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Senator Lamar Alexander has today issued the following statement on the floor of the Senate of the United States:

 • This is Senator McCain said his amendment donâ? ????? Grandmaâ cut t? s health insurance pay for someone Elsea? br s insurance.â ????
this?? If you find by savings in waste, fraud and abuse Grandmaâ? s health insurance spending, these savings on to grandmother. Medicare’s trustees? told us that it is starting to billions of dollars in unfunded liabilities for the Medicare program and the program bankruptcy 2015-2017. After the trustees of the Medicare, â? We need quick and effective action to address Medicare? S challenges.â? I donâ? T think, the Medicare trustees that the rapid and effective measures we take to prevent illness could bankrupt, was among five billion out of it and invest in some new ones? ? Click to learn more …

A * A Rather than take my word for it, Let’s go, Rise.â a headline in the Wall Street Journal ??????? “Some health premiums? This means that the cost increases for insurance. So my question is, why should we spend 0.5 billion U.S. dollars, more than ten years, cut Medicare, the tax increase and lead to some increase debt Americansâ? Health care premiums? I thought the whole exercise is to reduce the cost of health care premiums.â ????

was that? This law could be in the thought that we have a system that nearly all Americans and everything seems to make change at a time in history. Why don? T, we prefer to make step by step again, the confidence of the American people? Republicans take these proposals in the Senate this month and next month and as long as it takes to achieve real reform of health care. Grandmaâ cut? S Medicare spending half a trillion dollars on a new program at a time when Medicare is going bankrupt is not really health care reform.â?

Alexander full remarks:

Mr. Kyl. Mr. Speaker, I ask unanimous consent that controlled during the 30 minutes with the Republicans, we are entitled to participate in a symposium.

The ACTING President pro tempore. Without objection, it is so ordered.

Mr. Kyl. Mr. President, I will start by some remarks on the amendment of Senator McCain, my colleague from Arizona, submitted. This is a change that the minority leader just said, the older people in America are protected. He will refuse Medicare cuts contains this bill.

The economist Milton Friedman said: “There is nothing like a free lunch” and to medical care is considered good. There is nothing that .. Someone has to pay for free health care, since this bill is a bill of $ 0500000000, the first question: Who pays the first answer is, who pays, what are the elders? America, as about half the cost of the bill, allegedly by cuts in Medicare.

Let me pay a little more accurate than the Republican leaders just broke, which means this is followed by about 0 million in cuts as Medicare. 7.5 billion hospitals that treat older people, 0 billion Medicare Advantage, which is the insurance program that provides benefits for seniors, more than half as a result of this reduction, 0 billion, 0.6 billion in nursing homes that older people are cut handle, 0.1 billion home care for seniors and 0 7 billion in palliative medicine, one of the most cruel of all sections. Of course, this dramatic cut, there is no way to avoid enjoying compromises in the care of seniors and seniors currently know. C. Therefore, they wrote our office and in meetings for open discussion and let us know that they reject. I cited two letters from constituents of mine in Arizona has sent the request to please not cut their Medicare Advantage program. This was seen as the jewel of the Medicare system, and many of them rely on Medicare Advantage for dental or vision care and hearing aid they have come to rely on. You do not buy the claim that somehow, we / 2 trillion cuts in Medicare, can somehow do without violating their care. You know better than that, and they are right. The care they promised affected to pay for the new government under the bill.

Finally, should, many are wondering what happened to the promise that they can have all the care they think we all have heard the President say often .. If the care you have, how to get and keep it That’s just not true There are 337 000 Arizona. Medicare Advantage patients are you like what they have but we know from the Congressional Budget Office, the benefits they have reduced as part of Medicare Advantage over half of you will say … What has happened to politics than love? I will not be able to keep it, if this bill goes.

This is why the Senator McCain was going to happen. If Democratic colleagues are not ready to protect Medicare, I can not imagine how the bill could be otherwise acceptable because it starts with the commitments that have the Congress and the President did our elderly.

Perhaps one reason why there are different numbers on one side of the aisle to another, is that we sometimes talk here is not apples to apples. We’re talking apples and oranges, and perhaps both numbers are correct in their context. The senator from Tennessee, the number 0.5 trillion when the program must be fully implemented. It is a very important statement. The other side will say it is only 1 / 2 billion euros for the first 10 years of the program. It is a correct statement is. But it is 0.5 billion euros for the first 10 years of full implementation program. What was the reason for this difference is? For the first 4 years, the money is collected, but very few benefits are out. The benefits start after 4 No. per year. So if we increase the first 10 years of the program means we pay more than the entire 10 years, but are almost all benefits in the last 6 years. Of course, we raised more money than we paid. But if we take the first 10 years of full implementation, it is like my colleague from Tennessee noted, at a cost of 0.5 billion .. So we sometimes get different numbers

Until we clarify what we are talking, one thing is clear: Whether 1 / 2 billion or 0.5 billion dollars, we’re talking real money with someone. you have to pay for it. If the elderly are to be expected in America pay half of it, it’s not fair to seniors of America, given the commitment we made. For them, the point that Senator McCain protecting Medicare, protecting the elderly in America can we do with the simple change of Senator McCain, the back is done in committee -.. that it takes a day -. And here again without these cuts in Medicare Bill

Mr Alexander. I see the senator from Idaho here. I want to hear comments to learn. If there is a problem in this debate on the entire health care why the Republican side we want to change the debate a step-by-step approach to reduce the cost of premiums, symbolizes the issue of insurance. As the senator from Arizona, is said to solvent as fast as we can, as efficiently as possible we need to do about health insurance. Kansas Senator said the other day that the 5 billion proposal to take Medicare and grandmother will devote some new program to buy to write a check on an overdrawn account at a bank a big car. There is much truth in it.

The President said this year, something I agree. He said that the discussion on health care not only to health care. It is about the role of the federal government in the daily lives of Americans. It is all right. The debate on health care, as we begin this week, not just health care. This is the stimulus to the recovery of General Motors. This is the trillion dollar debt. This is the acquisition of Washington. It is spending, taxes too much, too much debt. The provisions of Medicare in this bill are a perfect symbol of this. That is why Senator McCain is right. What he said is not spending for Medicare and grandmother cut on a new program. They save in waste, fraud and abuse of Medicare Grandma devote find grandmother. Make sure that those of us who are older and those of us who are younger and are looking forward to calculate Medicare payment functioning.

Later this week we will talk more about rising premiums. There has been much discussed since yesterday, rising after the Wall Street Journal, some health premiums. For those who get their insurance through large employers, this bill will not make much difference. And for small employers, if your insurance from a small employer, it will not make a big difference. When will the individual insurance market with purchase, you go, your premiums increase, unless we have some money from somewhere to help pay a portion of your premiums, at least for about half of Americans in the individual market. Where can we find this money? From grandmother. We will get it from Medicare. is what is wrong with this bill. And what is right about the McCain amendment is that it just will not cut Medicare insurance. If we are to find savings and we hope to offer in Medicare, we should be spending on Medicare solvent.

I wonder if the senator Idaho is to listen to seniors in his State of the 5 billion proposed Medicare cuts and how they feel, take the money and spend it to create a new program?

Mr. Crapo. I thank the Senator from Tennessee. Certainly, we hear from seniors in Idaho, to see through it. It is quite clear to the people of Idaho that what we see is a growth market proposed massive federal government for more than 0.5 billion fully implemented in order on the backs of American taxpayers and seniors funded by Medicare cuts. In fact, in addition to those who have contacted me to see who lost their health benefits, I was to be contacted by a number of vendors. We are pleased with this talk in palliative home care or health facilities. /> Skilled nursing facilities or hospitals, etc.

The points that I have of them already went through a series of very large reductions to the extent that reductions in Idaho for home care, we lost something like 30 percent of our systems already. The way to explain it to me was that if you reduce the compensation that we receive, we have to cut anything in our budget, he said. We can not start, stones out of our buildings is what we do at the end, reduce the staff. . It would be nurses and doctors and other healthcare providers that are there to provide support to these people. We have the number of rooms we operate facilities or reduce what we offer. Ultimately, there is a reduction of services and access available to the elderly, including decreased quality of care they can be delivered.

Mr Alexander. In discussing reductions Medicare, another provision of the bill we are debating this month and next month we are moving in the debate on health care that treat the problem of paying doctors and hospitals Medicare patients. You get about 83 percent rate paid when they saw a private patient care. Every year, Congress must make to adapt to something we have a couple of years, the cuts would be automatically the amount of money we pay the doctors to see Medicare patients.

It is a big problem for Medicare patients. Because if not, the doctors are paid, they did not see patients and Medicare patients may find themselves increasingly under the condition that Medicaid patients with low-income Americans who are from the state program covered – that our biggest program is managed by the government – they are about 60 percent of the doctors for private patients, who are paid and do not see about half of Medicaid doctors new patients. I ask the Senator see paid, he can not see anywhere in this bill a provision for / 4 trillion needed to pay physicians within 10 years, what they do today? This should not come in the bill where it is / 4 trillion, will be? If it is coming cuts in Medicare, or is it adding to the deficit?

Mr. Crapo. Clearly it will increase by cuts in Medicare taxes or more debt or come only at the federal level.
Senator raises a very interesting point. The question of fixing the physician payment rates in Medicare is a huge problem that we tried for a number of years, a solution to the fact related disputes, which we expect every year to delay reductions that will happen. I mentioned this factor in the context of being a gadget accounts. What I mean by that? Those who say this bill reduces the deficit can tell because he about 0 billion in new taxes, about 0 billion Medicare cuts, and a number of tricks to the budget in this case the delay is not even in the expenditure part of the bill or one of the issues important to be satisfied, and this is the fix for physician compensation. If none of these things are not in this bill, this bill would increase significantly to offset the deficit.
What we see, in addition to these financial effects on the federal budget in view of the enormous increase in debt or more huge tax increases, even more than we talk about this law that we see the potential for effective access to medical care for older people will be further reduced by this factor. br <
/> Let me give you some statistics. In its 2008 report June, the Medicare Payment Advisory Commission or Medpace said that 29 percent of Medicare beneficiaries who were interviewed were looking for a family doctor and was difficult to find one to treat them. In other words, about 30 percent of Medicare beneficiaries are now difficult to find a doctor to take Medicare patients found. It is above $ 5000000000 before rebates and simply not all doctors, even in this bill.

A 2008 study by the Texas Medical Association found that only 58 percent of the doctors, the state of new Medicare patients taken, and only 38 percent of family doctors agree new patients. Again, it is an example for Medpace and a state that is what we know happened around the country, namely, that more and more doctors are no longer under the new Medicare patients and Medicaid patients with it since years. And yet we see these massive cuts in Medicare and proposed to the same effect on palliative care and home services and facilities that skilled nursing and hospitals, and we see that the doctors considered not even know that they should now get at big discounts. I think it’s more than 20 percent reduction in their compensation for the taking Medicare patients.

The solution here to create a comprehensive new federal law is not to cut Medicare. I want something both senators repeat Arizona and Tennessee have already said that it is essential. Reduce the budget of 4 billion Medicare, for any number, it is something that was encouraged in the form of lower growth path for Medicare. It’s something that Congress considered in the past. But he was never by those who these projections, the escalating cost of insurance checks, the intended disease that we, with the financial situation of Medicare with the goal of creating a massive new program to another federal law that the federal government grow over billions a lot – we talked about the number, the period of 10 years, 0, $ 5,000,000,000 -. and sick days with these dramatic cuts, the loss of service or loss of benefits to beneficiaries when they see this growth to new government with a new government program, it was not in the minds of all those who asked us, with credit problems Medicare to master, and he did not believe it was in the mind of everyone that we are a kind of health care reform, have asked to meet with the rising cost of premiums.

Mr Alexander. Mr. President, how much time remains in the Republican camp?

The ACTING President pro tempore. Senator has 8 1 / 2 minutes.

Mr Alexander. What President Let me know if can rest to 4 minutes.

The senator from Idaho come to the conclusion about us back then. has

The Senator from Idaho made an important point, our Democratic friends have settled in the next 30 minutes and a few other things can they tell the rest day. There were many things about yesterday’s report on the effect of this proposal, CBO 0.5 billion premium. Rather than take my word, we are on the news section of the “Wall Street Journal today go on”. Some of the health premiums rise

This means the rise. This means that the cost for your insurance for some Americans.

So my question is, why should we spend 0.5 billion over 10 years, cut Medicare, raise taxes, debt and run to raise some health premiums? I thought the whole exercise was to reduce the cost of health care premiums

The article says: The analysis released Monday by the nonpartisan Congressional Budget Office and Joint Committee on Taxation – We should pay. some attention to these outfits as nonpartisan – painted a complex and uncertain. He said that people who would pay for their own insurance to see a higher bill, though for higher benefits – would buy insurance from the government that forced you, is approved. If they are not low wages, are entitled to a tax credit the new government.

Where will the money come for these grants? It will come from Grandma. It will come from Medicare. It will come from taxes. And there are more debts

These facts

employees of small businesses come -.. Told the Wall Street Journal – see their insurance premiums would be unchanged – that is for small businesses, we will cut spending 0.5 billion over 10 years, Medicare, taxes cut, and increase premiums for millions of Americans, so that your insurance will continue to rate increase, it already was. Why would we do that, />
br /> We must change the debate. We have to start over. Instead of the full bill of 2000 pages of taxes, mandates and, as a general effect, increasing premiums and tax cuts and Medicare, we must set a clear goal, the cost reduction, and begin to go step by step towards that goal – the reduction of adverse actions against doctors, so that health care to buy across state borders to increase competition, so to combine small companies, health plans, so that they provide more security for workers at lower cost

. These three bills that I mentioned were proposed and rejected until now by the majority of Democrats. We should be more flexibility in the areas of health savings accounts, the efforts of the waste, fraud and abuse that are, in fact, Medicaid – the largest government program – and Medicare – the second – and stronger measures to promote wellness and prevention.
One approach, the comprehensive bill of 2,000 pages, the Washington-acquisition approach, the Americans very carefully. In my humble opinion, this law is to believe in its historical arrogance, we could use a system that nearly all 300 million Americans are affected, 16 percent of the economy and change to do everything at once.

Instead, why not go step by step to earn back the trust of the American people? Republicans take these proposals on the ground this month and next month and so long to try to see that we have received real health care reform. grandmaâ cut? s Medicare / 2 trillion and spend it on a new program at a time when Medicare is broke is no real healthcare reform.

Mr. Crapo. Mr. President, how much time is left?

The ACTING President pro tempore. There are 4 1 / 2 minutes left, Senator.

The Senator from Idaho
.
Mr. Crapo. Thank you, Mr. President. Let me conclude with our time today was tomorrow, focusing on the bigger picture a little, as my colleague from Tennessee, in his closing remarks added.

If you ask Americans whether they want health care reform would be the vast majority say yes. If you ask them what they mean to say the vast majority in the polls and in my personal experience: we want to reduce the rising costs of health care and health insurance under our control, and we want more access to high quality health care for people without access today and see for those who have limited access today.

This bill is not central to two points. What is the law, but the size of the government 0.5 billion € higher new federal spending, create new states massive controls on the economy and even the creation of a federal government insurance company. It raises taxes by about 0 billion and not only the rich will be designated. The vast majority of these taxes will hit directly on those who said Obama would not be achieved. Those earning less than 0,000 per year and, frankly, all along the chain cuts revenue

Medicare $ 4 billion. It is a major new unfunded mandate on our states that are struggling already, in its fiscal budget. As my colleague said, he raises the price of insurance premiums up to the individual market, always in the insurance market in small groups and are almost unchanged in the market for large insurance companies, according to the CBO study.

By the way, one thing that is in this study, CBO does not much in this huge market, in its view, does not look to the only part of the market, prices are reported to increase insurance is a reason that health care will continue to slow. In other words, there is a tax on these big, high cost of insurance premiums that are either passed through and cause their insurance to rise or by a reduction in the cost of insurance and avoid reducing the coverage of services in this policy. So, one way or another, all Americans to see their health care premiums up or in large groups, see their health care premiums are kept the same by the quality of the insurance.

If these two reasons for return, the Americans wanted health reform, we have seen premiums? We see quality improvement or increased access to care? Well, there are those receiving a grant under this program for this massive new federal program countries. But at what price? Mr. Speaker, $ 4,000,000,000 0.5 billion in cuts in Medicare, the creation of a large new government program is primarily financed by taxes on the backs of the dramatic increase in new taxes, massive increases in federal and Medicare cuts, and at the end we have a system in which we are witnessing an amazing increase in medical costs. For me this is not the kind of reform we need. My colleague from Tennessee, said that there are a number of reforms on which we can find common ground to reduce health care costs. There are a number of reforms on which we dispute that will allow us to gain access to quality care may increase. Here we should focus. That is why I am here today to the amendment of my colleague, John McCain, a movement on to support the launch of the Finance Committee bill. As already indicated, it could be done in one day, just delete the Medicare cuts that are included in the present. Fix the part of the bill, then we move.

I see my time is up.