John Garamendi

Mr. GARAMENDI

Mr. GARAMENDI. I guess, as politicians--all 435 of us--what happens when we get elected is we often read the polls. Hmm, let's see here: 67 percent of Americans are opposed to increasing the age from 65 to 67-- 71 percent of Democrats, 68 percent of Republicans, and 62 percent of Independents. That's pretty overwhelming. So, just to back up to what you were saying a few moments ago about the American public, they viscerally, internally, understand how important Medicare is. It's not just for themselves. They have parents, many of whom are now 65. My mother is 92. She's a Medicare recipient, and she depends upon Medicare for her hospitalization. Fortunately, she hasn't had an incident for more than 2 years now, but when she did, Medicare was there to provide the necessary services for her, and so it is for all of us who have parents who are in the Medicare system. We understand this, and we really want to make it quite clear that, as Democrats, we are in synchronization with the President on this issue. He has put forward specific proposals that over time will reduce the cost of Medicare without taking away the benefits, without changing the eligibility age. However, there are proposals--and I spoke earlier about one that has been put forth by the Speaker of the House--to increase the age to 67. No, that's a nonstarter. I'm not going to go into all the actuarial issues--which I could easily do--about why that makes no sense at all for employers, who would wind up paying more. It makes no sense at all for an individual, who is going to wind up paying more. It makes no sense to the Medicaid program, which you've already talked about, and it makes no sense in saving money. The total cost to the system would actually increase. The costs would be shifted, to be sure. No, not so. I guess I will do a little actuarial work here. Those people who are 65 to 67 years of age are more healthy than people who are 67 and above. You eliminate the healthy people from the risk pool, and guess what happens to those who are left--it's more expensive per person in that smaller risk pool. So what you want to do in all insurance programs is to increase the size of the risk pool so that the cost is shared among a larger population of people. What this proposal does is exactly the opposite. It shrinks the risk pool. It keeps in that risk pool less healthy people; it's more expensive; and those who are more healthy are outside. Yet they are now shifted on to the new exchanges that are going to be created, so the cost in the exchange is increased, and the cost for the per-person in Medicare is increased. So what's going on here? You've got to think this through. Bad idea. Bad concept.

Mr. GARAMENDI. I know. I've got to do it tomorrow. I'll get my flu shot. So these are the kinds of things that reduce costs, and the Affordable Care Act does that, not just for seniors but all the way down the board. Go ahead. You were about to make a comment. Then I want to turn to some of the pernicious things that are being proposed to Medicare and to seniors.

Mr. GARAMENDI. There are some very simple things in the Affordable Health Care Act that do reduce the cost, and this is the continuity of care. This is the kind of thing you're talking about. It is the management of a debilitating illness, for example, diabetes. If diabetes is properly managed, the kinds of extraordinarily damaging and expensive things that occur to individuals are either delayed or not happening at all. So management systems are put in place that dramatically reduce the overall costs. They cost a little bit up front because people are keeping in touch with the patient. It's not necessarily a doctor. It may be a case worker keeping in touch with the patient and making sure they're taking their medications, making sure they're doing the checkups that they need on a regular basis, getting that kind of thing. How about right now? I don't know. There are a whole bunch of people in this room--435. They're not here today, but how many have gotten their flu shots? If you want to reduce the costs of health care, get your flu shot. I think I'll go do that tomorrow.

Mr. GARAMENDI. That's a very good point, but let me interrupt. They were calculating an inflation rate that continued at this level. They did not calculate a reduction in the inflation rate. And in the more recent estimates of cost savings, they're now looking at this difference here. They're looking at a lower inflation rate. This saves billions upon billions of dollars in the Medicare system. So we are seeing that. I don't want to let a point go by that you raised, and that is, yes, all of us Democrats were whacked over the head in the elections about the $720 billion. I was, you were, and I suspect the rest of us were also. The $720 billion of savings reductions in Medicare did not come from benefits. In fact, the benefits were increased just as you said. I don't know how many times I said that over the last several months, but I'm going to say it again: it didn't come from there. It came from three areas. You said this earlier, and it bears repetition. First of all, it came out of the pockets of the insurance companies that were providing the additional Medicare insurance coverage; secondly, it came out of fraud and abuse; and, thirdly, it came out of payments to medical providers that were not performing good services. Specifically, one of the biggest were hospitals that had high infection rates. The Affordable Health Care Act said, we are not paying for the second admission when there is an infection acquired in the hospital. This is really good news to every Medicare beneficiary because suddenly the hospital goes, Oh, you mean we are going to have to pay for the cost of a readmission because of an infection? The government's not going to pay for it any more? Maybe we ought to clean up our act. Maybe we ought to have a little bit of hygiene in this hospital. We are now seeing a significant decline in the hospital infection rates. It's not expensive for hospitals to do, but extremely important for every individual that goes into a hospital, whether you're on Medicare or otherwise. Hospitals are now paying attention to hygiene, cleaning up, washing hands, other kinds of very simple, inexpensive things that keep people healthy and reduce the cost of Medicare and general health care.

Mr. GARAMENDI. Exactly. As those other services roll out, they will affect not only the Medicare portion of the health care system, but they will also affect the general population and should, because of the availability of insurance and the availability of the ability therefore get to a doctor, to get the continuation of care, should bring down the overall inflation rate for health care, which will dramatically affect Medicare, as well. What we are on is a track that is reducing what they call ``bending the inflation curve.'' It's happening. Here's the most dramatic chart that I've seen on this issue, that we are, in fact, bending the cost curve. And perhaps even more important, senior citizens are healthier. They're healthier. They're getting better care. They're getting more care.

Mr. GARAMENDI. Only in a free-market system would Congress pass a law to prohibit negotiating prices, which, I think, is kind of the essence of a market system. You raised a couple of points, and I just want to use a chart to expand on those points. The Affordable Health Care Act--ObamaCare-- really significantly enhanced benefits to Medicare recipients 65 and older. They got some really important benefits. You mentioned the drug benefit, benefit part D, the doughnut hole that is being closed. That's worth, I think, some $55 billion a year to seniors. There's other things that are in the Affordable Health Care Act that have already saved vast amounts of money to the Medicare program. For example, annual wellness visits for seniors. Why is it important? Well, you find out certain things, like you've got high blood pressure. And you take a pill--we ought to be negotiating that price--but you take a pill, and suddenly you're able to reduce your blood pressure and avoid a stroke, avoid some other kind of medical incident. You may find that you're on the path towards diabetes or other kinds of long-term, very expensive illnesses. So that wellness visit becomes exceedingly important, and also some treatments are available. Here's what's happened. Because of ObamaCare, the inflation rate in Medicare has been dramatically reduced. If you take a look at this particular chart, over the years it shows that beginning in 2005 and now in 2012, the annual increase in cost, the inflation rate in Medicare--it peaked in 2005, and then it began to come down. Here is the Affordable Health Care Act, or ObamaCare, and we have seen a decline to about 2\1/2\ percent inflation, which is actually less than the general health care inflation rate in the economy. This has occurred because of multiple factors, perhaps--and it's arguable, but we think one of the major factors is the advent of ObamaCare, or the Affordable Health Care Act, and the kinds of programs that are in the Affordable Health Care Act for Medicare recipients that reduce the cost of medical services.

Mr. GARAMENDI. Pain, serious pain.

Mr. GARAMENDI. Sheila Jackson Lee, thank you very much. I hope you are able to stick around. Jan.

Mr. GARAMENDI. Sure.

Mr. GARAMENDI. I thank you for bringing this issue back. And I don't want to leave it right yet. Our colleague from Illinois started her discussion with the values, the values that we Americans possessed back in the 1960s when Medicare began. That was the value of caring for each other, particularly caring for those seniors who at that time had 50 percent in poverty, I think 70 percent without insurance, and a very bad situation. I remember when I was a youngster, not even a teenager yet, my father took me to the county hospital. You mentioned the word poorhouse. That's what it was. And that is etched in my mind to this day, what was happening in that county hospital. It was just row after row of beds down a long ward. The cries, the sounds, and the odors were unbelievable. That was the only care available. And then Medicare came in. And we have moved to a different place, fortunately. Our values as Americans expressed in the most meaningful way, taking care of seniors, the issues of poverty, largely eliminated--no, that's not true. The issue of poverty among seniors substantially changed. We still have too much poverty. But medical services available, quality medical services that have extended the life of many. The point you were making about not everybody is so very, very true. As you were talking, I was just thinking, I read something about this, though increasing overall life expectancy at 65 has not increased equally across the social economic status, from 1977 to 2007, life expectancy for the top half of earners increased by 5 years, but only 1 year for the bottom half of earners. So, once again, you have this disparity class, if you would. White men without a high school diploma have a life expectancy of 67.5 years as compared to 80.4 years for those with a college degree. Once again, two different societies in America. Since 1990, life expectancy for the least educated whites has decreased--decreased--by 4 years. And now the argument is that we can increase the Medicare eligibility age to 67 because people are living longer. Hello? Who is living longer? Those who have higher incomes. Those who don't--and you said it so very well--those who work with their hands, whether they are a maid cleaning a hotel room or a farmer or a coal miner or any other task which is labor intensive, and that's physical labor intensive--by the time they get to 65, they're broken. Their body is broken. And to deny them the opportunity, I can tell you everybody I meet who is not 65 wants to live long enough to get to 65 and Medicare. So for our Republican friends, their principal negotiator has put on the table, the Speaker of the House has put on the table let's raise the eligibility age. Jan, you were talking about this earlier--let's go back at this--this is a fundamental dichotomy in how we value our seniors, how we value each other and how we are compassionate.

Mr. GARAMENDI. Let's describe the Senate bill.

Mr. GARAMENDI. Your points are so very, very well taken. It seems as though--you call it a trophy. The argument made by some is that we ought not raise this top tax rate, but you ought to hit the Medicare program, the beneficiaries, and make them pay more. As you've said, they're mostly middle class and poor. So what's that all about? And raising the age to 67 is really stupid. There is no other way to describe that. I was the insurance commissioner in California for 8 years, and let me tell you, you raise that age to 67, a lot of very, very bad things are going to happen. First of all, people between 65 and 67 are not likely to get insurance at all, let alone affordable, for the reason you said. That's the population that is almost uninsurable under the present system. Even with the Affordable Health Care Act, they're going to wind up paying a huge amount of money, and you're shifting the cost to them, to their employers, and to their State and local governments. You've saved no money. In fact, you've probably increased the cost because the benefits that go to seniors in the Affordable Care Act are not available to them, such benefits as annual checkups, medical services keeping people healthy. I'd like to come back to that in a little while, but I noticed our colleague from the great State of Texas is with us. Thank you for joining us once again to talk about something that I know you've spent your career here in Congress working on: Social Security, Medicare, and Medicaid.

Mr. GARAMENDI. So the argument that you've got to means-test this program is, Yes. And we do.

Mr. GARAMENDI. Exactly. The amount that you pay into Medicare is higher as your income goes up.

Mr. GARAMENDI. Let me just interrupt for a second. You started to discuss Social Security. I think what you meant was Medicare, which is where you have been taking the discussion. Medicare part B is means- tested--and has been since its inception.

Mr. GARAMENDI. Mr. Speaker, thank you for the opportunity. We're going to spend a good portion of this hour talking about something that is on everybody's mind, the fiscal cliff. Oh my goodness, the fiscal cliff is now just, well, 20 days away. So what are we going to do? Some have suggested that we really have to deal with entitlements, and I'm here to agree that we can and we should deal with entitlements. Certainly, two of those issues, which I really don't think we ought to call entitlements, but they happen to be fundamental programs here in America for Americans, should be dealt with. One that some people want to put on the table really doesn't deal with the deficit at all, and that's Social Security. So before we even get into this discussion tonight, let's just understand, for anybody that cares to take on this issue, that in dealing with the fiscal cliff, Social Security is not the problem. The deficit is not caused by Social Security. Social Security has never been and in its present form will not be part of the deficit issue. It's separate and apart. It is a special program, has its own source of revenue, has its own trust fund, and frankly, is not even running a deficit at all and has not run a deficit. So let's put Social Security to the side and say, yes, in the years ahead, maybe even next year, but probably 3 to 4 years out, Social Security will be dealt with, as it must, because we will have to make adjustments. But that is really not the debate about the deficit, sequestration, or the fiscal cliff. Coming back to the fiscal cliff, let's take up one of the very big programs, and I'm not talking here about the Department of Defense, which is one of the major expenditure items, but that's not the subject for tonight. Tonight the subject is Medicare and Medicaid. The Medicare program is a big one, and it certainly is a program that is expensive. It's a program that, over the years, has grown on the average faster than inflation. But, in the last 2 years, that's not the case, and we'll discuss that in more detail later. In fact, Medicare has fallen below the general rate of health care inflation. Let's talk about what we can do about Medicare. Instead of saying what we ought not do, we're going to start this discussion, at least my portion of it, talking about what we can do. And the President has put out several ideas that deserve the attention of the 435 Members of this House and the 100 Senators, because there are things that really can be done immediately to significantly reduce the cost of Medicare. Just in listening to my colleagues here on the floor discuss the departure of some extraordinary Members from the Ohio delegation, I came across an article in one of the local Hill newspapers, and this article says, ``GAO hits Medicare and Medicaid wasteful spending.'' Turns out that the GAO just issued a report, came out just this week, that Medicare had, in their estimation, $28 billion in fraud and wasteful spending in the year 2011--$28 billion. And in Medicaid, some $21 billion. Now, the President has suggested that one of the things we ought to do to reform the Medicare system and the Medicaid system is go after waste, fraud, and abuse. Well, there you have, what, 50-plus billion dollars of annual fraud, waste, and expenditure in the Medicare system. That goes a long way to solving the Medicare problem. And we ought to do that. And, in fact, a lot of that was done in the Affordable Health Care Act, and systems were put in place and they're working today. But there's even more that can be done, according to the GAO. And if we're going to start dealing with Medicare, why don't we start right there with that issue and perhaps some $50 billion, or if you want to be a little conservative, let's just say 40 or $30 billion that we can reduce immediately. By the way, this is going to take a few Federal employees to do that. Interestingly, in the Affordable Health Care Act there was a provision that added several thousand, a couple of thousand employees to the IRS for the specific purpose of going after Medicare and Medicaid fraud. Well, they were added, and then our Republican colleagues, in a fit of--well, just in a fit, decided that they would somehow save a lot of money by eliminating the men and women that were supposed to be hired to go after fraud. They tried to do it. Fortunately, they were not successful. I'm going to just name a couple of other ways in which we can reduce the cost of Medicare, and then I want to turn to my colleague from Illinois to expand on some of these issues. Very quickly, how about drugs? Would you believe that the Federal Government has no power to negotiate the price of drugs for seniors in the Medicare program? It's true. Congress passed a law back in the 2003-2004 period that denied the Federal Government the ability to negotiate prices. We could save a pile of money right there. There's some other things we can do--and some of this is already underway. We could penalize hospitals that have high infection rates; readmission to hospitals. Well, the Affordable Health Care Act is already doing that. And it's having an effect. We could also deal with the issues that occur with unnecessary payments. We can reform the system in the way in which payments are made so that they are more efficient and more effective. And those have been proposed by the President. In fact, there are many, many things that can be done to significantly reduce the cost of Medicare without doing the onerous, damaging proposals that have been made by many of our colleagues on the Republican side, such as increasing the age to 67 when you could apply for Medicare--and we'll discuss that in much more detail in a few moments--and such as going after the privatization of Medicare. Some really bad ideas are out there. And we don't need those bad ideas. What we need are some really good, solid ideas. Let me turn to my colleague from Illinois, Jan Schakowsky. This is a woman who's been deeply involved in this issue. She was on the Simpson- Bowles Committee. That's not the formal name but that's how we know it--the Simpson-Bowles Committee. And she's focused specifically on Social Security and Medicare. She's joining us tonight with extraordinary background and information on this. Jan, let's talk for a few minutes about your experiences and what you think we can do.

Mr. GARAMENDI

Mr. GARAMENDI. Mr. Speaker, I come to the House floor to celebrate the life of one of California's greatest native sons, the Ambassador of Jazz, Dave Brubeck. The man behind the immortal classics like ``Take Five'' and ``Blue Rondo a la Turk'' was born in Concord, California, a city I'm proud to represent. Drafted to serve in General Patton's Army during World War II, he formed the Army's first integrated band. He would later tour with black musicians in the Jim Crow South during the height of the civil rights movement, insisting on a mixed-race quartet and integrated crowds. Because of this courageous stand, 23 out of 25 of his shows were canceled one summer. ``Jazz is the voice of freedom,'' he said. With suave sophistication, Brubeck would become a leader in the West Coast cool jazz scene, putting California jazz on the map. Dave Brubeck performed before Presidents, Prime Ministers, Premiers, and pontiffs. He was named a Jazz Master by the National Endowment for the Arts, and he was awarded the National Medal of the Arts. On a personal note, during the 16 years I represented Stockton, Brubeck often came there to help the University of the Pacific and many charities. Today, I hope everyone can Take Five to remember a remarkable American: Dave Brubeck.

Mr. GARAMENDI

Mr. GARAMENDI. Mr. Speaker, I rise today to honor Sergeant Kauffman, Captain Mihelich, Officer Blasingame, and Officer Golez of Fairfield, California. Sergeant Kauffman will retire after nearly 30 years of law enforcement service with the City of Fairfield. He was hired as a Public Safety Officer with the Fairfield Police Department on July 5, 1983. Sergeant Kauffman served the community in a number of non- emergency patrol functions while putting himself through the police academy. After graduation, he was re-hired as a Police Officer on June 30, 1986 where he worked in various capacities that included Patrol, Investigations, Solano Narcotics Enforcement Team (Sol-NET), and Field Training. Sergeant Kauffman earned the Police Officer of the Quarter award in November 1999 for his reliability and commitment to community service. On December 31, 1999, he was promoted to Police Corporal and then earned the City Manager's Commendation on July 28, 2003 for his contributions and dedication to the City's Driver Training program. On March 3, 2006, Sergeant Kauffman was promoted to Police Sergeant and ultimately supervised a number of different units including Patrol, Professional Standards, and Major Crimes. In 2009, as the Police Department experienced changes in leadership and command staff, he stepped in and assisted City management in filling the gaps. Sergeant Kauffman assumed the Police Lieutenant's position and managed Patrol Operations for several months. He has a can-do attitude and he consistently provides quality service to the community. Sergeant Kauffman has been a valued employee and leader, and his commitment to the community was evidenced on a daily basis. He was a loyal representative of the law enforcement community and admired for his hard work, dedication, and positive work ethic. Captain Mihelich will retire after nearly 29 years of law enforcement service, with 25 years of that service to the City of Fairfield. After serving over three years as a Reserve Officer and Police Officer with the South San Francisco Police Department, Captain Mihelich was hired as a Police Officer with the Fairfield Police Department on October 12, 1987. As an officer, he worked in various capacities that included Patrol, Investigations, Drug Abuse Resistance Education (DARE), Special Operations, Gang Suppression, Special Activity Felony Enforcement (SAFE) Team, and Field Training. Captain Mihelich was promoted to Police Corporal on December 31, 1999 and then to Police Sergeant on December 28, 2001. He skillfully mentored and supervised units in Patrol and Training & Personnel, and was named Manager of the Year in 2006. After being promoted to Lieutenant on June 6, 2008, Captain Mihelich served as a Commander for Patrol, Quality of Life, and Administrative Services Bureaus. He was a strong and decisive leader and as the Police Department experienced changes in leadership and command staff, he consistently stepped in and assisted City management in filling the gaps. He assumed the Police Captain's position and managed the Support Services Division beginning in April 2011 before being formally promoted on February 10, 2012. Capitan Mihelich has been a valued employee and leader, and his commitment to the City and community was evidenced on a daily basis. He was a loyal representative of the law enforcement community and admired for his hard work, dedication, and positive work ethic. Captain Mihelich is commended for his selfless contribution to Fairfield and its constituents. Officer Blasingame will retire after 30 years of law enforcement service, with 23 years of that service to the City of Fairfield. After serving seven years as a Correctional Officer and Deputy Sheriff with the Solano County Sheriff's Office, he was hired as a Police Officer with the Fairfield Police Department on September 25, 1989, and served the community in a number of capacities within the Patrol and Investigations Bureaus. Officer Blasingame has received numerous commendations from citizens and coworkers for his consistent and skillful performance. Some of his most significant contributions to the Police Department have been sharing his knowledge and experience of solid investigative skills, exceptional memory, and quality reporting techniques with fellow officers. Officer Blasingame has been a dedicated team member, mentor and positive representation of the Fairfield Police Department. Officer Golez will retire after nearly 30 years of law enforcement service to the City of Fairfield. He was hired as a Public Safety Officer with the Fairfield Police Department on January 7, 1983, and served the community in a number of police and fire functions until he attended the police academy in early 1985. After graduation, he was promoted to Police Officer on May 20, 1985, where he worked in various capacities within the Patrol and Traffic units. Officer Golez has received numerous commendations from citizens and coworkers for his consistent and exemplary performance. Some of his most significant contributions to the Police Department have been the development of the Police Cadet Program and sharing his motorcycle expertise with fellow officers. Officer Golez has been a dedicated teacher, mentor and a positive representation of the Fairfield Police Department. Sergeant Kauffman and Captain Mihelich will be presented with their retirement memorabilia at 3 p.m. on Thursday, December 13, 2012, during an Employee Recognition reception in Willow Hall at the Fairfield Community Center. Officers Blasingame and Golez will be recognized in early January. All are welcome to join the celebration of these distinguished careers.

Mr. GARAMENDI

Mr. GARAMENDI. How about next week? We'll come back to the floor next week, and we'll pick up the issues of infrastructure, of jobs and the like. This week we need to focus on what has been put on the table by the Republicans and the Democrats on how to deal with the fiscal cliff, dealing with the issue of Social Security and Medicare. Social Security--no, not part of this problem. It is something we'll deal with perhaps in the next Congress or even in the one beyond that because we do have time to deal with Social Security. Medicare--for those who want to privatize Medicare, end it as we know it with a voucher or a premium support program--no. No way, no how are we going to go there. For those that want to work on changing the way in which Medicare operates to get savings, such as negotiating drug prices, dealing with fraud and abuse, the various payment systems that are in Medicare, all of which can save money and to continue the work of the Affordable Care Act, and the way it has already brought the inflation rate down from the 4 percent, 5 percent range down into 2, 2.5 percent range, this is an extraordinary savings right here. And that will be calculated in the years ahead. And, frankly, this will add up to hundreds of billions of dollars in the reduction and the projected cost of Medicare in the years ahead. So we're making progress. We've got work to do, and we're prepared to do it. The Democrats are prepared to put together a compromise. Let's get to work on it. The American public expects us to do that. And we can, and we will. With that, Mr. Speaker, I yield back the balance of my time.

Mr. GARAMENDI. Well, you are certainly well stating my position and I believe the position of our colleagues and I believe of the President. Social Security is not part of the current deficit problem. It is an issue. We'll have to deal with it at any time between now and the next 7, 8 years. And we can. It's been done before. At least three times in my memory, Social Security has been adjusted. One was discussed earlier with the issue of the COLA. That's been adjusted. There are things that can be done to deal with Social Security, but that is a debate separate and apart from the deficit and the fiscal cliff debate. The fiscal cliff debate is a tax issue, and it's also a spending issue. Today we focus largely on the issue of what are we going to do about Medicare, a big part of the Federal expenditures. And our argument is this: we're here to protect Medicare for seniors, period. We're not here to cut the benefits for seniors. We're here to see to it that Medicare, which has been a program for seniors since 1964-65, is going to continue to be there for seniors as well as the benefits package that's there. There are reforms and changes that can be made to reduce the cost of Medicare but not to reduce the benefits. We've talked about many of those. So here's where we're coming. Within that area, there are very, very significant savings that can be made. The prescription drug benefit, $150 billion over 10 years. Other issues having to do with keeping people healthy, to extend their health care, issues having to do with how much we pay for certain services, fraud and abuse. All of those things could add up to the potential savings--not the potential savings--to the savings that the President has called for, which is somewhere in the range of $300 billion over 10 years--additional savings over and above what has already taken place in the Affordable Care Act. And we've seen in this decline in the inflation rate in health care some of the effects of the Affordable Care Act. So there are things that can be done and will be done. Social Security is not a part of this debate. But I also want to point out here in the last closing minutes of this a couple of things that I think are very, very important. The President has put forth a very detailed program calling for $1.6 trillion in additional revenue over 10 years; and that is money that is to come from the expiration of the George W. Bush tax cuts for the top 2 percent. Now I want to make this clear. I said this earlier--yes, it's worth repeating because it's not said very often--every American taxpayer gets a tax reduction. The superwealthy to the very minimum taxpayer in this Nation gets a reduction in what the President is proposing. And that is to continue at the current tax rate for those with under $250,000 adjusted gross income. For those who have income over and above that, they get that tax reduction. And above that, they're going to pay an additional amount up to 3.9 percent in two different tranches. So everyone gets a tax break. But those superwealthy, the 2 percent, they're going to pay more, and that will amount to a substantial amount of money over 10 years. And, frankly, they've had 12 years of really low, low taxes--the lowest taxes, really, ever since the 1930s. The President has also proposed something that's very important. We talked about this last week. I want to talk about this again the next time we come here. And that is, how do we grow jobs? How do we put people back to work? The President has proposed an additional $50 billion. He did this more than a year ago in the American Jobs Act, and he's put it back on the table: $50 billion in infrastructure. Let's build the foundation. That deserves a lot of discussion; and, frankly, it's something we ought to enact here right away and put people back to work. There are other savings that he's proposed over the course of the next 2 years. We don't have time now. I notice my time has just about expired, if you would like to take a final shot at this, Mr. Curson. And by the way, this is the first opportunity I have had to spend part of my hour with you. You are a very articulate spokesperson for the working men and women in this Nation. You know the issues of Medicare and Social Security so very, very well. And I know, coming from Michigan and Detroit, you know the need to build the jobs portion of our economy. So why don't you close, and then I will wrap this up.

Mr. GARAMENDI. Well, there are certainly a series of things that we know we can do to reduce the cost of Medicare. Some of those are already in place. They've been brought forward by the Affordable Care Act. Others are yet to be done. The prescription drug issue is out there, enormous savings, $160 billion or $150 billion right there over a 10-year period. The fraud in the system, some of that was dealt with with the Affordable Care Act, but there's much more that can be done. There are fraudulent billings for durable medical equipment as well as other kinds of services that are provided. Those need to be addressed. The systems that are being put in place, that is, moving away from fee-for- service, will significantly address that. In the area of hospitalization, again, there are programs that are viable, that are not yet implemented, that are not part of the savings that have already been calculated, for example, programs on the dual eligibles. The dual eligibles are those people that do not have sufficient income, but are already quite ill that may be 20 years of age, and they're getting Medicaid as well as Medicare. There are savings that can be found in the way in which we organize that. For those seniors that are on Medicare, an organized health care system that keeps them healthy, that is, taking the prevention program a step further, or two or three steps further, so that there is a continuity of care and there is a follow-up, maybe a social worker or simply somebody on the phone saying how are you doing; are you taking your medicine; are you able to get the food that you need so that people can stay healthy. A healthy population significantly reduces cost. The use of the Affordable Care Act--not just for Medicare, but for the total cost of the system--has a very, very powerful cost reduction in it; and it's called ``insurance.'' Forty million Americans are going to be insured. That means that those people are less likely, far less likely to go to the emergency room to get their care. The Affordable Care Act also provides for clinics. Where a private doctor may not be available, a clinic would be available. So all of these things provide more care to people and, in doing so, reduce the cost of the extraordinarily expensive care that comes from when people don't get continuing services of health care. So Medicare is a huge issue before all of us. On the Democratic side, we're saying, yes, there are savings available in Medicare, we should take advantage of those, but we're not going to cut benefits. And we're not going to privatize Medicare or end Medicare as we know it. There are other things that we can do, we're willing to do it; let's compromise on those things that make sense without destroying the Medicare program. Not on our watch are we going to see the benefit package reduced in such a way as to harm seniors--no way. And no way are we going to end Medicare as we know it. We'll draw a line in the sand; we'll save the money; we'll put that cost curve even on a better trajectory, and that is a very, very formidable and positive trajectory there. Let's spend just a moment of time, as we come towards the end of our time, on Social Security, which many people--well, not on the Democratic side, but let's talk about Social Security and should it be on the cutting table here, should it be part of the deficit reduction. Mr. Courtney.

Mr. GARAMENDI. I think it really would add cost. We discussed earlier that the Affordable Health Care Act has a very powerful cost-saving mechanism called Staying Healthy. And that is the prevention programs. If you move that age from 65 to 67, you're going to have a significant population of seniors who will not have access to that preventative medicine program. It's not going to be there for them. So the potential for them to develop long-term, debilitating diseases increases. And when they get to Medicare, they will be much more expensive, to say nothing of what happens to them during that 2-year period when they can't get to Medicare. You said something earlier on and I'm going to go back to this. You talked about what happened before Medicare--the 50 percent of the population of seniors without medical insurance, the poverty rate. When you said that, my mind flashed back to when I was a young man in the 1950s--actually, not even a teenager--my dad took me to the county hospital. We were ranchers out in the boondocks of California, and nobody had insurance who was in their senior years. The county hospital sticks in my mind as the reason for Medicare. It was beyond horrible. There was just a row of beds, the most horrible odor in that ward-- people dying. It was so compelling. And today, there are issues out there. But we have seen the population of seniors healthy, living longer--20 years longer than they were just 45 years ago--50 years ago now. This is so important to seniors. And it is the Democratic Party that has stood for Medicare all of these decades. And we're not going to let it go. We're not going to let Medicare go. It is a foundation of our humanity and our compassion as Americans for all because all of us want to live long enough to get into Medicare. Reforms are possible. We've talked about several of them here today. I know that our colleague from Michigan spoke earlier. If you'd like to come back in and talk about this, we'd welcome you. We'll go back here for a little longer. Mr. Curson.

Mr. GARAMENDI. Mr. Welch, we will do it. Mr. Courtney from Connecticut has some ideas about other things that we can do.

Mr. GARAMENDI. If I might interrupt you for a moment. Under the current law, the U.S. Government Medicare program, it is prevented by law.

Mr. GARAMENDI. Mr. Courtney of the great State of Connecticut, thank you very much for bringing this information to us. Your chart is a dramatic one, when you consider the period of time and the extraordinary reduction in the inflation rate in Medicare. If you had another line on that showing the general inflation in health care for the general population, it would actually be above Medicare, that entire slope all the way down. And it's significantly above it. So what's happened--in part, I think, you're correct; there may be other forces involved here, but certainly you can see the effect of the Affordable Health Care Act. And you identified very well some of the critical cost savings that are in that. And it's well worth repeating it, which I will do with you. And we ought to go back so the public comes to understand what was in the Affordable Health Care Act. For those over 65 that are in Medicare, those changes are critically important. First of all, stay healthy. If you want to save money on hospitals and doctors, stay healthy. And so you have an annual wellness visit. I think something like 50, 60 million Americans have been able to take advantage of that free annual visit. You've got high blood pressure? Well, let's take some blood pressure medicine. You're headed for diabetes? Here's a dietary program or exercise program. We can deal with those. You keep people out of the hospitals. The hospital infection rate, the other one you talked about, very powerful. I hear from hospitals in my district, and I'm sure my colleagues do also. They don't want that readmission because that comes right out of the hospital's pocket. And also there's a penalty. So there are many, many issues here that are involved in the Affordable Health Care Act that have caused that slope downward to continue. Enormous savings to Medicare. Because when you look at the Medicare issue, it's a projection for 10 years. And the projected rate 2 years ago was 5, 6 percent. And where are you, down in the 2 percent range now? Those are multibillion dollars a year the American public will not have to pay in taxes and increases in expenditures. So these things begin to add up. But there are many, many more savings. I don't want to dominate all this time. I see that other of our colleagues have come and joined us. Peter Welch from Vermont.