Thursday, February 25, 2010; 4:52 PM
BECERRA: Mr. President, thank you very much for bringing us all together. I do want to address something that my friend, Paul Ryan, said, because I almost think that we can't have this discussion any further without addressing something Paul said.
Paul, you called into question the Congressional Budget Office. Now, we could all agree to disagree. We could all have our politics, but if there's no referee on the field, we can never agree how the game should be played.
RYAN: Let me clarify just to be clear.
BECERRA: No, no, let me -- if I could just finish. And so I think we have to decide, do we believe in the Congressional Budget Office or not? Because Paul, you and I have sat on the Budget Committee for years together and you have on any number of occasions in those years cited the Congressional Budget Office to make your point, referred to the Congressional Budget Office's projections to make your point. And today, you essentially said you can't trust the Congressional Budget Office.
RYAN: No, that is not what I'm saying.
BECERRA: Well, that was my interpretation. I apologize if I misinterpreted.
RYAN: I am not questioning the quality of their scoring. I am questioning the reality of their scoring.
BECERRA: If I could just finish my -- OK. I -- I take your point on your clarification.
RYAN: Let me just say it, 10 years of tax increases, 10 years of Medicare cuts to pay for six years of spending.
BECERRA: If I -- if I could just try to make my point.
So then I'm assuming then that you do believe that the CBO is a legitimate agency to render decisions on spending for the Congress.
RYAN: You know I believe that.
BECERRA: OK, so then let's work with that, because quite honestly, if we can't work with CBO numbers, we're lost. We're lost because we really will get into a food fight. And so I apologize, Paul, if I misinterpreted what I had heard. I appreciate that we left the referee on the field.
BECERRA: So if the referee is on the field, then we have to at least accept what the referee has said, and the referee said that the bills that are before us reduce the deficit, the federal government's deficit, by over $100 billion in the first 10 years. The Congressional Budget Office, the referee, not political parties, the referee, said that these bills reduce the deficit in the succeeding years, after the first 10 years, by over $1 trillion.
Now, you're right. All the discussion makes it clear it wasn't easy. There are going to be some savings that we extract out of Medicare. What we do in these bills is try to make the point that as we reduce the deficit, we're not going to put the onus, the burden of those cuts on seniors who receive Medicare. We're asking the providers to stop, as some of my colleagues in the Senate said, over- utilizing or over-spending in services so that we don't see someone having four different X-rays for chest pains. And so what we're trying to do is figure out the ways to reduce the costs without impacting benefits. In fact, that's how in these two bills that the Senate and House passed, we were actually able to close the doughnut hole for prescription drug coverage in Medicare and still extract, according to the CBO, over $100 billion in savings.
So Mr. President, I would just say the thing that I would love for us to get into the details of in terms of those deficit reductions that are made is the fact that we do it while putting the brakes on Medicare overpayments that went to insurance companies which were getting reimbursed at greater levels than were doctors and hospitals that relied on traditional Medicare fee-for-service to provide services to our seniors.
We have any number of provisions that deal with the issue of fraud, which it says at least totals $60 billion. And working with some of our Republican colleagues, we are doing exactly that, going after the waste that's in the system, certainly the fraud. And that's how we extract the number of the savings.
And finally, perhaps one of the unsung secrets of what we learn from listening to doctors and hospitals and all the different providers is that we can actually do a far better job of coordinating care for people. And if you -- if you make sure that someone who walks in the door of any one of the great physicians who are in this room when they were practicing, and made sure that we followed them through not just that first visit to the primary care or family doctor, but then into the specialist, and then into the hospital.
And then afterwards to the, perhaps the nursing home or the home health center, that what you do is that you coordinate the care instead of have each provider do just its share and forget about the patient. If you coordinate the care, you can actually reduce costs dramatically.
And that's how we were able to reduce the cost for Medicare. That's how we were able to extract, according to the referee on the field, the Congressional Budget Office, over $100 billion in deficit reduction and over $1 trillion in deficit reduction in the second 10 years.
So I believe, Mr. President, what we have is a chance to discuss how we can actually put this country back on a good fiscal track and still do right by our seniors in Medicare and increase the amount of people who get covered by health insurance by about 31 million.