Nancy Pelosi

Ms. PELOSI

Ms. PELOSI. Mr. Speaker, last week the gentleman from California [Mr. Lantos], the gentlewoman from California [Ms. Woolsey], and I held a field hearing in San Francisco on the impact of the extreme Republican proposals to devastate both Medicare and Medicaid, and all this devastation has wrought to pay for a tax break for the rich, yes, a tax break for the rich. The Republican proposal would cut $270 billion from Medicare and $182 billion from Medicaid programs. Over 50 percent of the tax break will go to the highest 6 percent income earners in the country, over 50 percent of the tax break goes to the highest 6 percent of the population. The hearing was very revealing. We had an extraordinary list of panelists who are respected in their fields who presented their views on the impact of these drastic cuts. First, we heard from individuals, experts, really, because they can say directly how these cuts would affect them. The first panel was comprised of representatives of working families, mothers and children and seniors. Our first witness was a pioneer in the field of women's health and women's rights, Del Martin. At age 74, Del was a delegate to the White House Conference on Aging and is a respected community leader. Del said seniors are more than willing to carry their share of the deficit reduction burden. We are told that Medicare is responsible for only 6 percent of last year's Federal deficit. Why then, why then is Medicare being cut by 35 percent? That is not fair. Congressional leaders refused to even consider eliminating tax breaks and loopholes which primarily benefit the wealthy. You do not need a PhD in economics to know there is something drastically wrong in this balancing act. Del went on to say in her testimony the increase in Medicare costs for her personally projected over the Republican plan would amount to over 27 percent of her income, and this percentage would increase as her income diminishes as time goes by. She said as she grows older, that if this Medicare plan is put into effect, her children may have to help her, and that is why these Medicare and Medicaid cuts, these drastic cuts proposed by the extreme Republican majority are of concern to not only our senior citizens but our middle-aged, middle-income families and children in America. I think it was Betty Davis who said, Mr. Speaker, growing old is not for sissies. And being elderly in our country and being faced with these cuts in Medicare and Medicaid will have a devastating impact on America's families, because if our parents are not cared for, the delivery of service is not paid for by Medicare and Medicaid, then who is going to pay? Under the Republican plan, I will tell you who is going to pay. The Republicans will have a call on the income of the working children of those parents from those elderly parents. The Republican plan will say that a woman, a spouse whose husband has gone, say, to a nursing home under Medicaid will not be able to retain even the $14,000 per year that she is now allowed to save. That money will have to go for her husband's care in the nursing home, and she will be pauperized and not able to stay in the community, and that the Republican plan will allow States to call on the home that that spouse is living in, in order to pay for her husband's care in the nursing home. So this strikes right to the economic and health security of our senior citizens, but also the economic security of their children as those working married children who are trying to raise their own families will now have more responsibility for the health care bills of their parents. Another member of the panel was a remarkable young woman, Melica Sadasar, who is director of Family Rights and Dignity, an organization for homeless and low-income families. She spoke to the consequences that changing Medicaid into block grants would have on poor children. She said the decision to block grant Medicaid relegates mothers and children to a caste of disposable human rights. These political decisions simply say that our children, that their lives are not valuable, that their futures are irrelevant. This is political savagery, she had said. This is child abuse masquerading as congressional legislation. ``How can we say to an entire generation of children that their country will not protect or invest in them?'' Mr. Speaker, I contend that these changes in Medicare and Medicaid will not lead to balancing the budget or reducing the deficit. Indeed, the best way for us to do that is to invest in human capital, to invest, to intervene earlier if someone is sick or in need of care, rather than waiting until the bill is so much higher. Finally, on that panel, Mr. Speaker, Bruce Livingston, the executive director of Health Access, spoke, and he talked very movingly about his parents and what the impact would be on their economics and indeed on their dignity and indeed on his financial security. He said that his father was a Vietnam vet and a career U.S. civil servant, had wisely and carefully structured a health plan for himself and his mother prior to his father's death. That included reliance on Medicare and Medicaid. Now, like many Americans, his mother must rely solely on herself and whatever benefits she still receives from her husband's pension to make ends meet. Bruce said, My father worked very hard to provide security for his family. This was the most important thing in his life. When I asked him why he fought in that war, he said, ``I wanted to care for my family.'' My father would turn over in his grave if he thought the security he built for my mother was threatened because of proposals for tax cuts for the wealthy. Bruce's father and mother made their financial decisions based on the promise that Medicare and Medicaid would be there for them. Bruce said, ``My parents kept their promises to the U.S. Government. Now, as their son, I ask you to keep your promise to them.'' As I said earlier, Bruce is part of that sandwich generation where he will now have his assets and his income called upon to help pay for his mother's health care costs. I saw an interesting poster at one of the rallies that said, ``My children cannot afford my health care.'' What does it do to the dignity of a senior who has worked all of his or her life to provide for his or her retirement to then have to go to their working-age children, middle-income, working-age children who are caring for their own children, and say, ``We need to call on your assets to take care of my health care benefits because Medicare and Medicaid are no longer there?'' It is interesting to hear our colleagues, to talk about the choices seniors will have. Oh, yes, they will have a choice. They can stay in Medicare with higher premiums and lower benefits. If they go into one of these other managed plans, I predict, Mr. Speaker, you can call that the Roach Motel plan, because once they go in that plan, they are not going to have any choices. It is in and it is not out, and let me choose another plan because I do not like it in there; so seniors have to be very, very concerned about this Republican proposal. [[Page H 9875]] Well, it is clear it is easy to understand why the Republicans want to change Medicare. They did not believe in it in the first place. Ninety-five percent of the Republicans in the Congress voted against Medicare 30 years ago when it was passed in the Congress of the United States. They have not liked it. Now they want to move on from it, and it providing the health security to America's seniors. We had other panels that I am going to get around to. But first I would like to yield to some of my colleagues from Northern California so that they can address some of the other voices that they are hearing from their districts. They can tell us about some of the other voices they are hearing from their districts on the Republican proposal. I first would like to yield to that fighter for seniors, the gentleman from California [Mr. Farr], who has been in very close touch with the seniors in his district and is here to report on their concerns about the impact of the Republican cuts in Medicare and Medicaid to give a tax break to the 6 percent wealthiest in our country.

Ms. PELOSI. I thank the gentlewoman from California for her statement this evening, for her participation in the hearing, and for her leadership on this very important issue. It was interesting then and now to hear your point that as a leader in local government, the time that you have spent, the period of public comment that is required for changes in the infrastructure in your district, be it a sidewalk or whatever, and how quickly the Republican majority wants to move forth with its stealth plan before anybody can really see what it is. I know our colleague, Mr. Farr, has a similar experience.

Ms. PELOSI. I thank the gentlewoman for her participation in our special order tonight. I would just comment on her role as a member of the Committee on the Budget, thank her for her leadership role there in representing the values of our community. Many of us believe the budget of our country should be a statement of our Nation's values and those values should reflect the priority we place on investing in our children and in the health care of all our people and certainly protections for our senior citizens. We have grave concerns about how those at the low end of the economic scale fare in our country, but we have a large responsibility to middle-income and working people in our country to make sure that they are not paying the bill for everyone, and they would bear a terrible brunt from these Medicare and Medicaid cuts, unless they think that unless you are a senior, unless you are a poor person, this does not matter to you. They have to know that they are directly impacted by it, and their ability to raise and educate their own children will be very, very much affected by the Republican proposals, which I believe are not a statement of America's values, and I hope that the American people will speak out loudly and clearly to our Republican Members of Congress to make their voices heard to our colleagues so that they will reject this ill-advised and ill-conceived, in-secret proposal to cut Medicare and Medicaid to give a tax break to the wealthiest Americans.

Ms. PELOSI. I thank the gentleman, and I yield to the gentlewoman from California for her closing remarks.

Ms. PELOSI. In the interest of time, Mr. Speaker, I may have to take another special order to go to our third panel. But with your permission, I would like to put their statements in the Record. That would be the statement of Mr. Paul Di Donato, Dr. Bergman, and I have one more, but I will reference that. Dr. Bergman, who is from the Packard Children's Hospital at Stanford said, without a regular pediatrician and with limited financial resources, he was talking about the impact on children, without a regular pediatrician and with limited financial resources, these families will often be forced to wait until the child's illness has progressed to a more serious and complicated level. Beyond the increased costs of providing health care in the emergency room and treating illnesses of increased severity because of delay in initiating treatment, there is the more important cost, there is the more important cost in unnecessary suffering of children. Delays in treatment often lead to lifelong disabling conditions or chronic illnesses. And that is not about balancing a budget. It is about a false sense of values. The other statement I want to put in the Record is from Anthony Wagner from Laguna Honda Hospital, city and county of San Francisco. I will be addressing his remarks in another special order.

Ms. PELOSI. Well, I agree. I think that the one thing that everyone in this body will agree to, and that is that we are proud of our country, that it is a great country and that it is a decent country. And I do not think that greatness and decency are associated with what you just described about how our senior citizens, who helped build our country, would be treated under this plan. So I think it is very important for people to understand, certainly we have concerns about the poor in our country. But if you are not poor, you are still very much at risk under this plan. And we have said it over and over again. If you are working, middle-age, middle-income people, you will be more responsible under this plan for your parents' care, paying for it, just at the same time as you may be putting your children through school. I did want to also say how the Republican proposal would undermine, undermine the excellence of the American health care system. People always say, if I ever were to be sick, I want to be sick in America. We had some very fine testimony from experts who gave us their professional judgment about what the impact of these cuts would be. Congreswoman Woolsey mentioned one, Dr. Tom Peters from Marin County. I wanted to quote from the statement of Dr. Wintroub from the University of California, San Francisco, one of the finest teaching hospitals in the country. And Mr. Speaker, I will include his statement as well as that of Tim McMurdo, Tom Peters, and Richard Cordova for the Record as well. Mr. Speaker, Dr. Wintroub testified that by eliminating Medicare payments for teaching and patient care, as well as graduate medical education, the Republicans are putting in jeopardy the future of health care delivery in this country. The indirect medical education adjustment, the direct medical education and the disproportionate share payments account for over 15 percent of all Medicare and Medicaid revenues to UCSF, University of California San Francisco, an excellent teaching hospital, and 42 percent of the total budget for UCSF Medical Center is dependent on Medicare and Medicaid. In addition to that, Mr. McMurdo, chief executive officer, San Mateo County General Hospital testified that the proposed cuts to Medicare and Medicaid programs will have a catastrophic effect on hospitals and clinics that have heretofore relied on the stability of Federal and State payments to help cover the cost of care. This reliance has grown increasingly important since private insurance carriers continue to cut payments to hospitals and physicians as the number of uninsured people continues to grow. It is estimated that hospitals and other providers in our bay area will lose hundreds of millions of dollars over the next 7 years if these cuts are enacted. Mr. Cordova, from the San Francisco General Hospital, said, you cannot slash both Medicare and Medicaid, Medi-Cal disproportionate share hospital payments for graduate medical education and indirect medical education support and essentially eliminate the entitlement status for Medi-Cal without causing a virtual earthquake in the provision of health care for many of our most needy residents. Mr. Peters says, the blunt truth of the matter is, if you ridicule and deny the efforts at comprehensive redesign of the American health care system and instead insist only on weakening two of its most important components, the quality and availability of health care for all Americans is threatened. Mr. Speaker, the point being that even the wealthiest Americans will not have access to the kind of quality of care that exists today when we undermine it for the rest of the country. I yield to the gentlewoman from California, if she has anything to say on that subject, as she presided over that section of the panel.

Ms. PELOSI. It is very hard to understand why they would think that that is a good idea. But it is also easy to understand why they do not want anybody having public hearings to have to come in and testify as to why that is not a good idea. I did want to put on the Record some more testimony from our hearing in San Francisco, but I am pleased to yield to the gentleman from California if he had something further to add before that.

Ms. PELOSI

Ms. PELOSI. The savings that come from his proposal are to be plowed back into Medicare.

Ms. PELOSI. A plan that approaches----

Ms. PELOSI. Mr. Speaker, would the gentleman yield?

Ms. PELOSI. Mr. Speaker, I thank the gentleman, and I do want Mr. Weldon to get around to his special order, because he has been such a tremendous leader in the House on fire safety, but I want to respond to him directly about his question about the plan. The plan I support is called Medicare. I do think that when we talk about the trustees talking about needing some shoring up, it always has. A half dozen times we have had to shore up the Medicare trust fund, and we will do it again. And we can address the waste, fraud, and abuse issue as well. But what we really need is access to universal health care in America to reduce the rising cost of health care in our country which will then have its impact on Medicare costs and Medicaid costs. So the plan that I support is one that has been successful and it is called Medicare. I just want to make one other point. The gentleman talked about some anecdotal evidence of abuses at SSI. I am with him on that. Put it all on the table. Subject it all to the harshest scrutiny. Our complaint is not that social services are not subject to scrutiny. We do not fight for them so that people can waste money, we fight for them so people's needs are met. Our complaint is everything is not on the table.

Ms. PELOSI. Mr. Weldon, I want to make the point that when we talk about the fact that there have been all these hearings on the Republican Medicare proposals, they have not been on the proposal that is on the table right now. As we all know, it is congressional procedure to air the legislation that we are going to vote on. Have we talked in concept about Medicare and about changes in Medicare that might be advisable? Certainly. But do we know the particulars of the substitute plan that was placed on the table Monday night by Mr. Archer? Most of us do not. That is the plan the American people should have a period of public comment on. Maybe they will like it. Why be afraid of it?

Ms. PELOSI. Mr. Speaker, I was seeking recognition for a couple of different reasons, but I would be pleased to address that point.

Ms. PELOSI. If the gentleman will yield further, the gentleman is talking about increases in defense spending, an overall number. We are talking about what are those dollars spent on and how can there be savings of waste, fraud and abuse and inefficiencies in the defense budget that is subjected to the same kind of scrutiny that the rest of the budget is? It is about that.

Ms. PELOSI. Would the gentleman yield?

Ms. PELOSI. If the gentleman will yield, the gentleman knows the esteem with which Members on this side of the aisle hold him for the values and courage he has demonstrated on his own side of the aisle on these issues. But it is amazing to hear the gentleman be so surprised that people will comment on a plan, and, yes, we have talked about these issues in general, but in terms of subjecting the particular proposal to the public scrutiny, that has not been done. I appreciate what the gentleman said about chapter 1 and his participation as a teacher teaching disadvantaged children. That is why I know the gentleman probably shares a concern that many of us have that nearly $1 billion was cut out of the Labor-HHS budget for that chapter 1 program. When we talk about the defense budget, the point is we are all for a strong defense, and, God knows, nobody came here and said only the Republicans care about a strong defense. We all care about a strong defense. The point is that when we subjected the budget to cuts, both the rescission bill and in preparing for the budget for next year, defense was off the table. In fact, there was $7 billion more in the bill than even the administration had asked for, and billions more than last year's budget. So it may be the appropriate number. It may be the exact appropriate number. All we are saying is, as we subject all of our spending to the harsh scrutiny, why is defense not on the stable?

Ms. PELOSI. Not the level of cuts. But we cannot just--the point is, I support the President's approach, which is----

Ms. PELOSI. No, I do not support the President's level of cuts. [[Page H 9890]]

Ms. PELOSI. I support a plan that approaches----

Ms. PELOSI

Ms. PELOSI. Mr. Speaker, the gentleman from Georgia knows I regard him as a gentleman, and just hearing him say that these people may be in violation of the law because they receive X amount of dollars and they give out X amount of dollars, I think we want the Record to be clear that he is not saying that they are in violation of the law, because we all know that anyone who gets grant money from the Federal Government cannot use one penny of that money for lobbying the Federal Government or for any PAC contributions. If the gentleman is saying that anyone who gets a grant from the Federal Government should not use other money to lobby the government or other money to make PAC contributions, then the gentleman would hopefully apply that to defense contractors and others who receive huge amounts of money from the Federal Government.

Ms. PELOSI. No, no, are you saying they used taxpayer dollars to do that?

Ms. PELOSI. Mr. Speaker, Is the gentleman saying they are using taxpayer dollars to do that?

Ms. PELOSI. I know that that is against the law.

Ms. PELOSI. If the gentlewoman would yield, just on that point, because obviously we have differing views on your version of the story in terms of Medicare. Is the gentleman stating that there are people out there using taxpayer dollars that they receive from grants for purposes other than what those grants were designated for?

Ms. PELOSI

Ms. PELOSI. I thank the gentleman for yielding and for taking this special order mourning the loss of Jim Kennelly and extending our condolences to our colleague. As a fellow graduate of Trinity College, Washington, DC, as our colleague Barbara Kennelly is, I know how important her family is to her, how much she loved her husband, how proud her mother is of her entire family and this proud tradition that the Bailey family and the Kennelly family have brought to Connecticut, indeed to the entire country. I hope it is a consolation to Barbara that so many of her colleagues express their love and admiration for her tonight. As was said this morning, as we mourn the loss of those who die, in this case Jim, let us thank God that he lived.