaw; we considered that not to pass the commonsense test. Yet it has been the major building block in causing this bill to come to fruition or to come to where it is today.

Mr. CORKER. If I could respond to that, I have only been around here by about 3 years, but I passed an incredible scene--I think many of you coming to the floor may have seen it--a huge gaggle of journalists and reporters and folks waiting outside a room where our colleagues are meeting. There is reason this bill does not lower cost. I came from a world where if you had a problem, you identified what the problem was and then you had sort of a central strategy that you built out to try to lower cost, which I think is what all of us thought that health care reform should do--let's lower cost and create greater access for the American people. Well, instead of that, we have had a process where it has been literally like 50 yellow stick-ums were put up on the wall to figure out how they could get 60 votes. There hasn't been an attempt to actually lower cost. There hasn't been an attempt to try to create a mechanism where Americans can actually choose, with transparency, the type of plans that work for them. Instead, it has been a game from the very beginning of trying to get 60 votes, and that is why none of the goals, except for one, has been achieved that they set out to achieve. This is going to drive up premiums, it is going to add to the deficit, and it is going to make Medicare more insolvent, which is pretty incredible because when I got here there was a bipartisan effort to make Medicare more solvent. Instead we are using money from that to leverage a whole new program with unfunded mandates to States, new taxes, as the Senator from South Dakota was talking about. So, again, what is happening in this room, and the reason I bring up the 50 yellow stick-ums on the wall, some of which were circled to try to get votes, that is what this has been about from day one. What is happening in the room right now is they are sitting around not dealing with the core of this bill, which is very detrimental to our country. But they are in this room trying to figure out which yellow stick-ums will get them the 60 votes. In the process, doing something that is going to be very detrimental to this country.

Mr. CORKER. I would say to the Senator, if I could, his point is so good. So many businesses in my State are saying: I wish I could go to my local banker and use 6 years' worth of cost and 10 years' worth of revenues to get a loan. They are saying: We can't do that back home. I think it is that very thing the Senator pointed out so eloquently, it is that very thing, again, that builds the huge amount of distrust. They know it does not work. They know it does not pass the commonsense test in South Dakota and Tennessee. I think they continue to again wonder: You can't make this kind of stuff up. Certainly, you can't do it back home. I thank the Senator.

Mr. CORKER. Look, I do not think that could be debated in a real way. There is no question when you add these mandates, you add the taxes, you actually drive up one of the major costs around hiring an employee in a firm. Then you add all the government intrusion. There is just the whole hassle factor of having to meet all the obligations that are laid out in this type of legislation. All those things just cause people to not want to hire folks. The thing is, it actually affects the most responsible companies most. The way this bill is written, if you are one of those companies that has not been providing health benefits, you can just pay a penalty, just pay a penalty and not cover them. But this bill actually does not just stymie job creation, it punishes the companies that are the most responsible smaller companies in our country. So, again, you all said it over and over again: The core of this bill, regardless of all the accouterments--and maybe we get three votes if we do this and lose one vote. I am sure there is some scribe in there that is confused with all the vote counting that has been taking place over the last few weeks. But the fact is, regardless of all these accouterments, the core of this bill is detrimental to our country. I certainly appreciate serving with all Senators, and I know all of us would love to see appropriate health care reform. I hope we are going to have the opportunity, after this bill is hopefully defeated, to be able to do that. I thank everyone for the time and patience.

Mr. CORKER. It is amazing the Senator brings that up. If he remembers, during the General Motors and Chrysler debate, which I know Americans equally paid attention to, there was this discussion about the fact--advocates for government funding talked about the fact that they had to compete against companies in other countries that may not provide health benefits. If you remember this whole discussion began around the fact that we wanted to lower costs, lower health care costs so our economy would be more productive. I think all of us said that is exactly what we need to do. So here we end up with a 2,074-page bill that does exactly the opposite. How we got here, it is kind of like you couldn't make this up--that a year ago here we were, as a matter of fact almost this exact time, having another historic vote around the whole issue of what might happen with these automotive companies and the big driving issue being, we can't be competitive because we have costs that they don't and all of us saying: Health care costs do make our country less competitive. So here we have a bill that is going to take us in exactly the opposite direction. This is why so many people have lost, rightfully so, faith in our ability to solve problems.

Mr. CORKER. There is no question--and return to certainty. The fact is, people, businesspeople--and I know sometimes it is hard for the other side of the aisle to see this, but it is all about the cost of delivering goods; secondly, understanding what the environment is going to be into the future. This body has been so active and this President so active producing legislation that is a job killer, No. 1, but also producing such uncertainty that they are afraid to hire. That is, again--I know I have said this before--resoundingly, that is the No. 1 reason people are not hiring people on Main Street. I do hope we stop this. I do believe this directly will kill jobs. But I also hope we will stop it and the American people will see we are working on things that save money and not things that cost money and take money out of businesses' pockets, out of Americans' pockets, which, by the way, that works hand in hand from the consumption standpoint. But this body doesn't seem to have gotten that message yet. I am feeling that a few of my friends on the other side of the aisle are greatly concerned. I hope, as the leader has said, we can stop this but then work together on something that lowers cost so businesses will actually have a desire to hire even more people.

Mr. CORKER. I met with a businessman in Tennessee on one of my more recent trips. They have an annual payroll of $4.2 million--their health care costs are $4.2 million a year for their employees. They file their tax return as a sub S company. The income from the company actually ends up being attributed to the partners. So when they file an income tax return, they don't take the money out of the company. They leave the money in to invest and make sure it is productive and they have jobs for other people. But that income is attributed to them. So he was showing me what this bill did to them. First, their percentage of health care costs is 12 percent of their payroll. He is way above the minimums this bill has said you have to be. I think it is 7 percent or something such as that. By the time he looked at the taxes that were going to be assessed to them because they filed--in other words, it was, again, their individual income, even though the money stayed in the company itself. What he was saying is: This means not only will we not hire any additional employees, we are not going to do that. But in addition, we are going to seriously look at dropping our health care plan and paying the penalties that come with this bill. I do fear, one of the things people do when they see that the government--a lot of companies in this country do things because they think it is the right thing to do. But a lot of companies, when they see government sort of mandating what they have to do or if they don't do that, there is an option for them to opt out and pay a penalty, when they feel like the government is being intrusive, sometimes they decide: Look, I am not going to do this anymore. What I would say, to answer the Senator's question is: No. 1, you end up depressing people's wages when you have these huge increases. Because at the end of the day, you have to have a profit to operate. You encourage people who are trying to do the right thing. You tax people at a level that, because of the way our taxation system works, takes money out of the company which, again, is used for productive good and to hire employees. At the very time when we are trying to create jobs--and I know you have been out here a great deal talking about the fact that we need to create jobs--we have legislation. This legislation that is before us is a job killer. The uncertainty of American companies about health care and then the fiscal issues and then this whole notion of cap and trade is, in fact, what resoundingly people across the country are saying is keeping them from hiring people.

Mr. CORKER. I think the fact is the two parties certainly have differences. We are seeing that by the huge amount of spending that is taking place right now. But the fact is, when we come together around bills, we do things that can stand the test of time. When we do that, it is not about political victory, it is about us airing our differences and seeing those places where we have common ground. I have watched each of you in your deliberations on the floor. I know very early on we talked about the fact that if we could just focus on the 80 percent we agree upon, we could pass a piece of legislation that would stand the test of time. Maybe it wouldn't solve every problem in the world, maybe it wouldn't go from end zone to end zone, but maybe if we went 50 yards down the field, it was 50 yards of solid gain for the American people, something that would stand the test of time, then we could come back and maybe get another piece of it as we moved along. I know almost everyone in this room has been a part of discussions to increase access, increase competitiveness, to drive down cost, to increase choices. This may be historic, if it passes. I actually still believe there is a chance that some of our friends on the other side of the aisle will realize that this is historic. But what is historic about it is this: If we pass this bill or if the Senate passes this bill, we will have missed a historic opportunity to work together and do something that will stand the test of time. All the energy would have been expended on a bill that does not pass the commonsense test, where the basic fundamentals are flawed. This issue will not come up again for a long time. I know how the calendar on the floor is. I certainly know about the patience of the American people. But the history part of this, we will have missed a historic opportunity to do something that will be good for the American people. That is the part, I guess, that bothers me the most.

Mr. CORKER

Mr. CORKER. Mr. President, I thank you.

Mr. CORKER. Mr. President, I ask unanimous consent that the Republicans be allowed to speak as a group over the next 30 minutes.