Bob Corker

Mr. CORKER

Mr. CORKER. Mr. President, I know the Senator has been a leader in making sure people throughout this country have appropriate health care. I thank the Senator for those comments. There is no one better to respond than a former Governor, the Senator from Idaho, Jim Risch.

Mr. CORKER

Mr. CORKER. I would like to thank the Senator from Arizona for his great leadership on this issue. I agree with all here. I would like to continue to discuss this, ``colloquize,'' if you will, and vote. That is what we need to do all weekend is talk about this issue and vote. There are numbers of amendments. But the thing that is interesting to me, I say to the Senator from Arizona--he has been one of the great champions in this country as it relates to how we live within our means. He has pointed out waste in government. He has pointed out overspending. What has happened during this Christmas season is, for our friends on the other side of the aisle Medicare has become the gift that just keeps on giving. I know the Senator talked about, during his campaign--and all of us have--that we need to get Medicare to a point where it is solvent, where seniors actually have the ability to use the benefits later on that now are in place. We have all talked about the need to make it solvent. What does the base of this bill do? It takes $464 billion out of Medicare to create a whole new entitlement. It doesn't even deal with the doc fix, as we have said many times. The reason, by the way, we do not know what this says is the leadership on the other side--this is another one of those yellow post- its. They are throwing it up on the wall just to see if it works. They are not telling us what the game plan is because they don't yet know whether it works. What they are hoping to do is to solve a major problem they have within their caucus, again, by taking from Medicare. If you think about the fact that the Mayo Clinic, which is the model for all of us, would not even take new Medicare patients, and yet our friends on the other side of the aisle are trying to throw a whole new decade of seniors into the plan, what that means is less and less seniors are going to have access to care. That is what this means. The other side of the aisle, I will have to say, based on history, I am surprised, but they continue, through their policies, to throw seniors under the bus. I do not understand what has happened. This must be about a political victory and not about health care reform. What we would do is more firmly put in place, again, bad policy. The problem with Medicare today is physicians and providers are paid fees to do more work. So now what we would be doing, instead of health care reform, which is what Senator Coburn and all of us have talked about for some time, we are putting in place, in cement, something that works poorly, that the Mayo Clinic said is damaging to them and their patients, we would be putting it in place for even more people. I thank the Senator for his leadership. I hope to be with him all weekend discussing amendments that are important and voting on those amendments. I can't imagine a better place for all of us to be.

Mr. CORKER

Mr. CORKER. Mr. President, I may not take 12 minutes, I tell the Senator from Illinois so he may plan his time. I am here to speak regarding the Gregg amendment. This health care debate, in many ways, has been going on the better part of this entire year. There are obviously differences in this body over philosophical issues and how health care needs to be delivered. One of the things I hope has come across is that all of us would like to see health care reform. I campaigned on health care reform. I used to be commissioner of finance for the State of Tennessee. In that particular role, I oversaw the Medicaid Program, which is called TennCare. I saw, firsthand, the tremendous plight of people not having appropriate health care and what they deal with on a daily basis. When I ran for the Senate--and I have been here 3 years now--I ran on the whole notion of health care reform. I have put forth numerous ideas during my first Congress, authored with others bills that I feel would have delivered health care in an appropriate way to citizens across this country. The other part of the debate, though, is not just philosophically how that is done--and we have had a lot of give and take on that--but it has been the issue of paying for something such as this. Early on, I sat down with the chairman of the Finance Committee. I have met ad nauseam with people on both sides regarding health care insurance and sent to the majority leader of the Senate a letter, signed by 36 Senators, to this effect: We all want to see health care reform. But we also want to ensure that the entitlements that are in place, and in particular in this case Medicare, are on a sound footing. We want to make sure those commitments we have made to seniors and future seniors will remain in place. And we want to make sure our country's fiscal condition is on solid footing. I could go into discussions about how we are perceived around the world as relates to our financial situation. I could talk about the value of the dollar. But I am going to speak about the one issue the Gregg amendment addresses, and that is keeping integrity in the Medicare Program. I believe the Senator from Illinois, who is going to speak in a moment, and myself would be much closer in this debate had we not begun with a fundamental building block of this bill using $464 billion in Medicare ``savings,'' to leverage an entirely new entitlement. For me that was an absolute nonstarter. I know for Senator Enzi from Wyoming it was an absolute nonstarter. We have a number of differences, but the fact that we would raid a program we all know is insolvent, that has $38.6 trillion of unfunded liabilities, that we know is going to end up creating havoc for our country if we do not deal with it, the fact that we would take savings from that program, which is insolvent, and use it to leverage a new entitlement, in my State and I think most States around the country, does not pass the commonsense test. People have lined up on both sides. My friends on the left certainly see this possibility, and certainly I am in no way implying any agenda issue, but this has become a political issue. The President obviously was over here yesterday advocating that everybody stick together and pass this bill. This one amendment we are getting ready to vote on this afternoon to me defines much of this debate; that is, are we truly as a country going to take $464 billion in savings from an insolvent program that everyone knows is insolvent and use that to leverage a new entitlement, that even when it begins is insolvent also? If you look at 10-year costs versus 10-year revenue, we know that over time, this new entitlement that might be created by this bill is also going to have tremendous fiscal implications to our country. One of the most offensive pieces of this legislation is not only will we be taking this $464 billion--and I realize the Senator from Illinois mentioned yesterday on the floor the fact that some of the things that are in this bill will lengthen the life of Medicare. I understand how the math works on that. I do. I understand that. But I think the fact that we would take, again, savings from a program that is an entitlement that people count on, that seniors count on and that future generations--these young people sitting before us on the steps, these wonderful people who have come here to help us--are going to ultimately be stuck paying for, taking that money to create a new entitlement, to me, does not make sense. The offensive part I was going to allude to is not even dealing with the SGR, the doc fix. This pays for the doc fix, or SGR, for 1 year. For those who are listening and don't know what that means, it means that physicians who deal with Medicare recipients for 1 year will not receive a 21-percent cut in reimbursements. But the very next year, there is going to be a 23-percent cut to physicians who serve Medicare recipients. This bill, instead of taking those savings and dealing with that--and over a 10-year period that would cost $250 billion, I might add-- instead of dealing with that, we are going to throw that off to the side and use the $464 billion to create a new entitlement. I do not know how anyone in this body can talk to their constituents or talk to any of us with a straight face and say that is a sensible thing to do. All of us know we have huge deficits, and even though we disagree about much of that, the stimulus, and other issues that are happening, the thing that we agree on is our country has some long-term issues that need to be dealt with. It seems to me we would show people around this world who loan us money and certainly show our citizens back home that we have the courage to deal with those entitlements. I am hoping we are going to have an opportunity to vote on a task force, a commission that will have a binding ability to cause us to deal with Medicare and Social Security in a defined amount of time very soon. But it seems to me the first huge step for all of us is to vote for the Gregg amendment today. I realize that if the Gregg amendment is adopted, the construct under which this entire health care reform bill is based would dissipate. I realize that. I realize we are creating a health care bill from something that is insolvent, taking money from it to create something that, again, will be insolvent. What I say to my friends on the left is I stand ready to talk about solutions. I have proposed solutions. I don't know how anybody in this body can with a straight face say we are being responsible as it relates to Medicare as an entitlement if, in fact, Members of this body do not support the Gregg amendment which would keep this savings from being used for a new entitlement and instead would lock it away in a manner to make Medicare more solvent for generations to come. I thank my colleagues for the time. I do believe it is the initial building blocks, the fundamentals of this bill that have kept us apart. I realize there are some emotional issues that separate Members of this body, and my guess is that Senator Reid, in his managers' amendment, in working with Senator Durbin and others, will figure out a way to resolve this issue. I know there is the issue of the public option. My guess is that will be figured out in some form or fashion on the other side of the aisle. There are other issues that I know are emotional that divide us. But the fundamental building blocks of this bill are flawed. They are flawed. It is this very issue, plus a couple of others, that has kept this body from being able to work together and has made this debate a very partisan debate. I regret that. I hope my friends on the other side of the aisle will over the next few days realize this is not something of common sense, this is not sensible. I hope they will reconvene and I hope that we together can focus on something that will stand the test of time instead of kicking the can down the road, knowing full well this is incredibly irresponsible. My guess is--and I would love to hear the Senator from Illinois dispute this--if this bill were to pass in its present form, that within a week or two, the majority will take up the issue of paying for the doc fix or not paying for it, but actually passing legislation to basically throw debt on these young men and women sitting in front of us. My guess is if this bill passes, the majority party will say: Oh, we have to deal with the doc fix; we have to deal with SGR. By the way, that is a $250 billion tab. My guess is the majority party is going to bring legislation forward in the next 2 or 3 weeks to deal with that-- or maybe not in the next 2 or 3 weeks. I guess since we have a 1-year-- within the next year the majority party will bring something forth to deal with this issue and point back to this moment of disingenuous activity on this floor. I hope that is not the case. I thank all involved. I know this has been a very vigorous debate which I hope will carry on until we get it right. But I am very disappointed that the fundamental building blocks of this bill have separated us. I hope this body will stop what it is doing in regard to Medicare, come together, and do something that stands the test of time. I realize my time is about up. I do not want to cause the Presiding Officer to tell me that. I yield the floor.

Mr. CORKER. No.

Mr. CORKER. I listened to the Senator from Illinois talking about Medicare, and I assume, based on his comments, there is a chance we may get a 100-to-zip vote on the Gregg amendment, which truly ensures that all Medicare savings are used to make sure Medicare is more solvent. The Bennet amendment, as I think the Senator knows, was parodied in the New York Times over the weekend, talking about it as toothless. It was a cover vote to give people the opportunity to be able to say they voted for something that saved Medicare, but actually the Gregg amendment does that. It puts the money away in such a fashion that all savings that are derived from Medicare are used to make Medicare more solvent. I am assuming that, since the Senator from Illinois is so supportive of ensuring that occurs, that he will be supporting this amendment.

Mr. CORKER. So what the Senator from Illinois just said is the answer is no; that they are willing to use Medicare savings to create a new entitlement and they are not willing to do something that absolutely locks away those savings so they can only be used to make Medicare more solvent. I think all of us know the Bennet amendment was a cover vote. Nothing around here that has any meaning passes with 100 votes, with 58 Democrats, 40 Republicans, 2 Independents. The fact is, the whip on the other side of the aisle, whom I respect and who is very eloquent, has just said that, yes, we are willing to raid Medicare and to take the savings from that, an insolvent program, to create a new entitlement or a new program--whatever you want to call it; I don't want to be pejorative--that is also going to be insolvent the day it starts, but, yes, we will take Medicare dollars directly. We will not do what Senator Gregg wants to do; that is, to be responsible, to try to make it solvent. We are going to lever it for a new entitlement--or a new program, whatever you want to call it--and I think, by virtue of this vote, we will see who in this body is serious about truly wanting to save Medicare for seniors and making sure young people are not hocked to the hilt in the future.

Mr. CORKER. Mr. President, how much time is there on the minority side?

Mr. CORKER. I wonder if the Senator from Illinois will yield for a question.

Mr. CORKER

Mr. CORKER. I know all of us benefit from the Senator's background as a physician and knowledge in the industry. I also thank the Senator from Arizona for spending a lifetime focusing on how special interests affect this body. I was thinking about this meeting taking place here in the Capitol not far from us from 2 to 3 p.m. with the President and 60 of our colleagues on the left, and I have this image of them being twisted up like pretzels because of the fact there are so many interest groups they have to sort of kowtow to. I have this image of a bunch of them up in a room with a yoga instructor, kind of loosening up, because they are so twisted in knots trying to basically undo all the pledges they have made to so many groups. I think about, for instance, Senator Ensign's amendment to deal with medical malpractice, but, no, the trial lawyers keep them from doing that. I think about the kinds of things Senator McCain ran on during his Presidential election campaign, and others of us have looked at, as has Senator Gregg, so that people in this country have choice; that we create a market system that allows people to have choice. But they cannot do that because the unions don't want them to do so. The unions don't allow them to cap the exclusion, which many of us have talked about. The unions keep them from doing appropriate health care reform, and so instead, what happens, in order to make this work? Again, they are so twisted up. Remember that Peter Orszag, the major guru within this administration regarding health care, has said the thing that will bend the cost curve down would be these exclusions. I am so glad Senator Gregg, who has the integrity and the longstanding knowledge to deal with this, is offering an amendment. Yesterday I was challenged on this by Senators on the other side of the aisle, but there is no doubt this bill throws seniors under the bus. We have an insolvent program that money is being taken from to create a whole new entitlement it is leveraging. If that is not throwing seniors under the bus, I don't know what is. So we have a program that is throwing seniors under the bus because the unions cannot be offended, the trial lawyers cannot be offended, so many other groups--AARP cannot be offended--and then we also lock 15 of the 31 million Americans who are receiving health care into a program none of us would be a part of--Medicaid. And they do that because of their unwillingness to address the free market issues that would make health care work in this country: medical malpractice issues, addressing defensive medicine, capping exclusions, and those kinds of things we Republicans have put forth from day one. So I think the Senator from Arizona is doing an outstanding job pointing out the conflicts of interest that exist in this bill. We have a group on the other side of the aisle that won't address health care in the appropriate way, and I believe are in another room twisted up in knots with themselves trying to figure out a way to get out of this box they have put themselves into, and a President who is basically giving them a pep talk to keep them from getting out of the box. I thank the Senator so much.

Mr. CORKER. I know Senator Enzi wants the floor.

Mr. CORKER. Madam President, I have just finished my second tour of all 95 counties in our State. In 91 of the 95 counties in our State, women do not have access to the types of medical services they should have. The reason is that this whole issue of malpractice is especially prevalent in the issue of OB. That is the area of babies being born. Obviously, a physician cannot determine if there is going to be a genetic deficiency of some kind or something else. But trial lawyers are out there waiting to ensure that no matter what happens, even if it is by the grace of God that something happens that is not so good, the fact is a trial lawyer is waiting there to take advantage of a physician. So they have just decided to leave that particular industry. We have had a bunch of side-by-side votes here. The American people understand the trickery that takes place. Fortunately, Senator McCain's favorite publication, the New York Times, pointed out what absurdity it was yesterday that we passed 100 to zip the Bennett amendment which everybody knows is toothless. Today, we have the opportunity to actually have a values vote. The American people can determine the values of each Senator. Senator Ensign has an amendment to cap the amount trial lawyers are paid. Senator Lincoln has one to cap the amount that people who are actually delivering health insurance are paid. This is a values vote. We have a nonprofit in our State that pours every bit of its money back into providing health insurance. Senator Lincoln's amendment would cap the amount that person is paid. Senator Ensign would cap the amount a trial lawyer is paid who is pursuing a physician and causing them to pay more. This is the first of a real values vote.

Mr. CORKER

Mr. CORKER. I did ask.

Mr. CORKER. I was watching this in my office.

Mr. CORKER. Mr. President, I have been listening to the debate, and it is seldom that debate on the Senate floor has much impact on me, I must add. But the fact is, I do think this amendment--the Lincoln amendment--is a terrible amendment. We should not be voting on compensation. But I am wondering, I ask Senator McCain, if we should offer a unanimous consent agreement to change the amendment to take into account AARP, PhRMA, and others. I wonder if the other side would be willing to take that unanimous consent request.

Mr. CORKER. Well, I think we have a lot of time today, so I think that will work. Mr. President, I was wondering if the Senator from Montana might educate us--and all seniors in this country who receive Medicare--if his intent is to make Medicare work better--and, by the way, I think he is, in some cases, working sincerely to do that--why is he taking those savings away from Medicare? And being the distinguished chairman of the Finance Committee, he knows as well as anybody in this country that Medicare is insolvent. Why is he not using whatever he believes to be good savings--and we may disagree with those savings--to make Medicare solvent, or at least to pay the physicians who treat Medicare recipients? They are going to get a 23-percent cut next year, and it will take $250 billion just to make them equal in 10 years. Why is he not using those savings to actually make Medicare work for the people who are already receiving it versus leveraging all the entitlement from one insolvent entitlement to another insolvent entitlement? Why would the chairman of the Finance Committee consider doing something like that?

Mr. CORKER. It is. I would rather not be any other place than on the floor talking about the most important piece of legislation we probably will deal with in our tenure here.

Mr. CORKER. I can tell. I have never seen the Senator from Arizona as happy as he is today in the fight against something that is so devastating. I don't understand what it is that would cause my friends on the left, on the other side of the aisle, to throw seniors under the bus. There is no doubt that there ought to be some changes in Medicare to make it more solvent. We all want to ensure that seniors, down the road, have the ability to benefit from Medicare. no question. I think we have all said from day one that we want to join with Senator Gregg and others to make sure Medicare is here for seniors. I do not understand--I listened to the last segment of my friends on the other side of the aisle talking about the many needs in this country. Many people don't have health insurance, and many of us have offered bills to solve that. I don't understand, and I hope you can explain it to me, why the left would be willing to throw seniors under the bus. Regardless of what you say about the bill, they are being thrown under the bus, and doctors are going to get a 23-percent cut in a year, and they are not even dealing with that, and they are taking $464 billion out of Medicare. What is it that would drive our friends on the left who in the past-- not today--have supported seniors but today are willing to throw them under the bus for a political victory? What drives them?

Mr. CORKER. Mr. President, I noticed the senior Senator from Montana referred to us being here, and I wonder if he would yield for a very short question.

Mr. CORKER. I was thinking about last year's campaign. The Senator from Arizona was highly involved in that campaign. I know he offered some health care solutions that were greatly maligned. But I think back on that, and I wonder, had our sitting President run on a health care reform bill that took money out of Medicare, which was insolvent, created a new entitlement, hurt seniors through home health, eliminated choices, making sure doctors got a 23-percent cut in a year, if he ran on a platform of health care reform that did that--had unfunded mandates to States, raised taxes--and told the American people while he was campaigning that their premiums were going to go up, I do wonder if the outcome would have been the same. As a matter of fact, I cannot imagine a health care policy being presented that is more off base than the one we are debating. But one that makes Medicare insolvent, has unfunded mandates to States when they are troubled, raises taxes and raises premiums. That is what we are discussing. Why my friends on the left want to give our President a victory on that basis is astounding to me. I don't know, but since you were up close and personal to that, I wonder if you might respond.

Mr. CORKER. I am glad to stay here.

Mr. CORKER

Mr. CORKER. Mr. President, it was interesting to hear my friend from Ohio. I plan to support the Hatch amendment regarding Medicare Advantage, but it is not because I don't believe we need to do some things to cause Medicare to be more solvent. I do believe that Medicare Advantage does have some subsidies to insurance companies that are higher than they should be. The fact is, this bill is taking money from a program that is insolvent, Medicare, and using that to create an entitlement. I will support the Hatch amendment, even though I would love to work with my friends on the other side of the aisle to do those things, to make Medicare more solvent, but I think what is so objectionable to all of us is to know that we have an insolvent Medicare Program that the trustees have said will be bankrupt in the year 2017, and my friends on the other side of the aisle are taking money from that program to leverage a new entitlement.

Mr. CORKER

Mr. CORKER. I thank the Chair. Mr. President, I am glad to be on the floor of the Senate with the distinguished Senators from Kansas and Connecticut and Montana. We have obviously before us one of the most important issues we will deal with in this body. I have had over 40 townhall-like meetings since the beginning of August. I can say without hesitation that I have never used those meetings to try to focus on some of the hot-button issues that divide us. On not one occasion have I tried to do that. I have tried to focus on the fundamentals of this health care bill. Way back when, when I began meeting with the distinguished chairman of the Finance Committee--I greatly appreciated his desire to meet with me--and realized that Medicare may be a place where money will be taken to leverage a new entitlement, I began expressing my concerns about that. Later, I sent a letter to Majority Leader Reid, signed by 36 Senators, talking about the fact that if Medicare moneys were used to leverage a new entitlement, we could not support that effort. The reason I say this is, this is the same exact thing I have been saying about this bill from day one, before it was ever constructed. I am very dismayed that we find ourselves here in December debating a bill that does exactly that. When I first came to this body, there was a lot of concern about the solvency of Medicare. Everyone here knows the trustees have stated that in 2017 Medicare will be absolutely insolvent. Two Senators from opposite sides of the aisle have tried to create legislation that would put in place a commission, eight Republicans and eight Democrats, to actually solve that issue. We realize we do not have the resources in Medicare to actually deal with the liabilities we have with seniors. The fact that we are taking $464 billion in savings out of Medicare to leverage a new entitlement, to me, is totally irresponsible. It is the same thing I have been saying from day one. I am dismayed that we would consider kicking the can down the road, making sure that people of the generation of the many people who are helping us on the floor today will be saddled with huge amounts of cost that they will not be able to deal with in a responsible manner. I am discouraged. The fact is, the other piece of this that is extremely troubling is that we all know we have the issue of SDR, the doc fix, which is a colloquial term to describe the fact that in any year after this bill passes, physicians across the country will be receiving a 23-percent cut for serving Medicare recipients. Medicare recipients understand what that means. It means they will have less physicians to deal with the needs they will have at that time. This bill, instead of dealing with that issue, deals with it for one year. What that means is there is about $250 billion worth of expenses that are not being dealt with with this Medicare savings. Let me go walk it one more time. We have a program that is insolvent. We have a program that cannot meet the needs of those people who have paid into it for years and many of us continue to pay into. This program is insolvent, and we are going to take moneys out of this program, $464 billion--something that most Americans cannot do, something that does not pass the commonsense test in Tennessee, and my guess is doesn't pass the commonsense test in most States--we are going to take $464 billion out of this program, this entitlement which is underfunded and insolvent, and we will leverage it to create a new entitlement for Americans. Yet we are not going to deal with the issue of the doc fix, which is a $250 billion issue. We are going to kick the can down the road. We are going to cause physicians around the country next year to, if this bill passes--if not, certainly they will be dealing with that this year--but we are going to cause physicians around the country another year to be concerned about these huge cuts, not deal with it in this bill, and possibly end up with a $250 billion obligation that could have been dealt with during this health care reform that now is not met, that is going to create additional fiscal burdens to this country and certainly great distress to seniors and physicians who care for them. I tried to stick with the basic fundamental building blocks of this bill. I don't think anybody in this body has ever heard me focus on some of the more emotional issues. The fact that we would use Medicare moneys to create a new entitlement, the fact that we would have an unfunded mandate to States through Medicaid of $25 billion, to me, is problematic; the fact that premiums are going to increase, whether it is the CBO number of 10 to 13 percent or the Oliver Wyman number in my State which says 60 percent, the fact that private premiums are going to go up and the fact that we are using 6 years' worth of costs and 10 years' worth of revenues--I don't know how we have gotten caught up in this debate in such a manner that we are ignoring basic fundamentals that I don't think any of us on our own accord would consider supporting. The fact is, I am afraid this, again, has become nothing but a political victory for the President. What I hope we will do is step back and do some things in a bipartisan way that will stand the test of time. I ran on health care reform. I would like to see us do responsible health care reform. The basic fundamentals of this bill do not meet that test. I see my time has expired. I thank the Chair and the Senators on the other side of the aisle who have worked hard to put this bill together. I hope they will step back away from these flawed fundamentals, and I hope in some form or fashion we will put together a bill that will stand the test of time. I yield the floor.

Mr. CORKER. Mr. President, how much time remains on our side?

Mr. CORKER

Mr. CORKER. I thank Dr. Coburn. As I listen to him, I realize we have a health care reform bill before us where half the money, $460 billion, is taken from a program that is insolvent. Instead of making it more solvent--a program that would take $38.6 trillion in the bank today, earning Treasury rates to make it solvent--it is a pretty big number-- we are taking $\1/2\ trillion out of that program to leverage a new entitlement. The reform we are getting out of that is we are moving half the folks into a program that not a person in this body would want to be a part of; is that correct?

Mr. CORKER. That is not the kind of health care reform I thought we were going to be doing. I am shocked. As a matter of fact, as I said many times, I don't think there is a person on the other side of the aisle who would vote for this bill if you and I offered it; do you think that?