John Linder

Mr. LINDER

Mr. LINDER. Mr. Speaker, may I inquire as to the time?

Mr. LINDER. Mr. Speaker, I yield 2 minutes to the gentleman from California [Mr. Dreier], a colleague on the Committee on Rules. (Mr. DREIER asked and was given permission to revise and extend his remarks.)

Mr. LINDER. Mr. Speaker, I reserve the right to close.

Mr. LINDER. Regular order.

Mr. LINDER. Mr. Speaker, House Resolution 238 is a modified closed rule that waives all points of order against H.R. 2425, the Medicare Preservation Act of 1995 and provides for consideration of this historic legislation. The rule allows for 3 hours of general debate to be equally divided between the chairmen and ranking minority members of the Committees on Ways and Means and Commerce. Following the 3 hours of general debate, the rule makes in order as an original bill for the purpose of amendment, the amendment in the nature of a substitute consisting of the text of H.R. 2485, as modified by the amendment printed in the Rules Committee report. The bill, as amended, shall be considered as the original bill for the purpose of further amendment under the 5-minute rule, and the bill shall be considered as read. All points of order against the provisions of the bill, as amended, are waived. The rule provides for consideration of an amendment in the nature of a substitute numbered 2 printed in the Congressional Record, if offered by the minority leader or his designee. All points of order are waived against this amendment. The amendment is considered as read, is not subject to amendment, and is debatable for 1 hour divided between a proponent and an opponent of the amendment. The rule provides that after a motion to rise has been rejected on any day, another motion to rise may only be offered by the chairman of the Committees on Ways and Means or Commerce, or by the majority leader, or a designee of either one of them. It also provides that the provisions of clause 5(c) of rule XXI shall not apply to votes on this bill, amendments, or the conference report for this bill. I expect that we will witness many eloquent speeches--pro and con--during today's debate, and these two provisions are simply designed to limit some common dilatory motions that may unnecessarily delay the consideration of this bill. Finally, this resolution provides one motion to recommit, with or without instructions, as is the right of the minority. If the motion to recommit does contain instructions, the rule provides that the motion may only be offered by the minority leader or his designee. Mr. Speaker, in about an hour, we will all participate in a historic event that will lead us to consider a bill that will almost immediately benefit millions of seniors, and eventually, millions of Americans who will one day look to Medicare for health care service. I am honored to carry to the House floor a rule that presents our monumental proposal to save Medicare. The fight to save Medicare began in earnest on April 3 of this year when the Medicare Board of Trustees that oversees the Medicare trust fund reported to Congress that the Medicare trust fund would begin to decline next year and would be completely bankrupt by the year 2002. The alarm to take drastic and immediate action to save the program has created an atmosphere that is both exciting and anxious for Medicare beneficiaries. While many have stood on the sidelines of the debate and pointed fingers of blame, we have accepted the trustee's challenge to rescue Medicare. The resolution crafted by the Rules Committees will bring to the House floor the Medicare Preservation Act--a bill that I believe is bold enough to preserve Medicare for another generation. As I previously stated, House Resolution 238 is a narrow rule allowing both sides of the aisle an opportunity to present the case that their proposal will protect Medicare for a generation of Americans. Ours is a carefully balanced bill that is the result of thousands of hours of work by Members of this House. This rule will preserve that delicate balance, and it is common practice for most bills coming out of the Ways and Means Committee to be considered under closed or modified closed rules. It is important to note that the original legislation creating the Medicare program for millions of Americans was considered under a closed rule in 1965. Before I lay out some of the general provisions of the act, I want to discuss two specific provisions included in this rule. First, the rule provides language to ensure that all areas of the country receive equitable funding through amendments to the capitation rate formula. While funding will be distributed based upon historical costs and changing populations, the rule provides that certain minimum funding levels will be maintained. The formula guarantees that historically low-cost areas will not be penalized because of their cost effectiveness. Second, the rule adds additional language to attack fraud and abuse in Medicare. The current Medicare system is so infected with fraud, abuse, and misuse that it wastes billions of dollars each year. I doubt that any Member of Congress has not had at least one constituent at a town hall meeting or other event to show the Member an example of a fraudulent or erroneous Medicare billing. My own mother has received three such billings in the last couple of years, and I am convinced that she is not the only one who has encountered this problem. Therefore, in addition to the antifraud provisions in the base text of this bill, this rule defines several new Federal health care crimes and defines penalties of up to 20 years in prison for violations of these laws, laws focusing on fraud, bribery, theft, embezzlement, and kickbacks. This provision covering doctors and hospitals engaging in this deceit deserves to be part of the bill, and this rule provides for its inclusion in the reform package. In addition to fighting fraud, this bill will reduce reimbursement rates for doctors and hospitals and provide seniors with more choices for health care delivery. To achieve these goals, the Medicare Preservation Act adds two new programs to the current Medicare program--MedicarePlus and Medisave. Through MedicarePlus, some citizens [[Page H 10316]] will decide to choose a plan that offers fixed rates, and covers prescription drugs, and even eyeglasses. Increasingly, Americans have stated that they appreciate their managed care program, and would stay in it. This bill affords them the opportunity to choose managed care. Those who opt for medical savings accounts through Medisave would be completely in control of their own health spending. All of these changes will assure that we secure the Medicare promise we made to our seniors. We have to be clear: No benefit will be cut. You can keep your doctor and you have the option to choose any other doctor. There will be no coercion into any specific program. In fact, if a senior chooses a MedicarePlus program or chooses Medisave and then becomes dissatisfied, the bill states that the senior can always move back to the current Medicare system. We expect a very high degree of satisfaction, however, as the Congressional Budget Office has concluded that about 25 percent of seniors will take advantage of these new programs in the first few years. Over and over again, Americans have shown that they make wise choices, and this plan gives our seniors that opportunity. Medicare is a 1965 Blue Cross/Blue Shield program in which costs have simply grown out of control. For example, when the program began, the Government subsidized 50 percent of the part B premium. Yet today, the subsidy that our children and grandchildren must pay has grown to 68.5 percent. Only the greediest of the elderly, none of whom I know, would ask their grandchildren to shoulder more of this burden. Therefore, we freeze the subsidy at this level. Despite cries from the other side that we are doubling premiums, the fact is that this proposal will simply raise the part B premium about $7 a month by year 7 of this plan. The $7 is a small price to pay to preserve both the future of Medicare and the future of our grandchildren. As I have stated before, the most extraordinary development has come in those nations that have put their trust in the power and potential of the marketplace. Market forces have modernized every other segment of our society, and I am certain that they will have the effect of improving quality and decreasing costs when applied to government health care. Without a doubt, H.R. 2425 will provide seniors with more choices and result in tremendous benefits to future generations of American seniors. We fulfill our promise to our citizens with this bill. The resolution that was favorably reported out of the Rules Committee is a fair rule that will allow for careful consideration of the Republican proposal to save Medicare and a minority substitute bill. I urge my colleagues to support the rule so that we may proceed with consideration of the merits of this extraordinarily important legislation. Mr. Speaker, I submit the following for inclusion in the Congressional Record.

Mr. LINDER. Point of order.

Mr. LINDER. Point of order.

Mr. LINDER. Point of order. Is that a parliamentary inquiry or a speech?

Mr. LINDER. Mr. Speaker, I yield myself the balance of my time. Mr. Speaker, in closing, I would like to emphasize again the quote or the comment made on this floor by the gentleman from Illinois [Mr. Durbin]. Mr. Durbin said Democrats are going to lose today. They are indeed. They are going to lose control of a program that they began and have held control over and has grown entirely out of control. They are going to lose control over the lives and choices of seniors in health care, and they are going to lose control over money of future generations to pay for it. We have heard a lot of florid prose today, not to say lurid prose. The gentleman from New Mexico said, we are decimating Medicare. To decimate means to reduce by one-tenth. We are actually increasing Medicare spending over the next 7 years to $1.6 trillion. It was $924 billion over the last 7 years. That is hardly to decimate to reduce by one-tenth. Much reference has been made to the rule regarding a 60 percent vote for increases in tax rates. There is no increase in tax rates in this bill. There are no increases in taxes in this bill. But those of us in the majority wondered if some on the minority would call the part B premium a tax and call it an increase. It has been called a premium for 30 years. But it is no doubt [[Page H 10327]] that somebody would begin to call it a tax in the debate today and take up another hour of time defending it. We have heard that Republicans have never supported Medicare. Yet when it passed 30 years ago, it passed 313 to 115 with nearly half of the Republicans in this House voting yes. We heard in the Committee on Rules yesterday by the gentleman from California [Mr. Stark], that in 8 of the last 9 years or 9 of the last 10 years, I forget which number he gave us, that bipartisan bills have been introduced, Republicans and Democrats, to change reimbursement rates to attempt to strengthen Medicare. It has not worked. It is growing out of control. In closing, let me give Members one more quote that I support from a Democrat. Just 2 years ago it was said, ``Today Medicaid and Medicare are going up at three times the rate of inflation. We propose to let it go up another two times the rate of inflation. This is not a Medicare or Medicaid cut.'' That Democrat was Mr. Clinton on October 5, 1993. Mr. Speaker, I move the previous question on the resolution. The previous question was ordered.

Mr. LINDER. Mr. Speaker, I reserve the balance of my time.

Mr. LINDER. Mr. Speaker, by direction of the Committee on Rules, I call up House Resolution 238 and ask for its immediate consideration.

Mr. LINDER. Mr. Speaker, for the purpose of debate only, I yield the customary 30 minutes to the gentleman from Massachusetts [Mr. Moakley], pending which I yield myself such time as I may consume. During consideration of this resolution, all time yielded is for the purpose of debate only. (Mr. LINDER asked and was given permission to revise and extend his remarks and include extraneous material.)

Mr. LINDER. Mr. Speaker, for the purpose of debate only, I yield 4 minutes to the gentleman from New York [Mr. Solomon], chairman of the Committee on Rules.

Mr. LINDER. Mr. Speaker, that is not that parliamentary inquiry.

Mr. LINDER. Mr. Speaker, for purposes of debate only, I yield 3 minutes to the gentlewoman from Ohio [Ms. Pryce], our colleague on the Committee on Rules.

Mr. LINDER. Mr. Speaker, I am pleased to yield for the purpose of debate only 3 minutes to the gentleman from Florida [Mr. Goss], a member of the Committee on Rules. (Mr. GOSS asked and was given permission to revise and extend his remarks.)

Mr. LINDER. Mr. Speaker, for the purpose of debate only, I yield 1 minute to the gentleman from New Mexico [Mr. Schiff].

Mr. LINDER. Mr. Speaker, may I inquire as to the time remaining on each side?

Mr. LINDER. Mr. Speaker, may I inquire as to how much time remains?

Mr. LINDER. Mr. Speaker, for the purpose of debate only, I yield 2 minutes to the gentleman from Connecticut [Mr. Shays].

Mr. LINDER. Mr. Speaker, for the purposes of debate only, I yield 2 minutes to the gentleman from Florida [Mr. Miller].

Mr. LINDER

Mr. LINDER. Mr. Speaker, I believe it was G.K. Chesterton who said, ``I still believe in liberalism, but, oh, there was a time when I believed in liberals.'' The liberals today are losing their mind over losing control over the people's health care. It is not so much how much we spend, it is who decides. The Republicans want to give that decision to the people who use the health care. Let them have the same choices that we have in health care. Do you want to opt out of the 1965 style Blue Cross program? Even Blue Cross does not provide that kind of health care delivery system anymore, but we have locked our seniors into a 30-year- old system from which they cannot escape. Do we want seniors to have the choices that we have? High deductible medical savings accounts, a managed care system, to stay with their current health care system? The old 30-year-old program does not allow any choices and it gives us a health care system that is increasing in cost at three times the rate of inflation. We cannot sustain that, our seniors do not want to try to sustain that, we need to fix it.

Mr. LINDER

Mr. LINDER. Mr. Speaker, I ask unanimous consent that the following committees and their subcommittees be permitted to sit today while the House is meeting in the Committee of the Whole House under the 5-minute rule: Committee on Agriculture, Committee on Commerce, Committee on Government Reform and Oversight, Committee on International Relations, Committee on the Judiciary, Committee on Resources, Committee on Science, Committee on Small Business, and Committee on Transportation and Infrastructure. It is my understanding that the minority has been consulted and that there is no objection to these requests.

Mr. LINDER

Mr. LINDER. Mr. Speaker, I really did not come intending to speak on this, but I have heard so many fairy tales in the last 20 minutes that I thought it was worth responding. Mr. Speaker, those poor seniors that came to the Committee on Commerce seeking information, only seeking information, made a phone call before they came to the police department in Washington DC and said, what must we do to get arrested? They did it, and they were arrested. They were immediately released. That is a fact, and they were sent on their way because they in fact did disrupt a committee hearing. We have heard a lot about doctors' hidden enticements in favor of fraud. [[Page H 10294]] Indeed, we even saw a previous speaker who had an ad up, or an editorial up that headlined, Bribes for Doctors. I happen to be the only person in this room tonight that was actually in the room when that discussion was held. Doctors are given back, over 7 years in prospective revenue to doctors, $26.1 billion. The original conversion factor that the House provided for them which I believe is $24.60 was changed to the Senate conversion factor of $35.42, and that difference is $300 million. The House decided to agree with the Senate in terms of the conversion factor. That is what they call a bribe. That is hardly what the National Council of Senior Citizens would argue that they got, those very seniors who came seeking information, which was 70-some million dollars. Ninety percent of their entire operating budget comes from the taxpayer to come and lobby the taxpayer. In point of fact, the Republican proposal for saving Medicare has no cuts to beneficiaries. None. Every single beneficiary can choose to stay in the same system at the same service, at their same doctors. Mr. Speaker, we do reduce revenues to providers, both hospitals and physicians, although we reduce it less than the Clinton proposal and the Democrat proposal. We do provide major, major fraud, bribery, kickback, false filing, false swearing, major fraud aprovisions, and we believe that between the provider reductions, the hospital reductions and the fraud provisions, plus those seniors who choose to opt out of current Medicare and into a Medisave account, into a high deductible and private insurance account with a medical savings account, we think, and the Congressional Budget Office believes, that 25 percent will opt out. The Congressional Budget Office tells us that with those opting out and the savings to providers and fraud, we will save $270 billion. We are delighted with that. None of that constitutes a reduction of a single dime in terms of a provider benefit. On part B there are some things that are slightly different. Part B is the doctor portion to pay for doctor visits. Currently the law says they pay $46 per month. It is a tax, really, off their Social Security benefit of $46 a month for part B. That constitutes them paying, our seniors paying roughly 31.5 percent of the cost of their part B. We propose to keep it there. Most of the seniors that I talk to are not proud of the fact that their grandchildren are paying 68.5 percent of their benefit, but that is something that has been established here over the last year in the formula. The Republicans intend to keep it there, at 68.5 percent subsidy of seniors part B. We know that costs go up with increasing seniors and with inflation, and so the typical senior is going to expect to raise their part B contribution, that 31.5 percent that they choose to pay is going to raise about $7 a month over 7 years. In fact, the Democrat plan goes up nearly as fast, but from a lower base. Mr. Speaker, it is time for us to understand that most of America now agrees with us that Medicare is going to be bankrupt in 7 years if we do not make changes. This year, this year, for the first time, we will be giving to you to spend more money on part A than we bring in. Now, it is true, it is true that Medicare has been said to be running out of money in the past, several times in the past, and sometimes in the past running out of money in shorter than 7 years. The Democrats' proposal was to raise taxes on our children and grandchildren 23 times in 27 years. We propose not to do that.

Mr. LINDER

Mr. LINDER. Mr. Speaker, there are currently a lot of scare tactics permeating the media regarding Medicare. To me, the most frightening scenario would be if Congress and the President do nothing, Medicare will go broke in 7 years. If the program becomes insolvent, the Government can not pay the health care bills of millions of retirees. The standard bearers of the status quo are suggesting that Medicare be saved only for the next election not the next generation. They have placed politics ahead of sound policy and they clearly care more about voters than the current and future retirees. Their so-called plan was thrown together only after the media called their bluff and exposed their demagoguery. Our plan, the Medicare Preservation Act, preserves traditional Medicare for any retiree who wants it. Let me say that another way. Anyone who prefers the current Medicare system may keep it. Others will have the right to choose [[Page H 10210]] health care plans the way everyone else does. What can be wrong with that?