Sunday, September 13, 2009 12:59 PM
CHRIS WALLACE (host): Senator McCaskill, do you really believe that that's possible, that you can take hundreds of billions of dollars out of Medicare without cutting services to seniors?
SEN. CLAIRE MCCASKILL (D-MO.): Well, I don't know how many ads you've seen for scooters on cable TV, but I see a lot of them. Those are scooters paid for by the American people, and a lot of them are going to folks who don't need scooters.
It's one example of many examples where we are paying for services or things instead of outcomes. And I think it's very important that we start focusing on the patient and what's good for the patient rather than five or 10 or eight CAT scans in one week so docs and hospitals are trying to pay for those machines.
There's lots of things we can do without cutting any of the services. And rankly, Medicare Advantage, with all due respect to Orrin, we just transferred a lot of taxpayer money to insurance companies. It hasn't brought down the cost of Medicare. It hasn't improved the services.
WALLACE: But -- but, Senator McCaskill, let me -- let me ask you, because this is a question I get a lot in e-mails. If there is already hundreds of billions of dollars of waste and fraud in Medicare, why would we want to trust government with an even bigger role in health care?
SEN. ORRIN HATCH (R-UTAH): You got that right.
MCCASKILL: Well, part of the problem is -- is that we've had the private sector come in and get Congress to do things. A great example is Medicare D.
For gosh sakes, where were all the fiscal conservatives, you know, five or six years ago when the Republican Congress and Republican president...
WALLACE: We should point out that's the prescription drug benefit.
MCCASKILL: ... passed a trillion-dollar program without any way of paying for it. That's a good example of where we have transferred money from taxpayers to private insurance companies, and it has not produced the kind of result the American people deserve.
WALLACE: Senator Graham...
MCCASKILL: We need to pay for this.
WALLACE: Let me bring in Senator Graham, because Democratic congressman Jim Cooper, one of the so-called Blue Dogs, who actually teaches health care policy, says that between private and public health care, we waste about $700 billion a year, so it should be easy to find these kinds of savings.
SEN. LINDSEY GRAHAM (R-S.C.): Well, no one's found them before, and the only way you're going to find them now is to do something that no one's been willing to do, and that's get in here and change the system.
You're not going to find $300 billion in Medicare and Medicaid savings. This trigger idea that at a certain point in time we'll stop spending and go back and cut things has never worked anywhere else, so the trigger is a phony baloney idea.
They said the same thing in Tennessee about TennCare, "We're going to make the system efficient and that's how we're going to pay for TennCare." Listen to what the governor of Tennessee had to say about that.
I voted against Medicare Part D for the very reason that we don't pay for things around here. The Wyden-Bennett bill -- seven Republicans and seven Democrats -- is revenue neutral. I'd like to talk to the president about it.
But here's the one thing that we've learned from this show today. The House bill is dead because deficit politics apparently matter, and the public option is unacceptable, so that's a good start.
If we can kill the House bill, let's sit down with Kent Conrad and others and see if we can do something reasonable. But it is not reasonable to assume that we're going to cut Medicare and Medicaid costs to pay for other people's insurance and get $300 billion savings and have a trigger that works in Washington. Neither one of those makes sense to me.
SEN. KENT CONRAD (D-N.D.): Chris, can I just say on this point...
WALLACE: Go ahead, Senator.
CONRAD: Look, we have negotiated with Medicare providers -- hospitals, nursing homes, home health -- hundreds of billions of dollars of savings. Why are they willing to come forward and negotiate those savings? Because they know with more people covered, they are going to have more business. They're going to have fewer circumstances in which they don't get compensated, they don't get paid.
So we have gotten hundreds of billions of dollars of savings from Medicare providers because they know they're going to get more business.
WALLACE: All right. We are almost...
GRAHAM: Can I add something? Can I add something? What about the doctor fix? Are we going to let it go into effect? It's supposed to go into effect every year and we never let it go into effect. That's exactly what's going to happen with these other cuts.