Paul Ryan

Mr. RYAN of Wisconsin

Mr. RYAN of Wisconsin. Mr. Speaker, will the gentlewoman yield?

Mr. RYAN of Wisconsin. Mr. Speaker, is the gentlewoman saying that the fallback plan according to the Congressional Budget Office will lead to higher drug prices for seniors to the tune of 8 to $12 billion?

Mr. RYAN of Wisconsin. Mr. Speaker, I thank the gentlewoman for yielding me time. I thank her for her leadership on this issue. Let me address a couple of the inaccuracies that the last speaker mentioned. That is the word we are using, ``privatize.'' Under the definition on the other side of privatization, under their definition Medicare is already privatized then, because Medicare right now is private providers providing care for our seniors. All the doctors in your country do not work for the Federal Government, the hospitals, the nursing homes. What it is is Medicare paying the bills to private providers to provide care for our seniors. Right now you have HMO's through Medicare providing care to our seniors. So today, under your logic, Medicare is already privatized. The point is this is not privatizing Medicare. I would like to bring the gentleman from New Jersey's (Mr. Pallone) attention to page 260 in the legislation where it says, ``No change in Medicare's defined benefit package'' shall occur. ``Nothing in this part,'' and this is the title they seek to strike, ``or the amendments made by this part, shall be construed as changing the entitlement to defined benefits under parts A and B of title XVIII of the Social Security Act.'' The point is this is not privatizing Medicare. What we are simply doing is adding to the choices that seniors have to make in their lives. And the kind of choices that we want to give seniors entitlement to are the same choices that we, as Members of Congress have, and 9 million other Federal workers and their loved-ones have in choosing their health care. So what we are saying here is every senior will always have access to traditional Medicare fee-for-service. Will their premiums go up by $500 like the gentleman from New Jersey (Mr. Pallone) said? No. The CBO says their premiums may go down. If anything their premiums could go up by a dollar a month. That is hardly a big increase given the fact that we are also covering prescription drugs. Now, I answer the question about rural. If you take a look at rural America, this is the most significant, the most significant package for rural America since Medicare was written in 1965. The House bill dedicates over $27 billion in payments to rural America to improve its Medicare program. That is even more than what the other body is doing. Now, I simply want to put a point here, and that is this: We have to recognize the facts that Medicare itself is going insolvent. If we do nothing, if we do not pass this prescription drug bill, Medicare is going to go insolvent and bankrupt. If that time when we see an America where we have 40 million retirees today coming to the day within 15 to 20 years when we will have 77 million retirees, that is a day we must be prepared for. And so the Medicare actuaries are telling us if we want to make Medicare whole for the baby boomers before adding a prescription drug benefit, we will have to raise Medicare FICA taxes by 80 percent if we are going to do it on FICA taxes. If you throw a prescription drug benefit on there, we could raise as much as 120 percent to keep Medicare solvent for the baby boomers. We do not want to see that happen because that would cost us jobs. That would be bad for the economy. What we want to see happen is a Medicare that is solvent, that is here for the baby boomers when they retire, and that is better for today's seniors. And by making it better for today's seniors, we will give them an entitlement to prescription drug benefits. We will give them the same kinds of choices we, as Members of Congress, have when we pick health care for our families. Those are the kinds of choices we are giving seniors in this legislation. It is not privatizing Medicare. Medicare will be the overseer, the regulator, the overseer of all of these programs just like it does today. What we are simply trying to do is improve benefits for today's seniors by modernizing it with a prescription drug benefit, giving them more choices like we as Congressmen and Congresswomen have, and do so so we can make this thing solvent, so this very, very important and vital program in the Federal Government will be there for the baby boomers when they retire, so we are not faced with the day when we are cutting back and rationing care and cranking up FICA taxes.

Mr. RYAN of Wisconsin. Mr. Speaker, will the gentleman yield?

Mr. RYAN of Wisconsin

Mr. RYAN of Wisconsin. Mr. Speaker, I rise today in support of H. Con. Res. 230, which honors the ten communities that received the National Civic League's All-America City Award for 2003. As the latest recipients of the prestigious 54-year-old award, these communities embody the spirit of American democracy by demonstrating how cooperation between citizens, businesses, volunteer organizations, and local government leads to the resolution of the critical problems facing America's cities. I am extremely proud to represent the Greater Racine Area, an All- America city and a tremendous asset to Wisconsin's First Congressional District. Over the past few years, the citizens of Racine and the surrounding area have worked diligently to implement multiple initiatives that have positively impacted the lives of those who live in Racine County. For example, the Racine Area Intergovernmental Sanitary Sewer Service, Revenue Sharing, Cooperation and Settlement Agreement is an initiative that uses revenue from Racine's outlying communities to make improvements to the city's wastewater treatment infrastructure and enhance the city's cultural attractions such as its zoo, fine arts museum and library. A second initiative, the West Sixth Street Revitalization effort involves the participation of citizens, local businesses and government to help rebuild run-down homes in the inner city. Finally, the Racine County Youth As Resources (YAR) program is an exemplary project that encourages young people to take an active role in improving their own neighborhoods. This program provides grants for youth-led community service projects such as neighborhood cleanup programs, educational programs and services for the elderly. I commend the citizens of the Greater Racine Area for their dedication to improving their community and applaud their willingness to employ innovative methods and basic American ideals toward the achievement of that goal. Racine, Wisconsin is truly a role model for other communities to follow and a deserving recipient of the 2003 All- America City Award. I ask my colleagues to join me in supporting H. Con. Res. 230, honoring the Greater Racine Area and the other nine communities that symbolize America's strong tradition of embracing civic responsibility and upholding the tenets of democracy.

Mr. RYAN of Wisconsin

Mr. RYAN of Wisconsin. Mr. Speaker, I, too, was sitting closest to the lone minority member in the Chamber. I was there in the Chamber next to the gentleman from Texas (Mr. Brady). I heard the comments. It was very, very clear that a physical threat was made, that a situation was getting out of control, that we had a physical situation on our hands; and if I were in the position that the chairman was, I believe that the Capitol Police or the Sergeant at Arms should have been called to restore order.

Mr. RYAN of Wisconsin

Mr. RYAN of Wisconsin. Mr. Speaker, I yield 7 minutes to the gentlewoman from Connecticut (Mrs. Johnson), the chairwoman of the Subcommittee on Health of the Committee on Ways and Means.

Mr. RYAN of Wisconsin. Mr. Speaker, the actuaries will not certify that it will extend the solvency of Medicare by any certain number of days.

Mr. RYAN of Wisconsin. Mr. Speaker, will the gentleman yield?

Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself such time as I may consume. I would like to address a couple of the points that the gentleman from Florida (Mr. Davis) made. In the gentleman from Florida's motion to instruct, it is akin to passing an amendment to say we are going to see to it that Medicare is bankrupt faster than it is already going bankrupt. The problem we are trying to deal with, Mr. Speaker, is this: we already have financial problems with Medicare. As it stands today, if we do not even do anything and we do not add any benefits like prescription drug benefit to Medicare, it is going insolvent in 10 years. At the height of the baby boom retirement when we have 77 million retirees in place in America, more than the 40 million we have today, almost double, we are going to exhaust all of the Medicare trust fund by the year 2036. So what we are trying to do here is this: we recognize so clearly that Medicare is an outdated program. Medicare is not modern. It is not comprehensive. It does not cover all the comprehensive health care needs a person has over the age of 65, especially; and that is why we out of the House passed very comprehensive legislation, comprehensive legislation to help not only add a prescription drug benefit to all in Medicare but give them access to comprehensive health care so they do not have to go out and buy a costly supplemental insurance plan, so they do not have to pay out of pocket with high retail prices with the buying power of one person for their prescription drugs. We have great comprehensive reforms for the current generation of retirees. But the one very important part of what we passed in the House is not only do we improve Medicare for today's generation of retirees by making it more modern; we also have very important reforms in this bill to make sure that the program is actually solvent for the next generation when they retire, and that is what we are trying to accomplish. If we simply add a benefit to Medicare on top of the current program in its current structure, all we end up accomplishing is accelerating the bankruptcy of Medicare. Mr. Speaker, we owe it to all Americans, not just the current generation of retirees, to fix this program; but we owe it to the next generation, the baby boom generation, to make sure that this program is there for them when they retire. The reforms that are in question that are being jettisoned or gutted in this motion to instruct are the very important reforms that get us to solvency for the baby boom generation, and those reforms are not vouchers. Those reforms are defined benefit plans that simply give seniors the same access to comprehensive health care plans that we as Members of Congress have and all other Federal employees and our families have; and those plans in competition with one another for our business, for the seniors' business will help reduce long-term costs so we can extend the solvency of this program for the baby boomers. As to the very important criticism, but very wrong criticism, that this is going to hurt the people who are not healthy, the sick and low- income, that is completely false, Mr. Speaker. This legislation very clearly has guaranteed issue. No plan can pick and choose who they are going to cover in Medicare. If they are in Wisconsin as a person of the age of 65, Medicare eligible, and they want an enhanced plan like a private PPO or Blue Cross like my wife chose for us in the Federal Employee Health Benefit Plan, everybody who is entitled to Medicare is entitled to that plan. These private plans cannot cherrypick and cannot deny people based on preexisting conditions. And that I would add can be found on page 260. Another very important part is that this has risk-adjustment payments. So if, for example, sicker people are going into a plan, they will have risk-adjustment payments, and that can be found on page 248 as well. So I would simply direct my colleagues to the legislation to find out that this does have risk-adjustment payments so it will not have a problem with healthy or nonhealthy people going into one plan or another. This language is what we must pass into law, not just out of the House, to save this vital program for the next generation while improving Medicare for the current generation. Mr. Speaker, I reserve the balance of my time.

Mr. RYAN of Wisconsin. If the gentleman will yield, on page 182 of the bill.

Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself such time as I may consume. I would like to address a few of the points that were made here on the floor. The gentleman from California, I think he has left the floor, said, Medicare is really not going broke. That is a new one to me. Because, Mr. Speaker, if we take a look at Medicare, the actuaries, I am not talking about the Congressional Budget Office even, but the actuaries are telling us, Medicare has a $13.2 trillion liability today. Today's Medicare program is going insolvent in 10 years, before doing anything, before adding any benefit. For example, if we had to actually pass legislation right here through taxes and we wanted to make Medicare solvent for the next generation, today we would have to raise Medicare FICA taxes by 80 percent. An 80 percent FICA tax hike is what would be required to fix this unfunded liability. Maybe that is, after all, what some on the other side are seeking to achieve. What we are trying to achieve here, Mr. Speaker, is to improve Medicare today by making it more comprehensive for today's seniors but also to save it for that baby boom generation. This motion to instruct will not save Medicare. It will bankrupt Medicare. So when we take a look at the reforms we have in this bill that the other side is targeting to try and jettison from this product, what we are simply trying to do is add choices. Give seniors more choices so they, like us in Congress, Federal workers can choose who their provider is. If they like what they have, if they have traditional Medicare and they like it and they have their drugs paid for by their employer or their supplemental paid for by someone else, great. They are the lucky ones, wonderful. They can keep it. But if like many of the constituents I have in Wisconsin, they have to dig deep into their pockets and buy a very costly supplemental, then they have to pay for their drugs out-of-pocket. Medicare is outdated for them. It is not comprehensive. We want to make it comprehensive. And by giving seniors more choices, that active choice drives competition because providers, all of those providers who are regulated and overseen by Medicare, who have to give a comprehensive benefit regulated by Medicare, those providers competing against each other for seniors' business will bring competition to the system and competition to the system will bring down costs over the long run. And the only way to make Medicare solvent for the baby boom generation is to bring down costs over the long run, otherwise we will have to raise taxes or we will have to cut benefits. That is what we want to avoid. Now, this is not Medicare+Choice. One of the speakers, the gentleman from Michigan, said this is the same old problem again, like Medicare+Choice. This is anything but Medicare+Choice. This is much like what Federal employees have, and that is the title of this bill that the motion to instruct seeks to remove. And the concept basically goes like this: today, under Medicare, if you want to get reimbursed as a provider, you have got to have an operation, a procedure. Medicare pays providers to operate on people, to have procedures. But if you give, as a provider, a person preventative medicine, disease management, keep them healthy, have better results, you do not get paid. So the incentive structure is really bizarre. What we want to do is reward providers for keeping people healthy, for giving them preventative medicine, for giving them disease management, for keeping them healthy, out of the hospital, out of the operating room. And guess what? Not only is that a healthier, happier life, it saves money; and that is what we are trying to do over the long run so we can modernize this program, give seniors the same options and choices like we as Members of Congress have; and if we can accomplish that, we can save money over the long run and save this very important, very vital program for the baby boom generation when they retire. Mr. Speaker, I yield back the balance of my time.

Mr. RYAN of Wisconsin

Mr. RYAN of Wisconsin. Mr. Speaker, I thank the chairman on the Committee on Energy and Commerce for expediting this bill, and I thank the gentleman from Wisconsin (Mr. Kleczka) for drafting this legislation and moving it through the committee and bringing it here to the floor today. I represent the First Congressional District of Wisconsin, which is just below Milwaukee. We in our area have a number of the employees that work for Harley. We have the distribution center in Franklin. We also make Buell motorcycles, which is a division of Harley-Davidson. Eric Buell, an entrepreneurial upstart, started Buell Motorcycles, it is now a part of Harley, and that is very much in keeping with the tradition of Harley-Davidson. We have 4,000 employees just in the Milwaukee area who are so proud to produce Harley-Davidson motorcycles. Harley-Davidson is an icon in the American culture. They more than just represent the American idea and dream of entrepreneurship, of starting a business in a woodshed in Milwaukee in 1903, and bringing it to a wonderful corporation providing a lot of jobs and pleasure. Mr. Speaker, more than that, Harley-Davidson is America. It is America because it brings our beautiful hogs all around the world. It is an ambassador of some of the greatest craftmanship of America. What is occurring this year on its 100th-year anniversary is events are taking place not just in Wisconsin, not just in America, but events are taking place all over the world to celebrate the 100th-year anniversary of this wonderful motorcycle, all of which are culminating in a huge event at the end of August in Milwaukee, Wisconsin. We are anticipating 10,000 motorcycles to ride in on that weekend with 200,000 people coming. I want to add my voice to the rest of those who have spoken today to commemorate Harley-Davidson, an American icon in our culture, something which has been there to provide for our American defense forces in World War I and World War II, has provided great jobs and given a lot of pride to the workers, and something that has given great pride to the riders and owners who restore these beautiful Harley-Davidson motorcycles.

Mr. RYAN of Wisconsin

Mr. RYAN of Wisconsin. Mr. Speaker, tomorrow, the flags of Kenosha County in Wisconsin will fly at half-staff in honor of U.S. Navy Seal Tom Retzer who was killed in the line of duty in the Near East on June 25, 2003. His father-in-law and mother-in-law live in Kenosha, and his wife and children reside in northern Virginia. The loss of this brave U.S. serviceman saddens us and reminds us of the dangers our military men and women face every day as they work to protect our country and stand up for freedom. Throughout our nation's history, courageous individuals like Tom Retzer have been willing to put their lives on the line to defend our land and liberty. We owe them and their families our support and our deepest gratitude. Without them, America's freedom would be fleeting. We honor the memory of Tom Retzer and offer prayers for him and his family.

Mr. RYAN of Wisconsin

Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself 15 seconds to respond just briefly only to say that health care is voluntary by businesses. Mr. Speaker, Boeing could drop their health care right now, today, to their employees. And, Mr. Speaker, that is what is happening today. Millions of businesses are making those kinds of decisions to drop health care. We are trying to make it more affordable. We are trying to keep it so that businesses can still offer health insurance at an affordable price to their employees. Mr. Speaker, I yield 2 minutes to the gentleman from California (Mr. Royce).

Mr. RYAN of Wisconsin. Mr. Speaker, I yield 2 minutes to the gentlewoman from Washington (Ms. Dunn), a member of the Committee on Ways and Means.

Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I just heard the ranking member say this is not a health bill, that this is a tax shelter. I beg to differ. Number one, what we are talking about here is really novel and revolutionary. We are saying that employers and employees can together contribute to their own savings account with pre-tax dollars, with tax- deductible dollars to purchase health care spending and to have a catastrophic plan. The gentleman from New York said, what about the people who do not have $4,000 to put in their health security savings account? Well, their employer can put $4,000 into their account. The purpose of this reform, Mr. Speaker, is to get at some of the big issues that are really hurting this country, and that is the cost of health insurance, the affordability, and the accessibility of health insurance. So what this reform does is it equips the individual in the family with the ability to go out into the health care marketplace with tax- deductible dollars to act like good consumers and buy their health insurance. It gives incentives. It actually requires, on health savings accounts, that employers provide catastrophic health insurance, or individuals who have their own health savings accounts have catastrophic health insurance. So it makes sure that people have health insurance if they really run into problems. But it allows people to manage their health care expenditures themselves. You know, it is often said that we spend more time shopping for cars or computers than we do for our own health insurance. Well, the reforms in this bipartisan Thomas-Lipinski bill give us those incentives to act like good consumers so we can watch our health care dollars. Health care inflation is out of control. Health care spending is out of control. Premium increases facing small businesses and individuals are out of control. We need to give consumers the ability to get it under control. That is what this legislation does. I am also interested in the argument that this is somehow fiscally irresponsible. I find that kind of a unique argument, given the fact that the gentleman from New York is about to bring a prescription drug substitute amendment to the floor that spends $600 billion more than the Republican plan does; a trillion dollar bill that spends a trillion dollars on his prescription drug bill versus the $400 billion that was paid for in the House budget resolution, as is this health savings account legislation. Mr. Speaker, I reserve the balance of my time so that the other side can yield time.

Mr. RYAN of Wisconsin. Mr. Speaker, I reserve the balance of my time.

Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself 30 seconds. Mr. Speaker, to respond to a couple of comments from the last speaker, I would say, number one, we are going to keep hearing this rhetoric, that this undermines or destroys employer-sponsored health care. Actually, it is far from that. It is the opposite of that. This makes it easier for employers to offer health care to their employees. What this does is it makes it easier because employers can offer less- costly catastrophic coverage and give their employees money, pretax money in their accounts, to purchase health care. This will lower the cost of health insurance and make it cheaper for employers to offer health care. Mr. Speaker, I yield 2\1/2\ minutes to the gentleman from Arizona (Mr. Hayworth), an esteemed member of the Committee on Ways and Means.

Mr. RYAN of Wisconsin. Mr. Speaker, I yield 2 minutes to the gentleman from Texas (Mr. Burgess).

Mr. RYAN of Wisconsin. Mr. Speaker, I yield back the balance of my time.

Mr. RYAN of Wisconsin. Mr. Speaker, I yield myself the remaining time. I would like to begin my closing by saying that the gentleman from California is a person who has worked in health care for many, many years; and I know that he is sincere in trying to do what he thinks is best to give access to people who need health care. I believe everyone who came to the floor and into the well who spoke on this bill today cares about health care. Mr. Speaker, I am relatively new to this body; but one thing I have learned is that if you are running out of arguments, the oldest trick in the book is to impugn the other person's motives. Tell them that all we want to do is help the rich and hurt the poor, that what we are trying to do is destroy employer-sponsored health care. Well, Mr. Speaker, two of the Nation's leading organizations who represent small employers, the people who are really facing these high premium hikes, the National Association of Manufacturers, the National Federation of Independent Businesses, this is one of their key priorities. They endorse this bill. What this does, Mr. Speaker, is it makes it easier for employers to offer health care to their employees. It helps us continue employer- sponsored health care. Another thing that we have been hearing, that this is fiscally irresponsible and adds to the deficit. Mr. Speaker, what is fiscally irresponsible is the substitute prescription drug bill that the minority is bringing to the floor which costs $600 billion more than the budget resolution allows. The budget resolution that passed this House balances the budget within the term of the budget resolution, within 10 years. And this is paid for and budgeted for in the budget resolution. Mr. Speaker, at the end of the day, after we have heard all of these arguments, it kind of comes down to two things, two different philosophies: socialism versus consumerism. They want socialized medicine. They want power to go to Washington where Washington can allocate the benefits, where Washington can ration the health care. We want power to go to the people. We want power to go to the consumers. We want people to have more choices. They want to restrict those choices. This does not take anything away from anybody, Mr. Speaker. This gives people more choices. This says to people, if you are having a hard time saving for your health care, we are going to make it easier for you to do that. If you are a small business and you cannot afford health care for your employees right now, we are giving you a new option to do just that. We are going to give employers the ability to say, look, you can put money in an account that you can deduct it from in your employee's name. Your employees contribute to this account. If you do it, you have to buy catastrophic health care coverage for them. So we are making sure with health care savings accounts that there is health insurance. And the beautiful part of this proposal, Mr. Speaker, is that this is the employee's money; it is their money that is at stake when they go out and buy health care. They are going to act like real consumers. They can take this money with them when they leave their job and go to another job. They can take this money with them into retirement throughout the rest of their life; and when they die, this money can go to their spouse. This money becomes the individual's money. One of the big problems we have in health care today is we do not act like consumers. We have third-party payers paying the bills, and so when we go and pay for health care, someone else is paying the bills, so we really do not care how much it costs. That is one of the reasons why the costs of health care are going up through the roof. This puts in place 280 million brains on behalf of bringing down health care costs and 280 million sets of eye balls watching this industry to make sure that doctors are charging the right kinds of prices, that hospitals are not overcharging, and that they are getting the best quality for their dollar. Mr. Speaker, it is about giving power to consumers versus giving power to bureaucrats in Washington. Let us give Americans more freedom, let us give consumers more power, and let us help bring down health care costs. Mr. Speaker, I urge passage of this bill.

Mr. RYAN of Wisconsin. Mr. Speaker, I yield 2 minutes to the gentlewoman from Florida (Ms. Harris). (Ms. HARRIS asked and was given permission to revise and extend her remarks.)

Mr. RYAN of Wisconsin. Mr. Speaker, I yield 30 seconds to the gentleman from Louisiana (Mr. McCrery), from the committee.

Mr. RYAN of Wisconsin

Mr. RYAN of Wisconsin. Mr. Speaker, I thank the gentlewoman for yielding me this time. I want to calm down a little bit. There has been a lot of shouting around here, a lot of heated rhetoric, a lot of hyperbole. Let us just look at a couple of facts. It is a fact that the Medicare actuaries are telling us that Medicare is going insolvent in 13 years. The entire trust fund goes bankrupt in 2036. It is a fact that if we add more money on top of Medicare without doing any reforms, you are going to accelerate the insolvency of Medicare. We can try and speak those facts away, but the fact remains that those are facts. Now, what this Democrat substitute does is it costs over $1 trillion. It accelerates the bankruptcy of Medicare. The basic assumption in this CBO estimate is that every employer providing private drug coverage for the retirees is going to drop it. And why would they not? Why would they not drop it if the Federal Government is going to pay for it all? What the facts are is that this plan is going to accelerate the bankruptcy of Medicare. Now, what are we trying to achieve with the Republican bill? Mr. Speaker, there are parts of this bill that none of us all like. I have my own criticisms. But what we are trying to achieve is not only modernizing this program so it works for today's seniors by giving them cheaper drugs and coverage of drugs, but we are also trying to modernize this program and save it for the baby boom generation. We have 77 million retirees coming in this country starting in 15 years; and if we accelerate the bankruptcy of this program as the Democrats are proposing to do, it is not going to be there for them. So what we are doing with these market-based reforms and giving seniors more choices? We are giving them the chance that this program will be solvent for the boomers when they retire. That is the responsible thing to do here. The responsible thing is to make it work for today's seniors, make it modern, make it comprehensive, work on prescription drug prices, work on prescription drug coverage, but give seniors more choices, use competition, use the things that have worked in the past so we can save this program for the baby boomers. That is what the Republican bill does.