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Senate Proceeding on Dec 4th, 2009 :: 2:39:40 to 2:56:40
Total video length: 9 hours 20 minutes Stream Tools: Stream Overview | Edit Time

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Max Baucus

2:39:37 to 2:39:58( Edit History Discussion )

Max Baucus: reason is that a government-run health system doesn't work. i yield the mr. baucus: mr. president? the presiding officer: the senator from montana.

Max Baucus

2:39:40 to 2:56:40( Edit History Discussion )
Speech By: Max Baucus

Max Baucus

2:39:59 to 2:40:20( Edit History Discussion )

Max Baucus: mr. baucus: mr. president, i understand that we're now under the order where the half-hour is allocated to the majority side, is that correct? the presiding officer: that's correct. we have 30 minutes, senator. mr. baucus: mr. president, i reserve myself ten minutes. the presiding officer: without objection, so ordered. mr. baucus: mr. president, i just want to just help people understand this legislation. i'm sure many do, but i'm there are some who don't with

Max Baucus

2:40:21 to 2:40:41( Edit History Discussion )

Max Baucus: respect to the choices that people will have. we have a uniquely american system of health care in america. it's roughly half public, half private. and the goal of this legislation is to retain what we have. it is basically that same balance of public and private. it's worked pretty well for america, it's uniquely american. we're not canada.

Max Baucus

2:40:42 to 2:41:03( Edit History Discussion )

Max Baucus: we're not great britain. we're not switzerland. we're the united states of america. i think it's just good to build on our current system, make our current system work better. i'm prompted to explain the choices in part by the statement by the senior senator from arizona who said that medicare

Max Baucus

2:41:04 to 2:41:25( Edit History Discussion )

Max Baucus: advantage get eyeglasses and dental care, and that's true. he went on to say that, gee, shouldn't members of congress like all that and want to keep all that because members congress get free free eyeglasses. well, that's really not true. members of congress don't get that.

Max Baucus

2:41:26 to 2:41:46( Edit History Discussion )

Max Baucus: but it is true that members of congress federal employees, all federal employees, members of congress, people of t forest service, all around the country, all the federal employees participate in the same system. it's called fehbp, federal employees health benefits pla where federal employees and member of congress, all

Max Baucus

2:41:47 to 2:42:07( Edit History Discussion )

Max Baucus: together, the same, can choose among many different private health insurance plans. there is an open rollment seon. in fact, we're in the middle of it right now where members of congress and all federal employees can look to see whether they want to choose a different insurance company or not. now, some of those companies do

Max Baucus

2:42:08 to 2:42:30( Edit History Discussion )

Max Baucus: provide dental and vision coverage. some don't. so if a federal employee wants to choose a plan that covers dental and vision, he or she can do so. just pay the premium and you're covered with dental and vision. and we're setting up under this

Max Baucus

2:42:31 to 2:42:52( Edit History Discussion )

Max Baucus: legislation an exchange very fehbp where people who don't have health insurance can go look on the exchange, choose among private companies, which one makes the most sense to them. some may have dental, some may have eyeglass coverage, some may not. that's just a choice people could make. and if they -- in addition to

Max Baucus

2:42:53 to 2:43:13( Edit History Discussion )

Max Baucus: that, there is even more choice because currently a federal employee does not have to join fehbp. a federal employee can choose not to get health insurance if he wants to or maybe through his or her spouse someplace else. the same would be true with the exchange set newspaper this legislation.

Max Baucus

2:43:14 to 2:43:34( Edit History Discussion )

Max Baucus: the person could buy among different competing private plans that offer health insurance on the exchange, or a person could go outside the exchange because he or she thinks he can get a better deal if that's what that person wants. so i just want to make it clear here that we're encouraging choice, we're encouraging competition, and i might say

Max Baucus

2:43:35 to 2:43:55( Edit History Discussion )

Max Baucus: that under the legislation, democrats of congress fully participate in co-equal with others. if there is a private option, members of congress can contribute -- can participate in that as well. in fact, we are requiring

Max Baucus

2:43:56 to 2:44:16( Edit History Discussion )

Max Baucus: senators and their staffs -- they don't have to participate in the exchange, but it's certainly available to them and they can opt out if they want to. now, let me just say a little bit about medicare advantage, and what does medpac say about medicare advantage? several years ago, congress established an advisory board,

Max Baucus

2:44:17 to 2:44:39( Edit History Discussion )

Max Baucus: it's now called medpac, to advise on how medicare should pay providers and traditional fee-for-service and private medical insurers and medicare advantage. again, medicare advantage are private companies. they have executives, stockholders. it's a pri and medpac advises how much congress should provide --

Max Baucus

2:44:40 to 2:45:00( Edit History Discussion )

Max Baucus: should pay medpac and other medicare providers and traditional fee-for-service. it's an independent agenc it's experts, nonpartisan, highly respected. each reports to congress and examines issues on medicare. here is what medpac had to say about the current state of

Max Baucus

2:45:01 to 2:45:21( Edit History Discussion )

Max Baucus: medicare advantage in its 2009, june, report. i'm going to quote now from this independent advisory panel -- "first we estimate that in 2009, mayor pays about $12 billion more for enrollees in benefit plans than it would in fee-for-service medicare. second, current high payments have resulted in some plans that

Max Baucus

2:45:22 to 2:45:44( Edit History Discussion )

Max Baucus: bring no innovation but simply mic fee-for-service medicare at a much higher cost to the program. in other words, they're saying that medicare advantage plans get paid for a lot more but with no innovation than -- than the fee-for-service medicare.

Max Baucus

2:45:45 to 2:46:07( Edit History Discussion )

Max Baucus: and they also say, sm, medpac -- "they're not enrolled in medicare advantage which are subsidized." in addition, they say, "these excessive payments often encourage inefficient plans to enter the program, further raising costs to medicare." because there's so currently given to medicare advantage plans, according to

Max Baucus

2:46:08 to 2:46:29( Edit History Discussion )

Max Baucus: medicationspac, that -- medmac that encourage inefficient plans to enter the program. why not? they're not all this extra money. further quoted from medpac, "the cost of subsidies is borne by taxpayers who finance the medicare program and by all medicare beneficiaries through par premiums." or to say it differently, about

Max Baucus

2:46:30 to 2:46:50( Edit History Discussion )

Max Baucus: 78% of americans who are not in medicare advantage plans are paying $90-per-year tax for which they get no benefit, which goes into the medicare advantage plans. in addition, the part-b premium for all beneficiaries is increased by about $3 regardless of whether you receive any of the benefit.

Max Baucus

2:46:51 to 2:47:13( Edit History Discussion )

Max Baucus: that's another quote from medpac. i might say a couple more qtes from medpac. "additional medicare advantage payments hasten the insolvency of the medicare part-a trust fund by 18 months." that's an interesting statement. "the additional m.a. payments hasten the insolvency medicare part-a trust fund by 18 months." that's the hospital version.

Max Baucus

2:47:14 to 2:47:35( Edit History Discussion )

Max Baucus: going on quotes from medpac, "although many plans are available, only some are of high quality in addition," continuing their quote, "only about half of the beneficiaries nationwide have access to a plan that c.m.s. rates as above average in overall plan quality." this is what medpac says, that's

Max Baucus

2:47:36 to 2:47:56( Edit History Discussion )

Max Baucus: the nonpartisan experts that help advise congress in what reimbursement levels, what they should be. now, we've heard day after day this this bill is cutting medicare benefits for our seniors. what my colleagues on the other side of the aisle realize that this bill does not cut, reduce, or eliminate a single guaranteed benefit.

Max Baucus

2:47:57 to 2:48:21( Edit History Discussion )

Max Baucus: they turn their argument to medicare advantage. i think they finally recognize that there are no guaranteed benefits cut in this legislation so they turn to medicare advantage and they argue that the efficiencies and savings would be achieved by ending billions of dollars of overpayments to these private plans will either end the program or dramatically cut services to beneficiaries. but let's just look at the

Max Baucus

2:48:22 to 2:48:44( Edit History Discussion )

Max Baucus: numbers. this chart shows the yearly spending for medicare advantage in billions of dollars. so you can see from the chart that in the year, say, 2009, $110 billion will be spent on medicare advantage plans. and moving to the right ten

Max Baucus

2:48:45 to 2:49:05( Edit History Discussion )

Max Baucus: years later, in the year 2019, it's about $204 billio excuse me, the -- is spent. so if you total it all up, it's about $1.7 trillion that will be spent on medicare advantage plans over the next ten years. now, you see that little -- what color is that?

Max Baucus

2:49:06 to 2:49:27( Edit History Discussion )

Max Baucus: it's kind of anrange, it's kind of an interesting sort of red, whater it is, at the top of that chart? that represents the reduction in medicare advantage plans payments under this legislation. it's not very much, as you can tell by looking at the chart. it averages out i think around 10% reduction in medicare

Max Baucus

2:49:28 to 2:49:49( Edit History Discussion )

Max Baucus: advantage payments. so when you hear the crocodile tears how medicare advantage is being cut, hear all these dramatic statements that so much is going to be taken away from seniors because congress is cutting medicare advantage, the fact is we're reducing the rate of increase in medicare

Max Baucus

2:49:50 to 2:50:10( Edit History Discussion )

Max Baucus: advantage payments by only about 10%, and under this legislation, about $1.7 trillion will be spent on medicare advantage plans. remember, medpac says these are overpayments. medpac say that this 10% is about -- reduction is what they should be paid.

Max Baucus

2:50:11 to 2:50:32( Edit History Discussion )

Max Baucus: and rember, too, that these are private plans. these are private companies. it's not medicare. these are private companies receiving these -- these payments. and they're insurance companies. it's interesting to me, mr. president, that a lot of

Max Baucus

2:50:33 to 2:50:54( Edit History Discussion )

Max Baucus: members of congress wild about insurance companies. well, medpac -- excuse me. the medicare advantage companies are insurance companies. they're private companies. that's what they are. they're insurance companies. they've got their private insurance company chief executive. they've got their private insurance company officers. they've got their private insurance company stockholders. they've got their private insurance company administrative

Max Baucus

2:50:55 to 2:51:15( Edit History Discussion )

Max Baucus: costs and marketing expenses. they're private insurance companies. that's what they are. and it's -- it's -- that -- we should not lose sight of all of that. now, i want to also point out that as private insurance

Max Baucus

2:51:16 to 2:51:38( Edit History Discussion )

Max Baucus: companies, these medicare advantage plans are doing pretty well. let me quote from an open hierm oppenheimer?? capital analyst about medicare advantage plans. "between 2006 and 2009, we estimate that medicare" he meant

Max Baucus

2:51:39 to 2:52:00( Edit History Discussion )

Max Baucus: advantage counted for nearly 79% of the gross profits in the industry highlighted by an estimated gross profit increase of $1.9 billion in 2009 relative to commercial risk earnings gains." now, commercial risk earnings gains are the ordinary health insurance companies but 75% of the gross profit increase was under medicare advantage plans

Max Baucus

2:52:01 to 2:52:23( Edit History Discussion )

Max Baucus: not traditional health insurance. i might say too -- i don't have the papers here. maybe i can find them. just worth noting. these are private companies.

Max Baucus

2:52:24 to 2:52:44( Edit History Discussion )

Max Baucus: they're not -- it's not know, traditional medicare. oh, here it is. let's look at -- this is interesting. you know, what is the compensation of these insurance companies' executives, these medicare advantage plans? aetna's -- of the c.e.o., the

Max Baucus

2:52:45 to 2:53:07( Edit History Discussion )

Max Baucus: total compensation of the c.e.o. of aetna is $24 million a year. the total compensation of the c.e.o. of coventry is $89 million. wellcare is $8 million humana, $4. million a year. united healthcare, $3 million. now, people should be able to make some money and officers of companies should be able to, you

Max Baucus

2:53:08 to 2:53:29( Edit History Discussion )

Max Baucus: know, do okay, but here we're talking about very high salaries that these insurance companies pay to their top executives and, frankly, if there's a 10% reduction in $1. trillion over7 trillion over ten years, they could, you think, take some of that 10%

Max Baucus

2:53:30 to 2:53:52( Edit History Discussion )

Max Baucus: maybe in salary reduction or dividend to stockholders, make other cost savings. it doesn't have t come out of their -- the beneficiaries. and it's , they the executives, that are making these decisions of where the 10% -- and that are making these decisions of where the 10% is allocated.

Max Baucus

2:53:53 to 2:54:13( Edit History Discussion )

Max Baucus: i just bottom line want to say i'm not opposed to medicare advantage plans. frankly are i think it's good that we have medicare advantage plans. medicare advantage plans provide a little competion to medicare. they just -- they help make -- keep the system on its but we have anbligation here as members of this senate, to taxpayers, to seniors to cut

Max Baucus

2:54:14 to 2:54:35( Edit History Discussion )

Max Baucus: waste and to -- and cut overpayments in a way that does not harm beneficiaries. and these are reductions recommended to congress by the best executive, best advisory board of experts we could find. they members of thin air, members of congress think this up. they were recommended to us by

Max Baucus

2:54:36 to 2:54:57( Edit History Discussion )

Max Baucus: the medpac advisory board. and, second, there is no reduction in guaranteed benefits to seniors. that's jt -- that's absolutely absolute. there's no reduction in guaranteed benefits to medicare advantage participants. so, a, we're being fair. this chart shows it. we're trying to find the right

Max Baucus

2:54:58 to 2:55:19( Edit History Discussion )

Max Baucus: level a way so there's no reduction in in -- in beneficiaries' benefits. in fact, under this legislation, we add more benefits for all medicare -- medicare advantage as well as traditional fee-for-service medicare. and i might add in this legislation, we to medicare advantage plans that show demonstrated improvement in quality.

Max Baucus

2:55:20 to 2:55:41( Edit History Discussion )

Max Baucus: as i mentioned, medpac said a lot of these plans are totally inefficient, a lot of these plans have no coordinated care, a lot of these plans do not have any quality but they get the extra money. so we're saying, let's get the compensation level fair, we do it in a competive bidding basis. i think the average bid for an area where we also say let's

Max Baucus

2:55:42 to 2:56:03( Edit History Discussion )

Max Baucus: make sure that there's no reduction in -- in guaranteed benefits at the same time. i think that's the responsible thing to do. so all these arguments, these sound bites, frankly, that you hear on the other side of the aisle are just that, they're sound bites. they're not really an honest anal here. so i just encourage us to keep

Max Baucus

2:56:04 to 2:56:25( Edit History Discussion )

Max Baucus: in mind, keep in perspective what we're doing here so we can help provide a better health care system for our country. this is only one part of it. there are many other parts but this is just one. mr. president, i'd now like to yield to the senator from michigan. ms. stabenow: thank you. thank you. mr. pres the presiding officer: you have 14 1/2 minutes.

Max Baucus

2:56:26 to 2:56:40( Edit History Discussion )

Max Baucus: i'm sorry, 13 1/2 minutes. mr. baucus: i see senator dodd's on the floor. could you, senator, maybe five minutes? we could probably get some more. ms. stabenow: seven minutes would do. mr. baucus: take what you want. we'll find the time.

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