Senate Proceeding on Oct 8th, 2009 :: 10:27:20 to 10:49:25
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10:27:18 to 10:27:39( Edit History Discussion )

Richard Burr: from north carolina. mr. burr: i thank the doctor from oklahoma, friend, mr. president. let me say from and a half years ago and i sat down and realized health care was unsustainable at its current level of investment. the american people have co

10:27:20 to 10:49:25( Edit History Discussion )
Speech By: Richard Burr

10:27:40 to 10:28:00( Edit History Discussion )

Richard Burr: a process that's gone too quickly. well, in the patients' choice act you find three and a half years worth of work. a four years before we tho had the right information we need to do health care reform adequately. well, the change in administrations, the new

10:28:01 to 10:28:22( Edit History Discussion )

Richard Burr: president, his time frame, we accelerated. but let me say right from the start, i its current level of investment. 17% of our product. health c now, i personally believe that the debate we were going to have in washington was over what

10:28:23 to 10:28:43( Edit History Discussion )

Richard Burr: of reform. dr. coburn raises a good point: cost. where are we from the standpoint of our nation? i just waiting for the last speakers to finish, on the page of this publication that says "baucus bill proskwrebgtd

10:28:44 to 10:29:04( Edit History Discussion )

Richard Burr: projected at $829 billion." in the small box down at the bottom of the page, "c.b.o.: deficit hits record trillion for fiscal year 2009." common sense would tell you t??t when you're in the type of financial shape the united states of america is, not only

10:29:05 to 10:29:26( Edit History Discussion )

Richard Burr: do you stop spending, you to look for ways to curb spending in a way to investor reduce the deficit, because the deficit is what our children and our grandchildren wil if you believe that it's unsustainable at its current level of investment, then you

10:29:27 to 10:29:47( Edit History Discussion )

Richard Burr: sort of understand where dr. coburn and i come from. the worst place that we start is how much more money do we need to spend care reform. but the truth is, mr. president, the baucus plan is not health care reform. it's health care skpha pbgs

10:29:48 to 10:30:08( Edit History Discussion )

Richard Burr: expansion. the debate in washington not about it is about how to expand medicare. the question is how do we pay for it so the c.b.o. says we've paid for it? what i'd like little bit of time exploring how

10:30:09 to 10:30:29( Edit History Discussion )

Richard Burr: the baucus plan pays for it. you with the caveat up front saying, as it relates to dr. coburn and mysel we don't believe we have to spend more to reform health care. and i think from what he said about the patients' choice act, we've made the point. we were the first two people in the to introduce comprehensive legislation.

10:30:30 to 10:30:50( Edit History Discussion )

Richard Burr: we cover the same amount of additional americans that the baucus plan covers. we do it without making additional in the expansion of coverage. why? because in addition to expanding coverage, we reform health care. we actually bend the

10:30:51 to 10:31:11( Edit History Discussion )

Richard Burr: the change the t application to where it's fair and equal for all people. mr. president, what we have to realize is that the baucus span a ten-year plan -- baucus plan

10:31:12 to 10:31:32( Edit History Discussion )

Richard Burr: is a ten-year plan. we collect revenues for ten years and we pay out for the expansion in six and a half years. let me say i we're collecting tax revenues for ten years but we're only paying benefit expansions for six and a half years. you've got to look at years 10 through 20 if you want to see 10 years worth of revenue

10:31:33 to 10:31:53( Edit History Discussion )

Richard Burr: collection and 10 years worth of expenses. as a matter of fact, if you took the first 10 years and you and said, well, if they started paying payments in the first year, this bill would actually cost $1.8 trillion, not $829 billion.

10:31:54 to 10:32:17( Edit History Discussion )

Richard Burr: $1.8 trillion. incorporated in the baucus bill are cuts to medicare, cuts that equal $449 billion. dr. coburnwo talked about the imminent reduction to physician reimbursements, 21% projected. and we all agree, we're never going to make that.

10:32:18 to 10:32:38( Edit History Discussion )

Richard Burr: and one of the attractions for health care professionals was the baucus bill said in year one, we're not going to make those cuts. well, they're going to cut medicare over ten y $449 billion. this is giving with one hand and taking away with the other hand. the health care professionals around this country have

10:32:39 to 10:32:59( Edit History Discussion )

Richard Burr: realized that even though their association that represents them doesn't. the baucus bill cuts $117.4 billion in medicare advantage. now, my colleagues are probably saying, "what's medicare advantage?" well, it's -- it's the preferred plan of 20% of america's seniors

10:33:00 to 10:33:20( Edit History Discussion )

Richard Burr: seniors. 20% of our seniors on medicare have chosen medicare advantage, a private-sector option traditional health care, traditional medicare, where they've looked at the two and they said, i'd rather have medicare advantage because i go in the hospital, medicare's

10:33:21 to 10:33:43( Edit History Discussion )

Richard Burr: going to charge me deductible right off the bat. medicare advantage? for medicare -- traditional medicare, you're going to have to part-a, part-b, part-d. medicare advantage? you get it all at one lump sum. you don't have to make separate selections. they provide you the doctor coverage, the hospital coverage,

10:33:44 to 10:34:04( Edit History Discussion )

Richard Burr: the drug coverage all in one plan. now, why is it under the target of some in washington to cut $117 billion in they say it's because we pay 114% of medicare per-person allocations to advantage where we pay 100% in

10:34:05 to 10:34:27( Edit History Discussion )

Richard Burr: traditional fee-for-service. that's exactly right. and i rember the debate that we had in washington when we it. because how do you get medicare advantage to offer this plan in rural awwrica and to offer it in rural america meant that you had to offer a greater reimbursement. this isn't reflective of a

10:34:28 to 10:34:50( Edit History Discussion )

Richard Burr: windfall for the companies. it was an incentive to offer this choice not just to urban seniors but to seniors everywhere in america. in my state of north carolina, 25% of all the seniors are enrolled in medicare advantage. when anybody gets up and says,

10:34:51 to 10:35:12( Edit History Discussion )

Richard Burr: pass this bill, the baucus bill, and you can keep your health care if you like it, there's caveat to that. unless you're 25% of the in north carolina orou're 20% of the seniors nationally, you lose your plan. you're going to go back in traditional medicare you're going to go back to where, when you hospital, they're going to say,

10:35:13 to 10:35:33( Edit History Discussion )

Richard Burr: write me a check annually, where your part-b is a spraim payment part-d is where you've got to figure whereas the other is seamless and covers everything.

10:35:34 to 10:35:54( Edit History Discussion )

Richard Burr: i will assure everybody, a $117 billion cut to medicare advantage will eliminate that product from the nobody will offer it. and 20% of america will lose the insurance t prefer, not keep it. medicaid expansion. it seems like a sensible way to go. if you want to expand coverage, which is where the debate's been in washington, well, let's just

10:35:55 to 10:36:15( Edit History Discussion )

Richard Burr: simply take a coverage tool that's out there today, medicaid, and let's raise the income limits so more people qualify for it. so instead of 100% of poverty, we raise it to 133% of poverty. well, it costs $345 billion.

10:36:16 to 10:36:36( Edit History Discussion )

Richard Burr: there's $33 billionn direct state spending. dr. coburn sai sort of split out of it, and they say, well, we're not going to charge you because you're on tough economic times. well, north carolina's at 10.8%. why aren't we included?

10:36:37 to 10:36:58( Edit History Discussion )

Richard Burr: government makes north carolina ante up, is going to be south of a billion dollars for a year for a state that had a $4 billion shortfall. where is my governor in other outrage at the proposal to expand medicaid to 133% of poverty? the tough thing is been sold that it's not going to

10:36:59 to 10:37:20( Edit History Discussion )

Richard Burr: cost anybody anything, and the truth is, it's going to cost seniors, taxpayers, it's going to cost unemployed. but more importantly, it's going to cost people who have health care insurance today. people who either have the money to purchase theirs, people whose

10:37:21 to 10:37:42( Edit History Discussion )

Richard Burr: employer offers them health care care, their cost is going to go up because of the restrictions and the mandates that exist within the the baucus bill would impose an annual $6.7 billion so-called

10:37:43 to 10:38:05( Edit History Discussion )

Richard Burr: fee on insurance companies. $6.7 billion now, over ten y $67 billion. $67 billion new fee on the insurance companies that we're trying to make the american people believe are going to reduce premiums, reduce

10:38:06 to 10:38:30( Edit History Discussion )

Richard Burr: and we're stickin $67 billion price tag. there's nobody in america when they hear that believes that health care is going t for the american people. for every person who's currently got a plan today, i will assure you, their premium will go up. they will pay more money, not

10:38:31 to 10:38:53( Edit History Discussion )

Richard Burr: less money. we grill the i.r.s. there's something we haven't talked about. because of the requirements in this bill to collect fees and to collect the lewen group, that the i.r.s. would need a their budget.

10:38:54 to 10:39:15( Edit History Discussion )

Richard Burr: now, the i.r.s. currently gets $12 billion annually for the administration costs -- administrative costs. the admin implementing the exchange subsidies would add nearly $40 billion from the baucus bill bill. we have additional costs at the i.r.s. because we've got to

10:39:16 to 10:39:36( Edit History Discussion )

Richard Burr: increase by 25% the i.r.s. requirements to go and collect and enforce this. we tax the chronically ill. i thought this one was those myths that late-nigh talks about. we tax in the baucus bill the

10:39:37 to 10:39:59( Edit History Discussion )

Richard Burr: chronically ill. current law says that if your health care charges exceeds 7.5% of your annual income, then you can deduct that off your taxes. and, clearly, the lower your

10:40:00 to 10:40:21( Edit History Discussion )

Richard Burr: income, the more likely you are to use -- to utilize the 7.5% exclusion. so what's the baucus bill do to raise money? it raises the exclusion to 10%. instead of at 7.5% of your adjusted gross income being able to deduct anything that exceeds

10:40:22 to 10:40:43( Edit History Discussion )

Richard Burr: that, it says you've got to exceed 10% of your adjusted gross income. now, for somebody that makes a million dollars a year, this is no big deal. they've probably got more than enough insurance to take care of it. for somebody that's on a l income, for somebody that maybe doesn't have all the insurance that they need, for somebody that walks in and is chronically

10:40:44 to 10:41:04( Edit History Discussion )

Richard Burr: ill, has a chronic disease and they're making payments, they're covering their co-pays, they occasionally go to the hospital, they've got that $ charge for walking in the door even though they've got insurance, getting -- at the end of the year, they make $20,000 or $25,000 a year.

10:41:05 to 10:41:27( Edit History Discussion )

Richard Burr: and all of a sudden 2.5% of their gross -- adjusted gross income is no longer a deduction that they get. what's that? that's taxing the chronically ill in this country. listen, i've got to give them credit. they've left nobody out of this bill from taxing them. they've left nobody out of this bill from instituting a new fee.

10:41:28 to 10:41:49( Edit History Discussion )

Richard Burr: as a matter of we're just going to have to take applied to us in an indirect way way. because, you see, incorporated in the baucus bill, we collect a new device tax. to the heart naisht goes in to get a -- patient that goes in to

10:41:50 to 10:42:10( Edit History Discussion )

Richard Burr: get a heart catheterization, to the senior that goes in to get a hip replacement. it's a device. any medical device that's used, there's a $40 billion device tax over 10 years. now, what does that do for the

10:42:11 to 10:42:31( Edit History Discussion )

Richard Burr: innovation of new devices? dr. coburn can speak to it better than i can. when we were able to swch from to switch from open-heart surgery to bypass surgery, we probably from $40,000 or open-heart bypass surgery, when we were able to catheterize somebody and put a

10:42:32 to 10:42:53( Edit History Discussion )

Richard Burr: reduced significantly the cost, we reduced invasion, we were able to raise the quality of we couldn't have done that if somebody hadn't innovated a cath and a we'd still be d surgery surnlings. you think of all the medical procedures we do in this country

10:42:54 to 10:43:14( Edit History Discussion )

Richard Burr: and you thif all the devices that have think of all the devices that have been created by doctors, because every time they go into somebody, every time they cut in there' of infection today, there's a consequence of recovery. it means a stay in the hospital is longer. you see, when you see a new device enter into the

10:43:15 to 10:43:36( Edit History Discussion )

Richard Burr: marketplace, you actually see a new efficiency come into health care. you see reduced health care costs because you're taking either somebody out of an inpatient setting and you're putting them in an outpatient setting, or you're taking an inpatient patient and you're getting them out of the hospital faster. actuallyyou could make the

10:43:37 to 10:43:59( Edit History Discussion )

Richard Burr: case that innovation devices is health because it's driving down costs, because it's moving patients out out, and quality of life goes up. but in this bill, we raise $40 billion over 10 years,

10:44:00 to 10:44:20( Edit History Discussion )

Richard Burr: $4 billion a year on taxes on devices. now, if you listened to the things i've talked about, you probably are sitting at home trying to figure this out m -- i'm going to pay more in health care because they're taxing devices. i'm going to pay more in health care if, in fact, i've got a

10:44:21 to 10:44:42( Edit History Discussion )

Richard Burr: chronic illness becse i'm not going to be able to deduct that out-of-pocket cost that's between 7.5% and 10% of my adjusted gross income. i'm going to have to cover as a taxpayer the 25% expansion in the i.r.s.

10:44:43 to 10:45:05( Edit History Discussion )

Richard Burr: they're going to impose a $6.7 billion so-called fee on the insurance industry, or $67 billio i've got an insurance policy so that through to me as a covered life under the insurance plan. i'm going to pick up in the state that i live in the

10:45:06 to 10:45:28( Edit History Discussion )

Richard Burr: increase in the limitations on medicaid when we go fro poverty to is 33% of poverty. -- to 133% of p how can you make a claim that this bends the cost curve? if you tried to make the claim,

10:45:29 to 10:45:49( Edit History Discussion )

Richard Burr: it bends the cost curve up down. dr. coburn and i listened very intently as the president kicked f this create a program that provide

10:45:50 to 10:46:12( Edit History Discussion )

Richard Burr: coverage for as many americans as we possibly could we did that. bend the cost curve down. well, we investment in prevention, wellness, and chronic disease management. the only three direct areas of savings

10:46:13 to 10:46:35( Edit History Discussion )

Richard Burr: we can talk all night about court reform -- tort reform and we aspects. they are indirect, and they are significant -- significant -- savings that we can achieve by incorporating these health care. but in the patients' choice act, whreected to keep it very narrowly drafted.

10:46:36 to 10:46:56( Edit History Discussion )

Richard Burr: disease? why because we went around this countries and went to self-insured companies that went four increase costs. why? because they changed the lifestyles of their workers. they actually paid their workers, in some cases, to quit smoking, to lose weight, to get exercise, to take an educati

10:46:57 to 10:47:18( Edit History Discussion )

Richard Burr: program on a chronic disease that they had to make sure that they got the treatment that they wanted. what was the net result? in every case the per-enrollee savings were so significanthat the companies continued to try to spend more to reduce health care costs. the

10:47:19 to 10:47:40( Edit History Discussion )

Richard Burr: employee productivity of their employees was better, and they had no annual increas care we're sitting here ignoring everything that's been learned in america

10:47:41 to 10:48:03( Edit History Discussion )

Richard Burr: self-insured companies, by some insurers who are doing things at targeting chronic disease and actually paying doctors to educate. we've ignored all of t why? because we're having a debate in washington with the baucus bill about coverage expansion, not about health care reform. and coverage expansion costs a

10:48:04 to 10:48:25( Edit History Discussion )

Richard Burr: lot of money. $829 billion. and we're having that debate and we're telling the american people, this is about reform. and if you read the fine print, if you read the bottom of page, if you read the part they

10:48:26 to 10:48:48( Edit History Discussion )

Richard Burr: don't want you to rember, it says, this year alone a $1.4 trillion that's $1.4 trillion we didn't have that we had to go out and borrow. the last thing we need is more money in health care.

10:48:49 to 10:49:10( Edit History Discussion )

Richard Burr: at 16% of our gross domestic product, w we can maintain that level of investment. the challenges on us to come up with the reforms that continue to invest and promote innovation innovation, that expands coverage and, reduces

10:49:11 to 10:49:26( Edit History Discussion )

Richard Burr: what do the american people want? they want heal go down, and they want quality to go up. we don't accomplish baucus you do in the coburn-burr bill. it is not perfect, but it heads in the right direction.