Jay Rockefeller

Mr. ROCKEFELLER

Mr. ROCKEFELLER. The Senator will complete his remarks.

Mr. ROCKEFELLER. I yield the floor.

Mr. ROCKEFELLER. The Republicans are clearly headed toward a Medicaid block grant. On Wednesday in the Finance Committee we are meant to be marking up a welfare reform bill that will be all block grants. It will all be block grants. They will say it is not, but it is. They are all for it. Some of them who were not last year are this year. Let me list a few of the consequences of a Medicaid block grant. No longer will 18 million children have a guarantee of health insurance. No longer will 8 million low-income women have a guarantee of health insurance. Sure, some States may do it, other States will not. About 6 million low-income disabled will lose their health insurance coverage. Moving back to Medicare. Medicare is a critical element of a senior's Social Security. Millions of seniors depend on their monthly Social Security checks to buy food, to pay the rent, to buy prescription drugs, and pay their utilities. Those same Social Security recipients depend on the Medicare Program for health insurance coverage, Medicare coverage that they contributed to all of their working lives. Now we are going to say that seniors who worked hard all their lives, and planned their retirements taking into account their Social Security and Medicare benefit, that we will pull the rug out from under them. We cannot have it both ways, they say. Boy, are they making a case against themselves. Republicans have promised not to touch Social Security. In fact, before last year's election, the Republicans also said they had no intention of cutting Medicare benefits. I quote Majority Leader Dole: President Clinton and Vice President Gore are resorting to scare tactics * * * falsely accusing Republicans of secret plans to cut Medicare benefits.--Washington Post, November 6, 1994. And from the head of the Republican National Committee, Haley Barbour: The outrage, as far as I'm concerned is the Democrats' big lie campaign that Contract with America would require huge Medicare cuts. It would not. Republicans were not going to cut Medicare. That is what they said. But that is certainly not what they are doing. The Senate budget resolution cuts Medicare by $256 billion and the Contract With America budget resolution cuts Medicare by $270 billion. And, because of the way they plan to cut Medicare benefits--by shifting health costs to seniors--seniors are going to see their Social Security COLA's reduced by half. My colleague from Massachusetts, Senator Kennedy, referred to this last Friday as a stealth Social Security cut. And, I could not agree more. We do not yet know how the Senate Republicans plan to cut Medicare, but we do know what the House Republicans are thinking about. I will outline just a few of their ideas to cut Medicare by making seniors pay more. [[Page S7065]] These proposals are all taken directly from the House Republican Budget Committee document. First, there is a mandatory managed care proposal. Under this proposal, seniors would have to pay more if they went to a hospital or doctor that was not in the Medicare network. Under this plan, seniors would not have a choice of signing up for managed care. Their enrollment in this Medicare managed care program would be automatic and mandatory. Another Republican proposal would increase premiums for new Medicare beneficiaries who choose fee-for-service. New Medicare beneficiaries would pay a part B premium that is $20 a month higher if they choose Medicare fee-for-service. Under another Republican proposal, the Medicare deductible for physician services would be doubled, from $100 to $200 and then indexed for inflation. And, there has been a lot of talk about handing out Medicare vouchers. Under the Republican plan, Medicare would be capped and vouchers handed out. The government would make a standard contribution and seniors would have to make up any price differences between the government voucher and the price of their health insurance. The House Budget Document says ``Medicare could continue to offer the traditional Medicare benefit plan * * * [but] most likely, the beneficiary would have to pay an amount in addition to the voucher.'' Next, the Republicans want to require new copayments for home health care, lab services, and skilled nursing home care. Finally, the Republicans favor an across-the-board hike in every senior's part B premium which is currently $46.10 a month. Day after day, the Republicans have come to the Senate floor and denied that they are cutting Medicare. Mr. President, when I talk to seniors in West Virginia about the above proposals and the increased costs that they are going to have to pay, they understand that their Medicare benefits are going to be cut. They see cuts in their Social Security benefits. The Republicans can talk about the billions of dollars that they are going to allow Medicare to increase by, but I want to talk about the average West Virginia senior getting by on a fixed income of about $10,700 a year. Under the Republican budget resolution, seniors living on fixed incomes are going to see half of their Social Security COLAs get eaten up by new Medicare charges--that is a cut. When half of the seniors in West Virginia who live in rural areas risk having their rural hospital shut its door--that is major cut in services. Mr. President, my colleagues on the other side of the aisle have tremendous discipline when it comes to staying on message. They can repeat, and repeat, and repeat that these Medicare cuts are not really cuts at all. They can say over and over and over again that there are no tax cuts in their budget resolution. But anyone who reads this budget resolution will see the $170 billion that has been set aside for tax cuts and the $256 billion cut in Medicare and the $175 billion cut in Medicaid. My amendment will put money back into the pockets of senior citizens. My amendment says that we are not going to balance the budget and pay for tax cuts by gutting Medicare and making seniors pay more. This amendment is about setting priorities. If this amendment was adopted, the budget resolution would still achieve balance by 2002. This amendment says that health care and long-term care for seniors, and health care for children and the disabled, should not be destroyed so that we can hand out tax cuts to the wealthy. This amendment would make sure that millions of working families and retirees who depend on Medicare and Medicaid for their health care and long-term care needs would not be left out in the cold and swamped with huge health bills. Mr. President, I urge my colleagues to vote for my amendment and tell the American people loud and clear that we in the Senate have our priorities right.

Mr. ROCKEFELLER. I thank the Senator from California. How can it be courageous to ask those with the least to pay the bills racked up by those who already have so much? Yes, we all want to balance the budget. Yes, we all want to balance the budget. And, we have offered amendments that would still balance the budget by 2002. This amendment does not subtract one single thing-- not one dime--from the effort to balance the budget. In 1993 we went to bat when we were in charge. Now they are in charge. Let them go to bat, but not take the bat and crush so many vulnerable people in our country. We have seen this before. Economic voodoo that asks working families in places like West Virginia to shoulder the load while providing a windfall for the well-heeled. Mr. President, I would just insert and would ask this be included in the Record the piece of paper, which we have not talked much about, Medicaid. This has been a Medicare debate. But Medicaid is included in this amendment.

Mr. ROCKEFELLER. It not only does that, it not only repeals that national compact, but I have here the Social Security law. These are the Social Security laws. If we turn to page 625 of the Social Security law, title 18, Medicare is called ``Health Insurance for the Aged and Disabled.'' Senior citizens are going to have to pay out of their Social Security COLA the increased costs of Medicare because of what the folks on the other side of the aisle are proposing. They say it has nothing to do with Social Security. This is a Social Security cut, because they will not be able to spend it on anything else but higher Medicare costs. This is the Social Security law. This is the health insurance for the aged and the disabled. That is called a cut in Social Security in any West Virginians' home who is elderly, that I know of.

Mr. ROCKEFELLER. Mr. President, just a short minute. I would have to say to my good friend from the State of Washington that he did mischaracterize what I said. I think it is important for the Record that the mischaracterization be straightened out. I did not at all suggest $100 billion was symbolic. What I suggested was that we were not obviously going to be able to create a solution to the long-term trust fund problem by the $100 billion, but that we sure as heck are not, as is the case in the budget the Senator proposes, doing this massive cut in Medicare, thus causing seniors to have to pay out of pocket and dip into their Social Security cost-of-living adjustment. In no sense did I mean it was symbolic. It is anything but symbolic. We would be bringing relief to senior citizens, and for that matter also to Medicaid. I really must object to the use of the word symbolism because I never did say that. I used the word priorities. It is a question of priorities. I want the Record to be clear on that.

Mr. ROCKEFELLER. Would the Senator from Washington yield?

Mr. ROCKEFELLER. I would say again to the Senator from New Hampshire, what he is suggesting is that we take Medicare money, $256 billion, and cuts in Medicaid, and use those health care cuts to pay for tax cuts. Both the Republican CBO Director and the past Democratic CBO Director had a common view on this. The only way to achieve short term savings of this magnitude is to cut doctor and hospital payments and make seniors pay more. Up to half of a senior's Social Security cost-of- living increase would be used to pay for this increase in the cost of Medicare. So you are not only getting them on Medicare but you are getting them on Social Security. Is that not correct?

Mr. ROCKEFELLER. It will be a question. Taking off from what the Senator from Washington has indicated, does it not strike the Senator, in looking at the amendment of Senator Lautenberg and myself, that we are not in any way pretending that this $100 billion is going to cure the trust fund problem? What we are trying to establish is a matter of priorities. Obviously $100 billion is not going to solve the problem, but neither does the Republican budget resolution before us; $100 billion kept in Medicare, kept in health care funds, is a statement of what is important as opposed to putting it into some reserve fund which I believe most people in this Chamber believe is going to be used for tax cuts for the wealthy. So would the Senator not agree that by putting $100 billion back into health care, we are not so much saying this is going to solve the problem, because obviously it is not--neither does the Republican budget resolution--but is it not a matter of keeping the money in Medicare and not spending it on other uses?

Mr. ROCKEFELLER. Will the Senator from New Hampshire yield?

Mr. ROCKEFELLER. I thank the Senator from Nebraska. Mr. President, let us review the record, the whole record. When reckless Wall Street unrestraint brought this Nation to the edge of financial ruin, Republicans insisted that an ``invisible hand,'' Adam Smith's invisible hand, would help families, and restore their jobs, their homes, their children and their savings. But alas, the ``invisible hand'' was very much invisible. Unemployment lines snaked blocks long, banks went belly-up, plants were boarded up, homes and farms went on the auction block. Bad times, hard times--nowhere harder than in my State of West Virginia. After the crash, Democrats took action to repair the all too visible damage done by the Republican's stubborn refusal to address the needs of working families. Democrats worked to undo neglected banking regulation, disinvestment in education and training, lack of emphasis and lack of attention to national infrastructure building, to unstick stagnant wages, and pay down the staggering mountain of debt. I could be talking about Franklin Roosevelt's redress of Herbert Hoover's wrongheaded economics. But, no, I am recalling the reckless excesses of the 1980's and the work we Democrats began in the last several years to undo that horrible damage done by the Republicans. Our colleagues across the aisle have spent the last few days wringing their hands and gnashing their teeth over the debt that now hangs over our children. Oh, no curse ever visited upon the human race is worse, to listen to them talk one after the other. You cannot have it both ways. They talk about the depletion of the Medicare trust fund, about the need for pain and sacrifice. I wonder how they failed to see the danger during the 1980's, when massive tax cuts for the wealthiest fraction of the Nation tripled the national debt. I will say that again--when massive tax cuts for the wealthiest fraction of the Nation, corporate and private, tripled the national debt. ``You cannot have it both ways,'' they said. They sure tried in 1980, when billions were borrowed against the next generation to finance savings and loan bailouts. Did they forget about that one? A little oversight on the part of the Republicans. And we are still paying for it. People out there do not forget about that. It is a Republican legacy. When tax loopholes were opened for junk bond binges, where was their concern about the debt being passed on to the next generation all during that period? I think the greatest scandal of my time in Congress was the S&L bailout period, courtesy of the other side. Talk about passing on debt to future generations. I never heard a word about that in the 1980's or early 1990's, or even up until last year. I wonder where the urgency and concern last year and the year before was when Democrats were cutting the first trillion off of that deficit. The first deficit reduction in decades, and not one Republican in either House voted for it. You cannot have it both ways, they say. Not one Republican was for lifting a trillion dollars in debt off of the next generation. I wonder where was the passion and the compassion for the next generation when we had a chance last year to pass health care reform. We had a chance to stop cost shifting and all of the things that have exploded our health care system out of sight. The Republicans could not even wait to savage that one, because it was put forward by Bill Clinton. They called it socialized medicine and Government medicine. We heard it all the time. I will not pull out my Blue Cross/Blue Shield card like I usually do. But Blue Cross/Blue Shield coverage, which is what most Members of Congress have, is not a Government-run health program. But we are paying the price now. They overwhelmingly condemned health care reform. Where were they then? Health reform that would have reined in costs without slashing services and quality. Instead we heard all of those passionate speeches denouncing price caps, which they now propose. ``You cannot have it both ways,'' they said. Denouncing limits on choice of a doctor, which they now are ready to force on seniors. Oh, yes, if seniors pay more, it will be different. Those who can afford it, will have a choice. Those who can not afford the extra costs will not be able to keep their lifelong doctor. But the fee-for-service system which the Republicans so glorified last year, they could not stop talking about the glory of choice, the glory of choice, it will not be available to all seniors under their Medicare budget. The glory of choice. We do not hear it this year. You have to pay more for it, if you are a senior. They talk about 90 percent of their tax cuts going to families earning less than $100,000. I would like to bring up a point on that. They talk about $100,000 and where their tax cut would go once they have the $170 billion left over, after this is all over. I would like to point out two things: First, the average West Virginia senior has an income of about $10,700 year. To him or her, $100,000 is rich. Real rich. Second, and I hold up the Republican bill here, there is not anything written into a bill. It is a sense of the Congress. A sense of the Congress that 90 percent of the recipients of any tax cuts--think that means something--``any tax cuts?'' Think they are thinking about tax cuts for the rich which must go to the middle class? A sense of the Congress. Mr. President, you and I both know that anything that is a sense of the Congress or a sense of the Senate is not worth the paper it is written on. But most of all, I wonder how anyone can look at this budget proposal and call its authors courageous? A budget scheme which asks everything of seniors, of students, of children, and the disabled, and gives more, and so much more, to the most secure, the most well off, the biggest companies and the most powerful interests.

Mr. ROCKEFELLER. Please proceed.

Mr. ROCKEFELLER. I would say to the Senator from California that I have only 14 minutes, and I have a lot to say.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, education is fundamental to our country's future. If we are serious about strengthening our country and staying competitive in a fierce global marketplace, America must educate its children and offer continuous education to working adults. Previously, we might have differed on some details and policies, but a tradition of bipartisanship support for basic education programs was something Americans could count on--from Head Start to Chapter 1 help for elementary schools to student loans for college. Fairly recently, under the leadership of President Bush, along with the National Governors Association that included Arkansas Governor Bill Clinton, that bipartisan commitment to basic education goals was visible and real. I support those goals and am horrified to see a budget resolution before the Senate that makes basic education programs the victim of major cuts. For example, how can we meet our goal of having every child enter school ready to learn if Head Start is cut by $3 billion? How can we ensure that our schools are safe and students steer clear of drugs, if the Safe and Drug-Free Schools program is virtually eliminated by a $1 billion budget cut? I worked hard to establish this program in 1986 with Republicans. Since then, I have visited numerous West Virginia classrooms and watched police officers in the DARE Program, to cite one example, make a real difference with students. How can we expect students to enter the modern workplace with the skills they need if we cut Federal funding for educational technology? In today's Washington Post, there is an excellent story about children signing up for time to work on computers at the local public library. What will happen if we pave a new information superhighway, but we don't provide an on ramp or instructions for our schools and libraries? Again, I have visited West Virginia classrooms, libraries and community centers and sat with children as they show me what they can learn on the Internet. Connecting students to technology is vital. This resolution undercuts our national commitment to lifelong learning by cutting college assistance and increasing student loan interest. It undercuts the School-to-Work programs, just passed last year with bipartisan support. The School-to-Work initiative was endorsed by both business and labor unions. It is a partnership between the Departments of Education and Labor. It is where we should be investing our energy and efforts. With Secretary Bob Reich, I visited a West Virginia program and watched students get hand-on experience to prepare them for the challenges of work in today's world. But this budget resolution, instead, proposes a cut of $5.3 billion from this relevant, needed program. I am personally disappointed by the suggestion of eliminating the AmeriCorps program. National service is something that works, and has won the hearts, the minds, the support of Americans everywhere. It is today's symbol and substance that stand for responsibility and values like community. Just this past weekend in West Virginia, I was with AmeriCorps and VISTA workers and former VISTA volunteers at a special 30th reunion event. The people in that room are committed to making a real difference for West Virginia, working in domestic violence shelters and providing primary health care through the Children's Health Van. This is important, meaningful work that kindles the kind of community spirit we need. I know, because it was VISTA that brought me to Emmons, West Virginia years ago. AmeriCorps has that same spirit, and deserves the same support.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, I believe the minority leader had agreed to yield 1 minute to the Senator from Maine, and also for a unanimous-consent request to the Senator from Oregon.

Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that after the Senator from Tennessee has spoken, that the Senator from Maryland, Senator Mikulski, may speak.

Mr. ROCKEFELLER. Mr. President, I ask unanimous consent that reading of the amendment be dispensed with.

Mr. ROCKEFELLER. Mr. President, I send an amendment to the desk and ask for its immediate consideration.

Mr. ROCKEFELLER. Mr. President, restraining myself from getting into debate with the Senator from Oregon over his closing paragraphs, I would yield such time to the Senator from New Jersey as he requires.

Mr. ROCKEFELLER. Senator Lautenberg does not appear to be on the floor.

Mr. ROCKEFELLER. I thank the Chair. The amendment that I sent up on behalf of Senator Lautenberg and myself, and other Senators, was not explained because the reading of it was cut off. So I thought I would just give a very quick explanation of what the amendment does. The Republican Senate budget resolution sets up a $170 billion reserve fund for cuts. The Republican budget makes room for even further tax cuts, in fact, beyond the $170 billion if they are financed with spending cuts. That is in the resolution. Under the budget resolution, Medicare, which is our subject of this day, would be cut by $256 billion. Medicaid would be cut by $175 billion over a period of 7 years. The Rockefeller-Lautenberg amendment simply would restore, of the $170 billion reserved, $100 billion now reserved for tax cuts, and it would put that money back into Medicare and Medicaid. That is the entire purpose of the amendment, and I want my colleagues on both sides to know that. Mr. President, I rise today to note several points. Over the past few weeks, many of my colleagues on the other side of the aisle have been trying to portray their intention to cut Medicare benefits as necessary to save the Medicare Program. They point to the projected insolvency of the Medicare hospital trust fund in 7 years and say that immediate action is necessary to maintain its solvency. They are working to save the Medicare Program, not to dismantle it. That is the way the logic is presented. Frankly, I question their motives. I had heard nary a word about the Medicare crisis from my colleagues until very, very recently. But short-term solvency of the Medicare hospital trust fund is not a new finding that was just discovered this year. The Medicare trustees sounded the alarm, in fact, about the short-term insolvency of the Medicare Program several years ago. For the past few years, the Medicare trustees have urged action on something called comprehensive health care reform. They have urged that we do comprehensive health care reform to address our country's overall systemic problem of rising health care costs that are, in turn, draining the hospital trust fund and the pockets of American families and businesses. In fact, the chart that the distinguished senior Senator from New Mexico had giving a quote of President Clinton was said within the context of doing comprehensive health care reform in which a whole variety of circumstances would come into play; and it was not just about cutting Medicare and Medicaid, it was about changing the entire system. And they have selected out a sentence which fits their current argument. But it does not fit the current argument, in fact, because it was about a comprehensive health care reform approach that he was taking at that time--and he was not successful, as the Presiding Officer and the American people well know. As my colleagues know full well, President Clinton responded to the warnings and to the alarms by putting a comprehensive health care plan on the table for congressional consideration. Now, one can argue that it did not get very far. One can argue that nothing happened at all. I would argue that it was dead on arrival, because the interest groups that did not want to see it succeed had a several month lead on television in terms of discrediting the program and talking about it as socialism and a Government takeover. The Government takeover argument is the one I particularly love. When people use that argument, I take out my Government takeover card. I belong to the largest Government program in the country. But, this is a Blue Cross/Blue Shield card. Senator Packwood, who is pacing the aisles on the other side, probably carries the same piece of plastic. The last I heard, Blue Cross/Blue Shield is a private company. In any event, the health legislation did not get anywhere because it was buried under a cloud of Harry and Louise ads and a lot of money. It was very sad, in fact, I think, because a lot of the problems we are now facing are because of the failure of this body to address comprehensive health care. The President's plan not only addressed rising health care costs in the Medicare program, but rising health care costs for all American households and businesses, and especially small businesses. Mr. President, I strongly agree with my Senate colleagues who urge immediate attention to the very serious problem of solving the trust fund. That [[Page S6972]] is a very serious problem, and it is something to worry about. So far I have not seen a single serious proposal that really addresses the solvency of the trust fund. Therein lies a real problem for me. In writing, not a proposal; on paper, not a proposal. In rhetoric, not really a proposal. I have heard a lot of rhetoric about restructuring and giving seniors more choice, but all I have seen and read about, and what is actually in the budget resolution, are huge cuts in Medicare--historic, unprecedented cuts in Medicare--to reduce the deficit by the year 2002. Huge cuts in Medicaid, also. The House-passed tax cut bill actually raids, as the minority leader indicated, raids the Medicare HI trust fund by $23 billion. That has not been pointed out very much on this floor. Now, we are the Senate, not the House, but the House has presented its plan and the Senate has not. A raid of $23 billion on the Medicare HI trust fund actually moves forward the date of the insolvency of the trust fund by 8 or 9 months. So they, in their wisdom, made the problem worse insofar as the trust fund was concerned. I have yet to see a serious role from my Republican colleagues about ensuring that the Medicare program will still be solvent when the baby boom generation comes into full play, about the year 2010. We are in the easy period now. This is calm time. A calm sea. It begins to change shortly after the turn of the century. I hear no acknowledgment from my colleagues that Medicare is, in fact, the most successful insurance program this country has. There may be some who wish to debate that. I would welcome that. The Medicare Program provides universal coverage for all seniors. There is not a senior that does not have health insurance, and does not know that when he or she wakes up in the morning or goes to bed at night. There is no need to have an annual tabulation on the number of 65-year-olds without insurance. We do not have to do that because it does not exist. We have to do that, of course, for children in this country. We have to do that for women in this country. We have to do that for men in this country who are under the age of 65, but not over the age of 65, because they are covered by Medicare. Everybody is covered. We are, in that respect, like every other modern industrial nation in the world, for 65 years and older. Medicare does not deny medical coverage because of a preexisting medical condition like most private insurance plans. Medicare does not charge sick people more for their health care, like most private insurance plans. Medicare allows seniors to continue seeing their lifelong doctor and go to any hospital they want. Now, one can attack the fee-for-service concept, but one cannot say that a senior is denied from seeing precisely the doctor they want or go to the hospital they want. If an HMO is available in an area, seniors can sign up with an HMO. They can often times receive additional benefits for so doing. But they have all of those options open to them right now. Up until very recently, the Medicare Program outperformed the private sector in holding down its costs. Over the past couple of years, Medicare costs have been slightly higher than the private sector costs, as I will get to in a moment--about 1 percent. Realize that the private sector is, in fact, insuring fewer and fewer people as the days, weeks, and months go by. Indeed, it is projected, as I know the Presiding Officer knows, that by the year 2000, 50 percent of Americans who work for a company will receive no health insurance benefits from that company. Now, over the past couple of years, as I indicated, Medicare costs have been slightly higher. Then again, Medicare's enrollment is increasing. People are getting older faster. The fastest growing age group is the 84-year-old and over age group. Also, Medicare pays for home care services and skilled nursing home care, types of services that are not normally covered under private insurance plans. According to the CBO projections, Medicare is actually projected to grow by only 1.1 percent more than private health insurance over the next 7 years, our budget window. And enrollment in that figure is factored out. So it becomes a more honest figure because we do not have the increased number of people. Medicare, in fact, is projected to grow by 8.3 percent a year on a per person basis; private health insurance is projected to grow by 7.2 percent a year on a per person basis; that is a 1.1 percent difference over the next 7 years. Medicare insures older people and the disabled--people with health needs, people with terrible health needs and preexisting conditions. Remember, the private market casts them off to the side. It should not be a surprise to my colleagues on either side of the aisle that Medicare's per-person health care costs are projected to grow slightly ahead of private health insurance plans. Mr. President, I have heard a lot of talk about needing to move the Medicare program into the 21st century by restructuring. I guess I do not share an enthusiasm for certain aspects of our private health insurance system as much as some of my colleagues. The Medicare program, in fact, was established because private health insurance refused, failed, to provide affordable insurance to senior citizens. That is why we did Medicare in the first place, because private insurance would not insure seniors. Now, many of my colleagues like to talk about the wonders of the marketplace. I understand that. Some remarkable things are happening in the marketplace. But I still see cherrypicking, red lining, medical underwriting, policy cancellations, job lock, families paying more and more money for fewer and fewer benefits. As I know the Presiding Officer knows, that is now what is happening in the private sector in so many companies. Companies are many times now saying, ``Yes, we will insure you, the employee, but we will no longer insure your dependents.'' But, then again, by the year 2000, 50 percent of people who work for a company will not receive any health insurance benefits at all, if CBO is correct. There has been an incredible amount of rhetoric about expanding choices for seniors. I was very active over the past 2 years in health care reform and there was constant talk that health reform would reduce choices. It is funny, I guess, how last year opponents of health reform tried to scare people about the Clinton plan by telling people it would take away their freedom to choose their own doctor, which in fact is not true; it did not. The truth is the President's plan would have greatly expanded the health care choices that Americans have today. But that has done nothing to stop people from misrepresenting the President's plan, because a dead plan is easy to misrepresent. Just a few months ago I read a document released by the office of my colleague from New Hampshire, Senator Gregg, who was speaking only a moment ago, that said: The Clinton health care reform plan projected $207 billion in savings under Medicare, forcing all seniors into managed care systems with per capita spending limits. That is not true, that was never true, about the Clinton plan. That is false. Now these same people are using the same powerful theme of choice as a way to disguise their own plan to cut Federal spending on Medicare. They are planning to force seniors to pay more out of pocket for their health care, and actually offer this as a savings to the Medicare Program. Not only does this strike me as disingenuous, but it ignores the real problems that our senior citizens have. I, frankly, have never had a senior citizen complain to me in the 31 years that I have been in West Virginia about Medicare not having enough choices. I have heard complaints about Medicare, but not about Medicare not having enough choices. They tell me they cannot afford prescription drugs and Medicare does not provide those, or that they have long-term care needs and Medicare does not provide for those. But I have never heard a single complaint from West Virginia senior citizens that they do not think they have enough choices. Just yesterday I received a letter from a West Virginia senior who lives in Mason County. She gets by on her Social Security check. That is it for her. Right now she cannot even afford to buy her heart medicine. It costs $138 a month. Fortunately, her doctor provides it to her without cost. She said [[Page S6973]] ``If anything happens to him I don't know what I will do.'' She also said, ``It's frightening to think that you have worked all your life and to have it taken away is very frightening.'' And then she said, ``If Senator Rockefeller cannot help us, who can?'' Well, I hope I can help. I will do all I can to help this good lady from Mason County. But to say something that I think casts a pall over this entire debate, and is deep within my own worry and concern about the future of America and American health care and Medicare and Medicaid in particular, I do not think I am going to be able to help her. Because I do not think there are going to be enough people voting in the way that I do to overcome the number of votes on the other side of the aisle. I predict that a majority--the Republican Party will vote virtually en bloc on this matter, and that there will not be enough Democrats to counter that by virtue of our numbers, and that we will lose, and the lady, my constituent from Mason County, will lose. And she will have to depend on her doctor providing her with her heart medicine at $138. Mr. President, even a $256 billion Medicare cut will do very little about the long-term solvency of the Medicare hospital trust fund. At most, these kinds of huge cuts may add a few more years of solvency to the hospital trust fund--a few more years. I would hardly consider this, however, saving Medicare. A few more years; 2 years, 3 years? It is not exactly saving Medicare. Given that the baby boom generation will just begin relying on Medicare in the year 2010, so anything only a few more years down the line will be worth very little in 15 years. If my colleagues truly cared about protecting the Medicare program they would realize that taking the Medicare debate out of the budget debate is essential. And it may be that my colleague from the State of Oregon agrees with me on this. They say they intend to do that, but in a different way, a way that I disagree with. I think plugging a figure into their budget resolution that adds up to $256 billion in Medicare cuts does not fool anyone. It does not fool any seniors in our State. Listening to talk shows and participating in radio talk shows in the last couple of weeks is providing clear evidence of that to me, about what seniors in West Virginia believe is about to happen to them, and which I am afraid is about to happen to them. It is a deep fear. We desperately need--and this is where I hope my colleague from Oregon might agree with me--we desperately need a bipartisan process to put Medicare on sound financial footing for the long term. We need to move past the current rhetorical budget-driven debate to the most important issues at hand, how best to keep Medicare dependable, secure, and valuable to seniors for generations. The short-term budget need of cutting Medicare by unprecedented amounts of money will have disastrous consequences on health care providers and beneficiaries. That is the short term. Rural hospitals in, I think, all of our States will close in the aggregate by the hundreds. Doctors will shun some Medicare patients in some States for the first time. Medicare beneficiaries, which is seniors and the disabled, will learn firsthand what Medicaid beneficiaries have had to cope with in trying to get a doctor to treat them when reimbursement rates are set so very low. I talked to a doctor in one part of our State the other day, 2 weeks ago, who told me he was seeing 65 patients a day. He is now in a managed care program and therefore his reimbursement is much less per patient. I know him. He is a very fine, good person. But, in order to keep up a living standard he has to see 65 patients a day. And I honestly do not know how you can see 65 patients a day without quality suffering. I could not do 65 appointments a day, individual appointments a day in my office. How can a doctor do 65 appointments a day? But he is doing that because he is in a managed care program and he has to do that because he is being reimbursed less for each patient. So, again the question of quality and how that plays. There is, I think, a right way and there is, I think, a wrong way to go about assuring the short-term and long-term solvency of the Medicare program. I believe the Republican proposal is the wrong way. Under this way--the wrong way--up to 55 percent of seniors' Social Security COLA will be eaten up by increased Medicare costs to that senior. For the one in four Americans that rely on Social Security for their entire income, this is brutal hardship. Under the proposal before us, Medicare's growth rate per person will be cut below the growth rate of private health insurance per person. That is an important statement. The rate of growth will be less under Medicare than under the private system, seriously again threatening health quality--65 patients a day, 70 patients a day? The amendment that Senator Lautenberg and I are offering on behalf of a number of our colleagues is not going to solve the Medicare solvency problem. I do not pretend that it will. The budget resolution before us will not solve the Medicare solvency problem. Our amendment is about setting priorities. Before we start legislating any new contracts with America, let us not forget about a contract that we already have with America's seniors, their families, and future generations. For all our zeal for deficit reduction--and that is good, that is well-meaning, well- intentioned, profoundly important, necessary work--we have lost sight of what Medicare is all about. It is a promise. It is a pledge to the American people that they will be able to live their lives in dignity and security far past their working days; that the sweat, the labor, the intellect and the care that they put into building America and in keeping our Nation strong and prosperous will be appreciated and valued when their resources wear out. We, the Federal Government, made a promise and no amount of bookkeeping should ever sway us from that promise. So instead of seeing a bankbook in Medicare, we should see an investment, not made by us but made in us. And it is our responsibility to ensure that investment of both funds and faith is always worthwhile. So, Mr. President, before we go too far into looting Medicare we would do well to strengthen it so that a pledge given to the Nation can be fulfilled many generations over. I thank the Chair. I yield the floor. Mr. PACKWOOD addressed the Chair.

Mr. ROCKEFELLER. As for individual Senators?

Mr. ROCKEFELLER. Mr. President, parliamentary inquiry. The Senator from New Hampshire had a certain amount of time because he was granted that by Senator Domenici. But other than that, there is no control of time, is there? In other words, time is controlled here, 6 hours on one side and 6 hours on this side, but not any automatic amount of time for each speaker?

Mr. ROCKEFELLER. Mr. President, I will just proceed with my statement, and I thank the Senator from New Hampshire.

Mr. ROCKEFELLER

Mr. ROCKEFELLER. Mr. President, just this week my Republican colleagues, belatedly, unveiled their budget priorities to the American people and the U.S. Senate. Their priorities are expressed in Senator Domenici's budget proposal which is now pending on the Senate floor. The loss leaders in this Republican budget are the basic health programs protecting our Nation's senior citizens, poor children, the disabled, and pregnant women, also known as Medicare and Medicaid. Historic levels of cuts in these programs--$256 billion out of Medicare and $175 billion out of Medicaid--make the major contribution to the deficit reduction in their proposal. Education gets hit hard, as do other investment priorities I care about, like job training. Our Nation's veterans lose. Working families who depend on the earned income tax credit lose. In my judgment, the people of West Virginia, whom I represent, lose under the Republican budget proposal. Nevertheless, the Republican budget priorities are here. Their budget is finally on the table and the subject of discussion and debate in the U.S. Senate. Is that what Republicans want to debate and talk about? No. The Republicans' first order of business during the floor action of their budget has been to exercise their parliamentary right to offer the first amendment. Their first amendment, offered by the chairman of the Budget Committee, Senator Domenici, is to substitute the President's fiscal year 1996 budget for their long-awaited proposal. It seems rather odd to propose a complete substitute for their much anticipated proposal before there has been any real debate on the Senate floor about what is in their proposal--who wins and who loses under their plan. And it is even more extraordinary that my Republican colleagues would choose to move to adopt the President's budget proposal as a substitute, after purporting to have just outlined their version of a responsible budget before the Senate. Why have they asked the Senate to vote on the President's budget before any meaningful Republican budget proposal? Why have they changed the subject? This amendment is nothing more than a political ploy. I suppose it is meant to make the point that the President's budget would not garner a majority of votes in the Senate. But we already know that. They are not going to vote for it and they are the majority of Members of this body. Undoubtedly, their proposed amendment will fail, regardless of how Democratic Senators vote. So they must be using their parliamentary right purely to make a political point. A point which seems obvious to me. I believe they have chosen to pursue this strategy because they want to distract the American people, the Senate, the media, from what ought to be the focus of our budget debate--the affects of the Republican budget proposal on the budgets of America's working families, seniors, small businesses, students, and on the investments I believe are important to the job creation and job growth. They do not want to talk about the details of their plan. They want to talk about somebody else's plan. They want to score political points. Well, much as they seem to dislike the fact that they are now being asked to produce the details of their budget and explain what their priorities are, it is their responsibility to do so. They are the new majority. We made tough choices when we were in the majority. We produced consistent deficit reduction. Under Democratic congressional leadership we reduced the deficit by over a trillion dollars in the last 5 years. We have met the challenge. It is their turn to lead. Their first response is to say let us talk about something else. Well that is just not good enough. They have a duty to explain what is in their proposal and why. They have yet to do that in any meaningful way, despite a slew of opening statements given on the floor today. For instance, we have heard people suggest the Medicare Program's growth is out of control and that is why it ought to be restricted. That is not the real reason the Republican budget slashes in Medicare. The real reason, I believe, is that they need huge amounts of Medicare cuts to pull off balancing the budget on their arbitrary timetable. The truth is Medicare's growing at the same rate as the health care costs of other Americans, including our health care costs of those of us here in Congress, maybe a percent higher. That is hardly way out of sync with the increases that individual Americans are coping with, and it is to be expected when we have yet to address the country's basic need for fundamental health care reform. So why the need to zero in on Medicare for mammoth cuts--to pay for an irresponsible and unfair tax cut for the rich. I would be derelict not to note that our failure to deal with the complicated issues of health care reform last year means that our deficit problem is even greater. Indeed, the major complaint about the President's fiscal year 1996 budget--that it does not produce sufficient deficit reduction--would be moot if we had achieved comprehensive health care reform last year. As Democrats have been warning for years, and as President Clinton insisted throughout his campaign, if we don't deal with our Nation's health care problems which affect our families, our businesses, our children and our seniors, and each of our Federal health programs, we will never get the deficit under control. I would like to believe that the Congress is still willing to step up to the health care challenge, although outside of rhetoric and a forced march to meet a predetermined budget target, I have not seen any evidence that my Republican colleagues are in fact willing to step up to the plate. I wish that was not the case, but I have to tell you what I believe to be true. Finally, I want to point out that even without reaching agreement on comprehensive health care reform, if the President's budget proposal had not included an additional tax break for working class families it would produce continued significant deficit reduction. The basic building blocks of the President's budget proposal focus on all the right priorities--it delivers on two promises to West Virginia and the rest of America: It comes through with funding for what matters most to our State: jobs, health care, fighting crime, and children. It has more money for highways, for education, and for job training. The President's budget proposal also continues to cut wasteful spending. It mothballs 130 programs that the President thinks should be shelved. It is a tight-fisted budget aimed at continuing the efforts of OBRA93 to cut the Federal deficit. But I recognize what is going on here. So do my colleagues, and so should the American people. I will not dignify the Republicans' attempt to shift the debate from their budget to an alternative that has no hope of passing with my vote. This important debate is about priorities. And it is their turn to explain theirs. I do not share them, but I have yet to hear an articulate defense of the details of their proposal. To conclude, I will vote against Senator Domenici's amendment to substitute the President's fiscal year 1996 budget for the hard- hearted, extreme proposals in the Republican budget plan--regarding which they seem unwilling to discuss in any careful detail. I will vote no despite the fact that I believe the President's budget, and therefore the amendment, would be a much better basis for a discussion of our national goals and priorities than the underlying Republican budget we have before us today, if only because it does not devastate the Medicare and Medicaid programs on which 70 million Americans rely for their health care. I am interested in hearing the Republican's explanation of how they believe their budget puts the emphasis where it belongs: on our Nation's economic development, jobs, health care, crime, and children-- or why it does not. That is the kind of Federal budget that deals with the day to day needs of West Virginia and that is the only kind of Federal budget which I can support.