Senate Proceeding on Oct 28th, 2009 :: 6:37:00 to 6:56:20
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6:36:57 to 6:37:18( Edit History Discussion )

John Cornyn: fo the future of this madam president, i yield the floor. a senator: madam president? the presiding officer: the senator from t bgs. mr. from tt. mr. cornyn: madam president, i ask unanimous consent to speak up to 15 minutes. the presiding officer: without objection. mr. cornyn: i would like to

6:37:00 to 6:56:20( Edit History Discussion )
Speech By: John Cornyn

6:37:19 to 6:37:39( Edit History Discussion )

John Cornyn: talk about another one of those consequential issues of our day that we've been talking about a lot lately, and that is health care reform. and i'd like to start by asking a question of my colleagues and anyone who is within the sound of my voice, and that would be: before we create a new government-run health care plan, why don't we fix the ones we already have?

6:37:40 to 6:38:02( Edit History Discussion )

John Cornyn: and why don't we do more to fight fraud and waste and abuse in medicare and medicaid? of course, government-run plan for seniors. it's part of a commitment we made that people who have achieved a certain age will have health care available to them, and that is a commitment we need

6:38:03 to 6:38:24( Edit History Discussion )

John Cornyn: to keep. medicaid, conversely, is for low-income individua. it's a state-federal government share program. but just like a new government plan can be dressed up in many different ways, kind of like a child on halloween, like some calling a government plan a

6:38:25 to 6:38:45( Edit History Discussion )

John Cornyn: public option or some calling, talking about opt-outs, opt-ins and triggers, once the mask comes off, what we are left is, is plain and simple, another government-run health care plan. when i was on the floor on monday and talking about our current government plans -- medicare and medicaid -- i

6:38:46 to 6:39:07( Edit History Discussion )

John Cornyn: pointed out the very serious fiscal problems that both of these programs have and ones that we really should attend to before we go creating another government-run plan with perhaps it own set of fiscal for example, medicare, which is health care for our seniors, has

6:39:08 to 6:39:29( Edit History Discussion )

John Cornyn: $38 trillion in unfunded liabilities and will go bankrupt in 2017 unless congress acts sooner. medicaid, we know, has its own share of problems. it actually reduces access to health care. it hand but denies that access

6:39:30 to 6:39:51( Edit History Discussion )

John Cornyn: because of unrealistically reimbursement rates to health care providers. so many health care providers in my state -- in texas and elsewhere -- won't accept the medicaid patients. what good is medicaid, what good is medicare if you can't find a physician who is willing to see you? it's not much good at all.

6:39:52 to 6:40:12( Edit History Discussion )

John Cornyn: i agree with our colleague, senator landrieu of louisiana, who suggests why don't we fix the two public options we have now instead of creating a new one stpwh this afternoon -- new one? this afternoon i would like to talk about how we need to fix another problem with our government plans. that is how we should do more to fight waste, fraud, and abuse.

6:40:13 to 6:40:33( Edit History Discussion )

John Cornyn: i noted earlier this week that both medicare and medicaid combined have, by some estimates, as much as $90 billion lost in taxpayer dol stolen from the intended beneficiaries of these two important government plans. "60 minutes" ran a story on this

6:40:34 to 6:40:54( Edit History Discussion )

John Cornyn: on sunday which included the story of a former federal judge billed the government for two artificial limbs on his behalf, even though he still has the ones god gave him when he was born. someone is using his name and in

6:40:55 to 6:41:15( Edit History Discussion )

John Cornyn: this instance his billing number ford to defraud the american taxpayer, and we ought to be doing more to stop it. this morning on theudiciary committee, we discussed health care fraud, listened to some witnesses from the justice department. and basically what i concluded from that hearing is there are more bad guys than there are

6:41:16 to 6:41:36( Edit History Discussion )

John Cornyn: good guys, and we're stuck with a lack of resources to deal with this. and we really need to change the way we approach it to prevent fraud and waste on the front end rather than to try to chase it down on the back end. according to the department of health and human services,

6:41:37 to 6:41:59( Edit History Discussion )

John Cornyn: 32.7 -- $32.7 billion, $32.7 billion of medicaid funds were consumed last year by waste, fraud, and abuse. that's about 10% of medicaid's total costs, which were $333 billion. medicare has similar problems. medicare fraud may consume up to

6:42:00 to 6:42:20( Edit History Discussion )

John Cornyn: 15% to 20% of the $454 billion in the medicare budget according to harvard professor malcome sperrow. that means the amount lost to fraud would be about $790 billion each year. some of the examples of waste,

6:42:21 to 6:42:41( Edit History Discussion )

John Cornyn: fraud and abuse should be embarrassing. in 2007 to 2009 more than $90 million of claims were ordered by dead doctors according to to the senate permanent committee on investigations last year. some of these dead doctors have been very productive. they have been ordering medicare benefits for up to ten years. just this past august in

6:42:42 to 6:43:03( Edit History Discussion )

John Cornyn: houston, the f.b.i. discovered that a doctor and his wife had defrauded health care providers of more than $31 million. st one doctor and his spouse, $31 million. they claim to have administered a number of injections and other treatments that never in fact occurred. but they still charged the

6:43:04 to 6:43:25( Edit History Discussion )

John Cornyn: taxpayer for them, and were paid cause of medicare fraud. defrauding the federal governme and the federal taxpayers through their health care programs is so lucrative that mafia figures and other criminals are getting into the act. according to the associated press this month, members of the russian armenian crime ring in

6:43:26 to 6:43:46( Edit History Discussion )

John Cornyn: los angeles were indicted for bilking medicare of more than $20 million. and a week after the f.b.i. issued search warrants related to medicare fra in miami, the body of a potential witness was found in the back seat of a carried tkeld with bullets -- car riddled with bullets. violent criminals are moving in to defraud the government and

6:43:47 to 6:44:07( Edit History Discussion )

John Cornyn: american taxpayer because the risks and reward look better to them than, for example, the drug trade. according to this same a.p. story, a medicare scamer could easily net $25,000 a day while risking a relatively modest ten years in prison if convicted on a single count.

6:44:08 to 6:44:29( Edit History Discussion )

John Cornyn: a cocaine dealer, by comparison, could take weeks to make that amount while risking life in prison. so it's a matter of incentives, risks and rewards. and apparently the risk of committing medicare and medicaid fraud is so low and so lucrative that it has continued to grow

6:44:30 to 6:44:50( Edit History Discussion )

John Cornyn: and grow and grow. now we know that vulnerability in programs takes -- according to the accounting office, the general accounting office found that about 65,000 medicaid beneficiaries in these states each visited six or more

6:44:51 to 6:45:11( Edit History Discussion )

John Cornyn: providers for the same type of controlled substance. each of these 65,000 medicaid beneficiaries visited six or more providers for the same type of controlled substance. these controlled substances included valium, others.

6:45:12 to 6:45:33( Edit History Discussion )

John Cornyn: together these 65,000 medicaid beneficiaries charged taxpayers 3 million to feed their - -- $63 million to feed their habits. sometimes the providers abide -- a florida -- for controlled

6:45:34 to 6:45:55( Edit History Discussion )

John Cornyn: substances to patients that he knew were drug abusers. and tragically five people died as a rest of the drugs that this doctor prescribed. now, we know there's a better way to deal with the fraud and the two public options for public-run plans that currently ist.

6:45:56 to 6:46:16( Edit History Discussion )

John Cornyn: we do not have to accept the 3% to 10% loss in taxpayer dollars because of fraud, waste, and abuse. 3% to 10% of the taxpayer dollars. let's just compare that for a second to another industry that deals with huge amounts of money and millions of transactions, the credit card industry.

6:46:17 to 6:46:38( Edit History Discussion )

John Cornyn: according to the center for health transfor may the credit card industry than $2 trillion in patriots every year from $700 million credit card transactions, used by millions of vendors. yet fraud in that industry is a fraction of what exists with federal government programs.

6:46:39 to 6:46:59( Edit History Discussion )

John Cornyn: at least 100 times higher. and then more closer to private health insurance companies do a much better job of fighting fraud, waste and abuse than do government bureaucrats. i know everyone likes to bash the insurance industry. but in this area they sure beat any government plan that i've seen. fraudulent claims in the private

6:47:00 to 6:47:20( Edit History Discussion )

John Cornyn: sector are mh lower. they're roughly 1.5% of all the claims submitted according to a new book called "stop paying the crooks," edited by jim frogie. this is because the private sector operates with a different

6:47:21 to 6:47:42( Edit History Discussion )

John Cornyn: paradigm. they predict as posed the federal government will pay first and chase the crooks later on. because, as i said earlier, there are more bad guys than good guys in our ef -- and our effort to combat fraud is under resourced, this pay first and

6:47:43 to 6:48:05( Edit History Discussion )

John Cornyn: chase the crooks down is not working. we need to change the paradigm to one that sector of detect and prevent rather than pay and chase so why isn't the federal government doing a better job of fighting fraud? we heard testimony this morning, as i said, from representatives of the department of justice and the department of health and

6:48:06 to 6:48:29( Edit History Discussion )

John Cornyn: human services, and they -- i congratulated them, first of all, for their service to our country. and they have had some modest successes wit the stepped up investigations and prosecutions for health care fraud. i say modest because the vol tomb of the -- the volume of the problem, the renorm tif the

6:48:30 to 6:48:51( Edit History Discussion )

John Cornyn: problem dwarf -- enormity ofhe problem dwarfs any of their efforts. still the administration, i will give them credit, are trying to get their hands around the problem. regarding medicaid, the inspector general of h.h.s. released a report in august. he said the data collected by the medicaid statistical information system was not

6:48:52 to 6:49:14( Edit History Discussion )

John Cornyn: timely or accurate enough to help fight fraud, waste, or abuse. data takes a year and a half to be publicly available, by which time the crooks will have gotten the money and will have escaped perhaps long retired in the caribbean. now, this morning the administration told us they were going to conduct a national fraud summit.

6:49:15 to 6:49:35( Edit History Discussion )

John Cornyn: and i can tell you sometimes having a meeting is a substitute for doing something about the problem. so having a summit is fine in and of itself, but i don't have a whole lot of confidence that another meeting or summit is going to solve this problem. instead we need to give the federal government and our law enforcement personnel in

6:49:36 to 6:49:56( Edit History Discussion )

John Cornyn: particular, and those custodians of the federal tax dollars, better tools to be able to solve the problem. madam president, i've offered a number of pieces of legislation designed to help fight health care fraud in medicare and medicaid. for example, last year -- or i should say earlier this year i introduced something i call the

6:49:57 to 6:50:17( Edit History Discussion )

John Cornyn: stop act, which is called the seniors an and taxpayers obligation protection act. this will give federal agencies greater tos and authority to detect waste, fraud, and abuse before they happen. the stop act has bipartisan sponsors, and i believe this provision should be a part of what we do to reform our health

6:50:18 to 6:50:40( Edit History Discussion )

John Cornyn: care system. i've also offered an amendment to the bill in the finance committee that would have made sure that we fix the fraud already existing in medicaid before we expand the program. specifically my amendment would have said that medicaid has to reduce its improper payment rate to 3-point 9%.

6:50:41 to 6:51:03( Edit History Discussion )

John Cornyn: now, that may sound like a lot, and it is still too high, but it is average of the improper payment rates across the federal government. so my suggestion was in my amendment juste average, and, yet, my amendment was voted down largely along partisan lines. well, madam president, fraud isn't the only problem we see in government health care programs and one reason why i'm skeptical

6:51:04 to 6:51:26( Edit History Discussion )

John Cornyn: of the so-called public option or government insurance companies or government takeovers of the rest of the health care sector that they don't currently control. it's a serious problem we ought to address rather than just create a new -- a new plan with a similar set of problems and see 3% to 10% of the amount of

6:51:27 to 6:51:47( Edit History Discussion )

John Cornyn: money we spend on this new program lost to crooks and other criminals. 61% of the american people in one poll said they believe the issues of fraud and waste in medicare and medicaid should be addressed before -- before we create a new government-run program. i believe we should listen to

6:51:48 to 6:52:08( Edit History Discussion )

John Cornyn: the american people. i believe that we should fix the current government-run programs before we create another one. and so, madam president, i leave with the -- a few more questions that i think must be addressed, will be addressed over the weeks

6:52:09 to 6:52:29( Edit History Discussion )

John Cornyn: and months ahead. first of all, we know that senator reid, along with help from democratic leadership, has merged a finance committee bill with another senate committee bill behind closed doors and sent to the congressional budget office to be scored or a cost estimate provided. i'd like to ask why can't we see the bill?

6:52:30 to 6:52:50( Edit History Discussion )

John Cornyn: why can't we see the bill? why can't the american people see the bill? -- bill so they can read it for themselves online and they can tell us how they will either be positively or negatively affected by the provisions in another thousand-page -- 1,000-page bill.

6:52:51 to 6:53:13( Edit History Discussion )

John Cornyn: secondly, i'd like to ask, and i guess we'll find out sooner or later, what we don't know now, how much will it cost? will this be another trillion dollar plus bill? and, third, i'd like to know how much this bill will raise premiums on people who already have health insurance coverage

6:53:14 to 6:53:34( Edit History Discussion )

John Cornyn: as virtually every opinion we've heard surveying the finance committee bills, the "help" committee bills, bills in the house have said that the federal controls on health insurance plans will actually raise premiums. so we need to know how much the reid bill is going to come to the floor that's been written

6:53:35 to 6:53:56( Edit History Discussion )

John Cornyn: behind closed doors that we need to see posted on the internet, we need to know how much it's going to cost, we need to know how much is itoing to insurance premiums for people who already have health coverage. and then the next question is, how much is it going to raise taxes on the middle class? now i know some people think that you can impose taxes on

6:53:57 to 6:54:18( Edit History Discussion )

John Cornyn: insurance plans, you can impose fees on medical device providers, can you do all of this and it will be absorbed by those entities, by those companies when expert after expert after expert tells us what we know what our common sense tells us, and that is those costs will be passed down to the consume. and they'll be passed down to

6:54:19 to 6:54:43( Edit History Discussion )

John Cornyn: the taxpayer to pay for them, middle-class taxpayers. how much will this bill raise taxes on the middle class? and then i think the american people would like to know -- and this was in the finance committee bill -- we'll find out, i assume at some point, whertsd the reid bill does the same thing,

6:54:44 to 6:55:05( Edit History Discussion )

John Cornyn: but there were $500,000 in cuts to medicare. yes,s that's right, the same medicare bill plan to go bankrupt by 2017. the proposal is let's take another half million dollar chunk out of this fiscally unsustainable program with $30 trillion in unfunded liabilities, we going to te

6:55:06 to 6:55:26( Edit History Discussion )

John Cornyn: that and cannibalize from that plan to create another plan or a public option as some like to say around here. well, i think these are all important questions and i wish i had the answers to them. i know that constituents call my office, they write me, they e-mail me, they tell me in person we're pretty worried about what we see coming out of

6:55:27 to 6:55:47( Edit History Discussion )

John Cornyn: washington these days with the spending and the debt, the responsibilities that we should be meeting today ourselves, but which we're kicking down the road and going to ask our children and grandchildren to pay for. and these are -- this particular subject is one that will affect all 300 million americans.

6:55:48 to 6:56:13( Edit History Discussion )

John Cornyn: i know they'lle paying close attention, as they should to the debate madam president, i yield the floor and of a quorum. the presiding officer: the clerk will call th

6:56:17 to 6:56:22( Edit History Discussion )

John Cornyn: snoolg