The Future of Medicare

Floor Speech

Mr. SCHWEIKERT. Thank you, Madam Speaker.

I promise I will not take the whole 60 minutes, because I know many folks have flights to get to.

Madam Speaker, one of the reasons I'm here--and we are also working on some additional, shall we say, display items for maybe next week. Maybe I'm out of my mind, but this last couple of weeks I've been actually reading from top to bottom, beginning to end, the Medicare trustees' Federal hospital insurance and Federal supplemental medical insurance trust fund actuarial report for 2011. It's actually more interesting than you would think, because you go through about 270 pages, lots of great information, not that hard to read, so anyone that's actually watching this, I strongly suggest, if you have the stomach for it and you really need a little help in falling asleep, this might be the occasion. Google it, take it off the Internet, but do this for me: This is one of those occasions I'm going to ask you to go to the very end of the report and start with the last three pages, because that's what I'm standing here to talk about is you have a report that basically gives a window of a dozen-some years of actuarial soundness, but when you get to the last three pages, it basically says something like Roseannadanna, that character from Saturday Night Live from 20 years ago: "Never mind.''

I brought a couple of the boards we already had printed up to sort of demonstrate what's going on, and then I wanted to talk about this.

Day after day after day after day in the political theater of this Congress, I see Members walk up to the floor, walk up to the press, send out press releases saying, "We don't want to change Medicare as it is in law today.'' How many times have we heard the attacks on the Republicans saying, "They're trying to change Medicare as we know it''? I need you to think about that comment, because what's in this report is Medicare as it is in law today. You need to understand what the left is defending and the crash that is just a few years away; and I'm standing here today to defend the fact that, as Republicans, we're saving the program. We are actually trying to find a way to make Medicare actuarially sound so that you and I can have it but also our kids and our grandkids can have it.

So let's actually first walk through the numbers, and then I'm going to read parts of these last three pages. I promise it's more interesting than it sounds, and it's more depressing than you can ever imagine, and this is the current law.

All right. A couple of primers on some spending out there.

2010, how much of our spending is mandatory?

2016, you'll start to notice mandatory spending is consuming everything we are.

Another point of reference. Today, when we borrow, we're actually having to borrow to cover all the discretionary. That's defense. That's all the alphabet agencies. We even have to borrow today to cover a portion of the mandatory spending. Think of that. The Medicares, the Social Securities, the Medicaids, the VA benefits, interest on the debt are actually living on borrowed money. I would think that would set off an alarm bell in someone's head that there's something horribly wrong out there.

So let's actually bounce on to this graph and just sort of give you a concept of how fast these numbers are eroding and why things like the battle over cut, cap, and balance are going on in this body, because there seems a willingness here by many Members--and I've got to be very careful how I phrase this--that I believe telling the public the truth of how difficult these numbers are and how dangerous they are to our Republic may mean they don't get reelected, may mean they have to stand up in front of an audience that for years and years and years they've said, "Don't worry. It's fine.'' How do you go back in front of that same audience and now tell them, well, maybe the numbers weren't fine, because the truth is in front of us right now.

Here is the 2010 sort of breakdown. Department of Defense, Military, Other Discretionary. We use this one, because this is last year's numbers. It's all done. We know what it was.

Do you see this? That's probably about 62, 63 percent of all spending was in the mandatory category. Think of this. This here, from the President's own numbers, is the 2016 projection, which is four budget cycles away, because, remember, right now we're working on the 2012. This is the 2016.

Do you see the difference in these two boards? Do you see that growth in that blue area? We go from something in the low sixties to 72, and I have one person who keeps telling me it's 73 percent of all spending.

But think of this. In about 13 1/2 years, every dime of this pie chart, every dime of spending, will be consumed by the mandatory portion of our spending. So 13 1/2 years. There's nothing left in defense. There's nothing left in the alphabet agencies. Mandatory spending, the entitlements, consume everything we are. And, remember, this is as the law is written today. So every time you see a Member walk up and say, "I don't want to make changes; I want to keep everything as it is in law today,'' they're basically saying your future is a crash. Everything will be consumed in these mandatory numbers.

Now let's actually walk through a couple of things that are in these last three pages of the 2011 Medicare actuarial report. Once again, please, I ask you, if you don't believe me, if you're someone who has trouble believing these statements that I come here to the floor and try to walk through, go take it off the Internet yourself and read these last three pages.

Part of the premise here is, to his credit--and I believe he is actually the chief actuary for Medicare, actually wrote a little Statement of Actuarial Opinion, the last three pages, and he puts it in perspective. He

basically says, yeah, the numbers in here are fine if you live in a fantasy world and assume Congress will never make certain changes. And understand, baked into these numbers, you'll love this one. I'll read it, and then I'll explain what this means. This is in the second paragraph. I'm going to read the second half of this paragraph:

"They are not reasonable as an indication of actuarial future costs. Current law would require a physician fee reduction of an estimated 29.4 percent on January 1, 2012--an implausible expectation.''

Did you hear that? Built into these numbers, January 1--what is that? Five months from now? January 1, doctors are to get a 29.4 percent cut in their compensation, and that's built into these numbers because these numbers don't work without taking that type of hit to the doctors.

How many doctors are going to see Medicare patients come January 2 when they've taken a 29.4 percent cut? So what traditionally happens around here is the Members of this body sometime in November, December, we're going to run to the floor, we're going to say that's not fair, we want to make sure Medicare recipients can actually see their doctor, and we're going to go back and raise up that compensation and keep it flat. We're going to get rid of that 29.4 percent cut that's already built into the law. The next day we should have a new actuarial report saying, oh, by the way, the dozen-some years that we said Medicare was fine is crashing, because it's built on premises that don't have reality.

I'm trying to find nice ways to phrase this. When you read an actuarial report, it's based on current law. What happens if built into that current law is absolute fantasy, and that 29.4 percent cut, which I will be one of the people who will walk onto this floor and do my best to stop that because that's not fair. It's not fair to the doctors. It's not fair to the people in the program. But you've got to understand. Then when Members of this body walk up here and say, "We want no changes to Medicare,'' when they say they want no changes, are they saying they want the law as it is today? They want doctors in January to get a 29.4 percent cut? You can't have it both ways. You can't walk up here and say, "We want to keep the law exactly as it is, no protection, no changes.''

"Oh, by the way, you're never going to see your doctor again after January 2.''

You have to actually go through more of these last three pages, this statement of opinion. It's devastating. And you start to realize the political theater around here hasn't been telling our public the truth. They're more concerned about winning political points than helping the American people understand we have a huge, important program here that's about to collapse under its own weight. We have the documents. We have the data. We're trying to step up and be responsible. But by being responsible, you get demagogued, you get attacked, you have people going out and holding up little protest signs. And then you talk to them and say, "Hey, read this,'' and they read it, and they look at you with these eyes saying, "I can't believe my own side's been lying to me. Why didn't they fess up and tell us this was coming?''

There are a couple of other things in here. Medicare prices for hospitals, skilled nursing facilities, home health, hospice, ambulatory surgery centers, diagnostic laboratories, and many other services would be less than half of their levels under prior law. That is built into this Medicare actuary report. Think that through. Built into the formulas today, those groupings are going to be receiving half the compensation? How many of them are ever going to treat, take care, diagnose, or provide hospice care for Medicare recipients? That's what the Republicans are trying to save. We're trying to fix it. We're trying not to let that happen.

Anyone that says they do not want changes to Medicare, they are actually supporting the downfall of the program. And that is actually why I stand here. I will be back next week with a series of slides that actually break out a number of segments from this Medicare actuary report, because it's time we start having Members come to this floor and tell the truth.

One last little thing here. For these reasons, the financial projections shown in this report for Medicare do not represent a reasonable expectation for actual program operations. What the Medicare actuary is basically saying is, What we've based much of the rhetoric on around here, if you dig into the numbers, this program has already changed as people know it. It was changed last year when they did the health care takeover vote. It's already built into the law.

As a Republican, we're trying to find ways to save this program, make it actuarially sound so it is there for the folks who are on it, for our children, for ourselves, and for the next generation. We are here to do the right thing. And if you don't believe me, go pull the report, and read through it yourself.

Madam Speaker, I yield back the balance of my time.

Source