Senate Proceeding on Nov 19th, 2009 :: 8:30:30 to 8:48:00
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8:30:30 to 8:30:50( Edit History Discussion )

John Thune: applied to the fill fill program for - mortgage foreclosures. the presiding officer: without objection. mr. specter: i yield the the pr president? the presiding officer: the senator from south dakota. mr. thune: i would ask at the conclusion of my remarks, that the senator from militia mick, senator -- michigan, senator

8:30:30 to 8:48:00( Edit History Discussion )
Speech By: John Thune

8:30:51 to 8:31:12( Edit History Discussion )

John Thune: stabenow be recognized. the presiding officer: without objection. mr. thune: we have a draft of the senate leadership majority's health care reform bill after spending several weeks behind closed doors producing that bill. at least some of the details are starting to emerge. and i think it's really critical that all members here in the united states senate have an

8:31:13 to 8:31:33( Edit History Discussion )

John Thune: opportunity to look very closely at what's in that bill. it should come as no surprise that it bill. much was made of the house of representatives being a 2,200-page bill when it was all said and done. th which hasn't been amended yet.

8:31:34 to 8:31:54( Edit History Discussion )

John Thune: obviously that will probably grow and expand as this bill comes to the floor. but i think we at least now have something we something we can review. and there was a lot -- a lot made last night by the majority as they went out and unrolled this bill at how fiscally responsible this particular

8:31:55 to 8:32:15( Edit History Discussion )

John Thune: proposal it is and how much of an improvement it is over recent drafts of the legislation. i want to point out a couple of things to my colleagues that puts into perspective what this bill would really do, what it entails, and how with all of the rhetoric about how it differs or improves upon previous versions

8:32:16 to 8:32:36( Edit History Discussion )

John Thune: or previous drafts of this bill, comes down to the basic same elements that have been in all of the bills that we have seen so far. the first point i want to make is with respect to cost. it is very clear that the cost of this bill, which was stated last night as $849 billion, is dramatically understated relative to its ful cost when

8:32:37 to 8:32:58( Edit History Discussion )

John Thune: it's fully implement. there are several reasons for that. one is that they push back the effective date -- the implementation date for many of these provisions to take effect to 2014. and so you won't see the actual spending in this bill start to kick in however -- however, mr.

8:32:59 to 8:33:21( Edit History Discussion )

John Thune: president, many of the revenue components in this bill begin to kick in next year on january 1, 2010. and so the tax increases, which are multiple, and which are hundreds of billions of dollars, wouldegin to take effect immediately starting january 1, it it it 2010 -- january 1,

8:33:22 to 8:33:44( Edit History Discussion )

John Thune: 2010, while much of the spending would be deferred. not taking effect until january 1, 2014. and so that distorts the true picture of what this legislation would cost and distorts it substantially. the other point i'll make is there are a couple of other provisions in the bill, which by their absence in one case, and

8:33:45 to 8:34:06( Edit History Discussion )

John Thune: by their inclusion in the other, understate the cost of this bill. one is the absence of the sustainable growth rate formula or the so-called physician fee fix, the reimbursement formula by which physicians are reimbursed not addressed in this bill. that is a $247 billion hole. $247 billion in additional

8:34:07 to 8:34:29( Edit History Discussion )

John Thune: spending not included in this bill. that obviously understates the overall cost of this. there is also a $72 - -- $72 billion assumption for a program called the class act. i want to read for you something that one of my colleagues on democrats side said about the class act. this is th senator from north dakota who is the chairman of the budget committee here in the

8:34:30 to 8:34:50( Edit History Discussion )

John Thune: senate called the class act the -- a ponzi scheme of the first order. the kind of madoff would be proud of. that's how he refers to this class act that's included in the bill and the savings that are associated with it. and, in fact, the $72 billion that it shows as revenue in the first 10 years turns into a

8:34:51 to 8:35:11( Edit History Discussion )

John Thune: deficit in the second 10 years. and so when 72 billion that are -- that is assumed would add to the revenues in this bill, and you add to the cost of this bill, the $247 billion that would be required to fund the physician fee formula over a 10-year period, the so-called surplus that that bill generates

8:35:12 to 8:35:33( Edit History Discussion )

John Thune: actually turns into a deficit. it goes from a surplu of $130 billion to a defici of $189 billion. so, again, a lot of gimmicks being used here to under the true cost of this bill to the american people. but all that being said, if you look at the overall cost when

8:35:34 to 8:35:54( Edit History Discussion )

John Thune: it's fully implemented over 10 years, here's what you come up with -- remember when the senate health, education, labor, and pensions committee passed its version of the bill out of the committee, the 10-year ful implemented cost for that bill was $2.2 billion, when the senate finance committee passed its version of the senate bill

8:35:55 to 8:36:19( Edit History Discussion )

John Thune: out of the committee, the implemented cost of that bill was $1.8 trillion. so $1.00 finance committee bill bill, $2.2 trillion for the -- the health, education, labor and pension bill, guess what the price tag is on the bill that was merged been unveiled for all the world

8:36:20 to 8:36:41( Edit History Discussion )

John Thune: to see? $2.5 trillion overall cost, 10-year, fully implemented cost. a $2.5 trillion expansion of the federal government here in washington, d.c., associated with the fully implemented cost of this bill. and so, mr. president, the point i'm t the cost of this bill is being

8:36:42 to 8:37:02( Edit History Discussion )

John Thune: dramatically understated by the authors of the bill to make it look like it comes in unde under $1 trillion when, in fact when you back out the two components i just mentioned it's over $1 trillion in the first 10 years and that's because they delay, again, the implementation of many of these provisions until budgetary gimmick that's de

8:37:03 to 8:37:23( Edit History Discussion )

John Thune: cost of this bill. but when you look at the fully implemented 10-year cost of this legislation, without the gimmick of the delayed implementation date and the other im-- gimmicks they included in here here, $2.5 trillion in additional costs to the taxpayers of this cou now, of course, t

8:37:24 to 8:37:47( Edit History Discussion )

John Thune: that $2.5 trillion has to be paid for somehow. and the way tha isn't any different than in any of the other bills that we've seen so far. it's paid for with higher taxes on small businesses and higher taxes on individuals, and it's paid for in cuts to medicare programs that would impact senior citizens around this country as well as medical providers from hospitals to home

8:37:48 to 8:38:10( Edit History Discussion )

John Thune: health agencies to hospice, you name it. you go right down the list, medical manufacturer or medical device manufacturers get hit pretty hard in this legislation. everybody gets hit whe i to the reimbursement side to pay for this and, of course, the american taxpayer gets hit hard when it comes to the tax increases include in there.

8:38:11 to 8:38:32( Edit History Discussion )

John Thune: $500 billi increases, $500 billion in medicare cuts to finance this $2.5 trillion expansion of the federal government to create a new entitlement program. thether thing this bill does that wasn't included in any previous version is that it does have an increase in the payroll tax on medicare. the argument made is that it only applies to the people in the higher income categories.

8:38:33 to 8:38:53( Edit History Discussion )

John Thune: in fact, they did try to carve out people und $200,000 a year. remember, the medicare tax, the payroll tax that every employee pays in this, 4.5% on their income matched by their employer for a total of 2.9% gets increased. it gets increased to pay for not reforming or making medicare

8:38:54 to 8:39:15( Edit History Discussion )

John Thune: more sustainable, a program that we all know is destined to bankrupt by the year 2017. the increase on theedicare tax will fund a whole new entitlement program unrelated to medicare. now, argument will be that it's a health care program. the fact of the matters the medicare payroll tax was put in place to fund medicare, a

8:39:16 to 8:39:37( Edit History Discussion )

John Thune: program that people would pay into s health care coverage. well, mr. president, the payroll tax that's included in this is going to go -- first off, it's going to a hit of lot of people in this country and if you're a couple that both make a couple -- $100,000 a year, you're already into the category that

8:39:38 to 8:39:59( Edit History Discussion )

John Thune: will be hit by the tax. but my -- one of my main objections -- i'm not for this tax increase in the first place, but one of my main objections is that the majority has chosen to use that tax increase not to make medicare more sustainable, but to create a whole new entitlement program with this bill. now, the other thing i want to point out because it's come u

8:40:00 to 8:40:20( Edit History Discussion )

John Thune: here just in the last day or two, but, you know there's been all of this discussion about mammograms, this preventive service task force came out a recommendation that women under 40 shouldn't have to -- shouldn't go throu mammogram screening. which, of course, a few years ago they made the opposite

8:40:21 to 8:40:42( Edit History Discussion )

John Thune: recommendation going back to 2002, the u.s. preventive services task force made the recommendation that women 40 and older undergo annual mammograms to check now that recommendation was completely reversed earlier this week. the 16-member task force ruled that patients under 50 or over 75 without special risk factors

8:40:43 to 8:41:03( Edit History Discussion )

John Thune: no longer need screening. of course, what's being said about that -- and they're backing away tha of health and human services, kathleen sebelius said that this is a recommendation, it's not binding. that may be true today. here's the problem with government-run health care.

8:41:04 to 8:41:24( Edit History Discussion )

John Thune: here is the problem with the direction we're headed with this legislation. government intervention and more required from those who contract it's safe to assume that the -- many of the thousand creations in this legislation, and there is a new medicare advisory

8:41:25 to 8:41:45( Edit History Discussion )

John Thune: board, will hav that are not just recommendations and advisory, but, in fact,inding. this is exactly the point many of my colleagues have been making about government-run health care. we have seen the model in places like europe and canada where the government imposes cost-control measures, that leads to

8:41:46 to 8:42:07( Edit History Discussion )

John Thune: rationing, and people are denied care, people are -- people want to go in and get a particular procedure and because of these -- these have been concluded that that is not a cost-effective thing to do, then some of these -- some of these decisions that traditionally have been made between patients and doctors get made by the government.

8:42:08 to 8:42:28( Edit History Discussion )

John Thune: and so i want to read for you something that was today in the -- the editorial in "the wall street journal,". and i thi it gets at t heart of -- of what i'm talking about here. but it says this, more important for the future, e version of obama care makes this task force -- that the private

8:42:29 to 8:42:49( Edit History Discussion )

John Thune: insurers will be required to cover as they' government contractors, what are recommendations will become de facto rules and under national health care, these kinds of cost analyses will become as government decides where finite tax dollars are allowed to go. in a rational system, the responsibility for health care

8:42:50 to 8:43:10( Edit History Discussion )

John Thune: ought to reside with patients and theiroctors. james thrall, a harvard medical professor and chairman of the americ says that the dangers of medicine being reduced to and accounting exercises subject to interpretations and underlying assumptions. end quote.

8:43:11 to 8:43:32( Edit History Discussion )

John Thune: based on cost in large group averages, not individuals. he goes on to say, ral, chairman i quote again, i fear we're entering an era of deliberate decisions where we choose to trade people's lives for money. end quote. now, what's important, i think about that -- about that

8:43:33 to 8:43:54( Edit History Discussion )

John Thune: observation is that he is, i think, poiing out what a lot of people are going to be very concerned about in this country, and -- and one of the things in this country, if you're a woman in my home state of south dakota, let's say you're 42 years old, the recommendation that was made by this task force, which everybody is now dismissing and saying, don't

8:43:55 to 8:44:16( Edit History Discussion )

John Thune: worry about it, it's not bieppedding in a piece of hedges -- binding legislation where you create stachity powers -- statutory powers and isn't able to make many of these decisions based on what's cost have someone in a state like mine or any woman in any state

8:44:17 to 8:44:39( Edit History Discussion )

John Thune: in this country who is in their 40's, because they said here that 50 should now be the get mammograms, you get a breast cancer screening done, that you could actually have women in this country who would be denied the opportunity to do that. and, of course, we all know, everybody can name in a personal way relate to people in this

8:44:40 to 8:45:01( Edit History Discussion )

John Thune: country who by virtue of that screening process and that test has been detected early and able to beat breast cancer, something that afflicts a great number of women across this country. now, that's one example. i use that as an example of how this new type of government-run program might work. but there are countless other examples of the very same thing.

8:45:02 to 8:45:22( Edit History Discussion )

John Thune: so, mr. president, as we head into this debate, again, i want to remind my colleagues that this type of undertaking, reforming health care ought to be about driving down costs, it ought to be about driving access to more americans, it ought to be about maintaining that important relationship between a

8:45:23 to 8:45:43( Edit History Discussion )

John Thune: physician and their patient, and not getting to where we have the government making those decisions, where we are actually bending the cost curve up rather than driving it down. and, by the way, the c.b.o. said in visa sponse to the majority's bill that that it actually increases cost by now to me, the fundamental goal

8:45:44 to 8:46:06( Edit History Discussion )

John Thune: of health care reform for most americans -- and i think most americans -- the key concern they have about health care today is its cost. everything that we have seen so far, including this most recent version, which we're going to have at some point on the floor of the senate, probably sometime after the increases cost, drives the cost curve up.

8:46:07 to 8:46:28( Edit History Discussion )

John Thune: how can you possibly be in favor something that cuts medicare to providers and toen this country? tharaises taxes on small business, raises taxes on middle-income americans and which also, ironically, raises the cost of health care, of health care in this country?

8:46:29 to 8:46:50( Edit History Discussion )

John Thune: and again i'm not saying this is -- this is the c.b.o. that has been consistent through all the bills that have been produced. it's consistent with this one as well, that the proposals and all thnew provision provisions that would be included here -- and again, $ trillion fully imple paid for by medicare cuts, half a trillion dollars in medicare

8:46:51 to 8:47:13( Edit History Discussion )

John Thune: cuts, ha tax increases and obviously much more than that obviously once you get into the fully implemented time period -- all that -- all that -- to raise health care costs for people in this country. how can we label that reform? mr. president, i hope the american people, who as they listen to this debate will

8:47:14 to 8:47:36( Edit History Discussion )

John Thune: engage, will take a hard look a this 2,074-page bill. i mean, it is going to be a of legislative, arcane we are all going to do our best to make sense out of it. but it is a massive bill, just this terms of its volume, but it also includes a massive expansion of the federal government here in washington, d.c., at tremendous cost to the

8:47:37 to 8:47:58( Edit History Discussion )

John Thune: taxpayers, to medicare beneficiaries, and in the end doesn't do anything to drive down the cost of health care. it simply increases it and puts at risk, i would argue, many of the types of things that i just talked about with regard to breast cancer scrning. when government controls, government is make decisions rather than patients and

8:47:59 to 8:48:01( Edit History Discussion )

John Thune: doctors, that is a world in which i don't think i want to