2003 Ron Paul 71:1
Mr. PAUL. Mr. Speaker, while there is little debate about the need to update and modernize
the Medicare system to allow seniors to
use Medicare funds for prescription drugs,
there is much debate about the proper means
to achieve this end. However, much of that
debate is phony, since neither H.R. 1 nor the
alternative allows seniors the ability to control
their own health care. Both plans give a large
bureaucracy the power to determine which
prescription drugs senior citizens can receive.
Under both plans, federal spending and control
over health care will rise dramatically. The
only difference is that the alternative puts seniors
under the total control of the federal bureaucracy,
while H.R. 1 shares this power with
private health maintenance organizations
and insurance companies. No wonder supporters
of nationalized health care are celebrating
the greatest expansion of federal control
over health care since the Great Society.
2003 Ron Paul 71:2
I am pleased that the drafters of H.R. 1 incorporate regulatory relief legislation, which
have supported in the past, into the bill. This
will help relieve some of the tremendous regulatory
burden imposed on health care providers
by the Federal Government. I am also
pleased that H.R. 1 contains several good provisions
addressing the congressionally-created
crisis in rural health and attempts to ensure
that physicians are fairly reimbursed by the
Medicare system.
2003 Ron Paul 71:3
However, Mr. Speaker, at the heart of this legislation is a fatally flawed plan that will fail
to provide seniors access to the pharmaceuticals
of their choice. H.R. 1 provides seniors
a choice between staying in traditionally
Medicare or joining an HMO or a Preferred
Provider Organization (PPO). No matter which
option the senior selects, choices about which
pharmaceuticals are available to seniors will
be made by a public or private sector bureaucrat.
Furthermore, the bureaucrats will have
poor to determine the aggregate prices
charged to the plans. Being forced to choose
between types of bureaucrats is not choice.
2003 Ron Paul 71:4
Thus, in order to get any help with their prescription drug costs, seniors have to relinquish
their ability to choose the type of prescriptions
that meet their own individual needs! The inevitable
result of this process will be rationing,
as Medicare and/or HMO bureaucrats attempt
to control costs by reducing the reimbursements
paid to pharmacists to below-market
levels (thus causing pharmacists to refuse to
participate in Medicare), and restricting the
type of pharmacies seniors may use in the
name of cost effectiveness. Bureaucrats
may even go so far as to forbid seniors from
using their own money to purchase Medicarecovered
pharmaceuticals. I remind may colleagues
that today the federal government
prohibits seniors from using their own money
to obtain health care services that differ from
those approved of by the Medicare bureaucracy!
2003 Ron Paul 71:5
This bill is even more pernicious when one realizes that this plan provides a perverse incentive
for private plans to dump seniors into
the government plans. In what is likely to be
a futile effort to prevent this from happening,
H.R. 1 extends federal subsidies to private insurers
to bribe them to keep providing private
drug coverage to senior citizens. However, the
Joint Economic Committee has estimated that
nearly 40 percent of private plans that currently
provide prescription drug coverage to
seniors will stop providing such coverage if
this plan is enacted. This number is certain to
skyrocket once the pharmaceutical companies
begin passing on any losses caused by Medicare
price controls to private plans.
2003 Ron Paul 71:6
Furthermore, these private plans will be subject to government regulations. Thus, even
seniors who are able to maintain their private
coverage will fall under federal control. Thus,
H.R. 1 will reduce the access of many seniors
to the prescription drugs of their choice!
2003 Ron Paul 71:7
Setting up a system where by many of those currently receiving private coverage are
hired into the government program exacerbates
one of the major problems with this bill:
it hastens the bankruptcy of the Medicare program
and the federal government. According
to Medicare Trustee, and professor of economics
at Texas A&M University, Tom Saving,
the costs of this bill could eventually amount
to two-thirds of the current public-held debt of
$3.8 trillion! Of course, estimates such as this
often widely underestimate the costs of government
programs. For example, in 1965, the
government estimate that the Medicare Part B
hospitalization program would cost $9 billion in
1990, but Medicare Part B costs $66 billion in
1990!
2003 Ron Paul 71:8
This new spending comes on top of recent increases in spending for homeland security,
foreign aid, federal education programs, and
new welfare initiatives, such as those transforming
churches into agents of the welfare
state. In addition we have launched a seemingly
endless program of global reconstruction
to spread democratic capitalism. The need
to limit spending is never seriously discussed:
it is simply assumed that Congress can spend
whatever it wants and rely on the Federal Reserve
to bail us out of trouble. This is a prescription
for disaster.
2003 Ron Paul 71:9
At the least, we should be debating whether to spend on warfare or welfare and choosing
between corporate welfare and welfare for the
poor instead of simply increasing spending on
every program. While I would much rather
spend federal monies on prescription drugs
then another unconstitutional war, increasing
spending on any program without corresponding
spending reductions endangers
our nations economic future.
2003 Ron Paul 71:10
Congress further exacerbates the fiscal problems created by this bill by failing to take
any steps to reform the government policies
responsible for the skyrocketing costs of prescription
drugs. Congress should help all
Americans by reforming federal patent laws
and FDA policies, which provide certain large
pharmaceutical companies a governmentgranted
monopoly over pharmaceutical products.
Perhaps the most important thing Congress
can do to reduce pharmaceutical policies
is liberalize the regulations surrounding
the reimportation of FDA-Approved pharmaceuticals.
2003 Ron Paul 71:11
As a representative of an area near the Texas-Mexico border, I often hear from angry
constituents who cannot purchase inexpensive
quality imported pharmaceuticals in their local
drug store. Some of these constituents regularly
travel to Mexico on their own to purchase
pharmaceuticals. It is an outrage that my constituents
are being denied the opportunity to
benefit from a true free market in pharmaceuticals
by their own government.
2003 Ron Paul 71:12
Supporters of H.R. 1 claim that this bill does liberalize the rules governing the importation
of prescription drugs. However, H.R. 1s importation
provision allows the Secretary of
Health and Human Services to arbitrarily restrict
the ability of American consumers to import
prescription drugs — and HHS Secretary
Thompson has already gone on record as determined
to do all he can to block a free trade
in pharmaceuticals! Thus, the importation language
in H.R. 1 is a smokescreen designed to
fool the gullible into thinking Congress is acting
to create a free market in pharmaceuticals.
2003 Ron Paul 71:13
The alternative suffers from the same flaws, and will have the same (if not worse) negative
consequences for seniors as will H.R. 1.
There are only two differences between the
two: First, under the alternative, seniors will
not be able to choice to have a federally subsidized
HMO bureaucrat deny them their
choice of prescription drugs; instead, seniors
will have to accept the control of bureaucrats
at the Center for Medicare and Medicaid Services
(CMS). Second, the alternative is even
more fiscally irresponsible than H.R. 1.
2003 Ron Paul 71:14
Mr. Speaker, our seniors deserve better than a choice between whether a private or
a public sector bureaucrat will control their
health care. Meaningful prescription drug legislation
should be based on the principles of
maximum choice and flexibility for senior citizens.
For example, my H.R. 1617 provides
seniors the ability to use Medicare dollars to
cover the costs of prescription drugs in a manner
that increases seniors control over their
own health care.
2003 Ron Paul 71:15
H.R. 1617 removes the numerical limitations and sunset provisions in the Medicare Medical
Savings Accounts (MSA) program. Medicare
MSAs consist of a special saving account containing
Medicare funds for seniors to use for
their routine medical expenses, including prescription
drug costs. Unlike the plans contained
in H.R. 4504, and the Democratic alternative,
Medicare MSAs allow seniors to use
Medicare funds to obtain the prescription
drugs that fit their unique needs. Medicare
MSAs also allow seniors to use Medicare
funds for other services not available under
traditional Medicare, such as mammograms.
2003 Ron Paul 71:16
Medicare MSAs will also ensure that seniors have access to a wide variety of health care
services by minimizing the role of the federal
bureaucracy. As many of my colleagues know,
an increasing number of health care providers
have withdrawn from the Medicare program
because of the paperwork burden and constant
interference with their practice by bureaucrats
from the Center for Medicare and
Medicaid Services. The MSA program frees
seniors and providers from this burden, thus
making it more likely that quality providers will
remain in the Medicare program!
2003 Ron Paul 71:17
There are claims that this bill provides seniors access to MSAs. It is true that this bill lifts
the numerical caps on Medicare MSAs; however,
it also imposes price controls and bureaucratic
requirements on MSA programs.
Thus, the MSAs contained in this bill do nothing
to free seniors and health care providers
from third party control of health care decisions!
2003 Ron Paul 71:18
Mr. Speaker, seniors should not be treated like children by the federal government and
told what health care services they can and
cannot have. We in Congress have a duty to
preserve and protect the Medicare trust fund.
We must keep the promise to Americas seniors
and working Americans, whose taxes finance
Medicare, that they will have quality
health care in their golden years. However, we
also have a duty to make sure that seniors
can get the health care that suits their needs,
instead of being forced into a cookie cutter
program designed by Washington, DC-based
bureaucrats! Medicare MSAs are a good first
step toward allowing seniors the freedom to
control their own health care.
2003 Ron Paul 71:19
Finally, Mr. Speaker, I would like to comment on the procedure under which this will
was brought before the House. Last week, the
committees with jurisdiction passed two separate,
but similar Medicare prescription drug
bills. In the middle of last night, the two bills
were merged to produce H.R. 1. The bills reported
out of Committee were each less than
400 pages, yet the bill we are voting on today
is 692 pages. So in the middle of the night,
the bill mysteriously doubled in size! Once
again, members are asked to vote on a significant
piece of legislation with far reaching effects
on the American people without having
had the chance to read, study, or even see
major portions of the bill.
2003 Ron Paul 71:20
In conclusion, Mr. Speaker, both H.R. 1 and the alternative force seniors to cede control
over which prescription medicines they may
receive. The only difference between them is
that H.R. 1 gives federally funded HMO bureaucrats
control over seniors prescription
drugs, whereas the alternative gives government
functionaries the power to tell seniors
which prescription drug they can (and cant)
have. Congress can, and must, do better for
our Nations seniors, by rejecting this command-
and-control approach. Instead, Congress
should give seniors the ability to use
Medicare funds to pay for the prescription
drugs of their choice by passing my legislation
that gives all seniors access to Medicare Medical
Savings Accounts.