Liability Insurance For Small Business Kansas
Liability Insurance For Small Business Kansas
House Session 2010-04-15 (18:26:35-19:26:58)
George Soros Q1 Portfolio Update
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Health Plan Cut Grandmaâ € ™ s Medicare a half-trillion
Senator Lamar Alexander today announced the following remarks on the floor of the U.S. Senate:
 € œWhat  · Senator McCain is basically saying is, with its amendment, cut donâ € ™ t Grandmaâ € ™ s Medicare to pay for someone Elsea € ™ s insurance.â €
 €  · ÖIF you find savings by cutting waste, s fraud and abuse in Medicare Grandmaâ € ™, these savings to spend on Grandma. Medicareâ € ™ s trustees told us that it 38000000000000 $ In unfunded liabilities for the Medicare program and the program will start going bankrupt in 2015-2017. Under the Medicare Trustees, â € ~ We need timely and effective measures to address Medicareâ € ™ s challenges.â € ™ I donâ € ™ t think the Medicare Trustees thought to take timely and effective action we could to was to keep bankrupt Medicare, 465 billion U.S. dollars, take it and give it to some new program.â €
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 €  · œRather than take my word for it, letâ € ™ s go, a Wall Street Journal headline: `Some contributions to health insurance to Rise.â € ™ ie, the cost of your insurance is increasing. So my question is, why should We spend $ 2500000000000 increase cut over ten years, Medicare, taxes and run up the debt to raise some Americansâ € ™ health insurance contributions? I thought the whole exercise was to lower health care costs premiums.â €
 € œThis  · account in thinking could we are a system that nearly all Americans and change it all at once influence historically. Why donâ € ™ t we have to earn place step by step again the confidence of the American people? Republicans will make these proposals in the Senate this month and next month and when it does get real health reform. Cutting Grandmaâ € ™ s Medicare a half-trillion dollars and expenditures to a new program at a time when Medicare is broke is not real health care reform.â €
Full Alexander Remarks:
Mr. Kyl. Mr. President, I ask unanimous consent that during the 30 minutes of the Republicans controlled, will we be allowed to enter into a conversation.
The Acting President pro tempore. Without objection, it is so ordered.
Mr. Kyl. Mr. President, I will be making some comments on the amendment Senator McCain, my colleague from Arizona start, has filed. This is a change, as the minority in the House of Representatives just said, the American seniors will be protected. It will ban the Medicare cuts this law contains.
The economist Milton Friedman once said: "It is no such thing as a free lunch, "and that applies to health care as well. There is no such thing as free health care. Someone has to pay it. Since this bill is a 2500000000000 $ Bill, is the first question: Who pays? The first answer of who pays, it is America's seniors, because about half the cost of Exchange is allegedly paid by Medicare cuts.
Let me break a little more accurate than the Republican leaders did exactly what that means. This is about 500 billion U.S. dollars in Medicare cuts as follows: $ 137.5 billion to treat in hospitals, senior citizens, $ 120,000,000,000 of Medicare Advantage, which the insurance program offers benefits for seniors who will be more than halved as a result, this is 120 billion U.S. dollars discount; 14.6 billion U.S. dollars from that nursing homes to treat senior citizens; $ 42100000000 from home health care for seniors and $ 7700000000 of hospice, one of the cruelest cut of all. Obviously, with this dramatic cut there is no way not to jeopardize care seniors now enjoy, and seniors know. That is why they were writing our offices and participation in Townhall meetings, We know that they reject this. I quoted from two letters from constituents of mine from Arizona asks sent please do not cut their Medicare Advantage Program. This was seen as the crown jewel the Medicare system, and many of them rely on Medicare Advantage for dental or vision care or assistance, are they hear come to trust. Do not buy Claims, somehow we can make $ 1 / 2 trillion cuts in Medicare without violating their kind support. You know better than that, and they are right. The care they have promised will be challenged to pay for this new government, under the right account.
After all, many ask what happens the promise that they keep the care they have received. We have all heard the President say that many times: If you like the care you have to get it keep getting. This is simply not true. There are 337 000 Arizonans to Medicare Advantage patients. They like what they have. But we know according to the Congressional Budget Office, that the benefits they would have under Medicare Advantage will be reduced by more than half. They say: What happened to the politics I like? I am not in a position to to keep it, if this bill goes.
Therefore, the change needs to happen is McCain. If our Democratic colleagues are not ready to protect Medicare, I can not imagine, how else could make the bill acceptable because it starts with the commitments that have the Congress and the president of our senior citizens.
Perhaps one of the reasons why there are different numbers from one side of the aisle to the other is that sometimes we are not talking apples to apples. We speak apples and oranges here, and maybe both numbers are correct in their context. The senator from Tennessee used the number 2500000000000 $, if the program is fully implemented is. This is a very important statement. The other side would argue that there is only $ 1 1 / 2 trillion U.S. dollars for the first 10 years the program. That is a correct statement. But it is 2500000000000 $ for the first 10 years the whole implementation of the program. What is the reason for the difference? For the first four years, money is collected, but very few benefits go out. The benefits for years to start No. 4 So when we take the first 10 years of the program, we collect money to pay them over the entire 10 years, but almost all the benefits appear only during the last six years. Of course we have more money than we paid collected. But if we take the first 10 years of full Implementation, it is as my colleague from Tennessee said, a fee of $ 2,500,000,000,000th This is how we sometimes get slightly different numbers.
As long as we clear about what we are talking, one thing is clear: whether it concerns 1 $ 2.1 trillion 2.5 trillion U.S. dollars, we are talking real money. Someone has to pay for it. If America's Seniors are asked to pay for half, this is not fair to America's seniors, given the commitment we have made them. That is the point Senator McCain. Protect Medicare protect America's seniors. We can do with the simple change to what Senator McCain has sent the bill to committee back – it would just 1 day – and send it here without such cuts in Medicare bill.
Mr. Alexander. I see the Senator from Idaho here. I want to his observations heard. If there is any problem in this whole debate, health care, why we symbolized on the Republican side want to change the debate a step-by-step approach to reducing the cost of premiums, it would be the Medicare issue. As the senator from Arizona said, what we talk about Medicare, it is as fast as solvents can we need, as efficiently as we can. The senator from Kansas, said recently that the proposal to take 465 billion U.S. dollars from grandma and Medicare spending It is a few new programs, such as writing a check on an overdrawn account at a bank to buy a large new car. There is much truth in it.
The President said earlier this year, I can only agree. He said the health care debate is not just about health care. It is about the role of the federal government in the daily lives of Americans. He is exactly right. The health care debate that we are beginning this week is not just about health. It's about the stimulus package, on the assumption from General Motors. It is about the trillion dollar debt. It is about the acquisitions Washington. It's about too much spending, too much taxation, too much debt. The Medicare provisions of this Law is a perfect symbol for it. That is why Senator McCain is right. What he says is not grandma's Medicare cut and spend it on some new program features. If you some savings in the waste can not find fraud, and abuse of Medicare's Grandma, spend your grandma. Make sure those of us who are older and those of us who are younger and look forward to Medicare may be counting on his ability to pay.
Later this week we learn more about the premium increase will speak. There was a lot of discussion yesterday, because after the Wall Street Journal, would get some contributions to health insurance. For people to get their insurance from large employers, will not make much difference this law. And for small employers, if your insurance from a small employer, it will make much difference. If you go to the individual market to buy insurance yourself, your premiums will rise, unless we go to get some money are to help from somewhere, take a portion of your premiums, at least for about half of Americans who are in the individual market. Where shall we get the money? Of Grandma. We will be there from Medicare. So that's what wrong with this law. And what is right, what is the McCain amendment, it simply says not to cut Medicare. If we find Savings, which we hope we can in Medicare, we should make Medicare solvent to spend.
I wonder if the senator from Idaho by Elderly hearing in his State of the cuts proposed 465 billion U.S. dollars in Medicare and how they take on the feeling that money and spend it to one To create a new program?
Mr. Crapo. I thank the Senator from Tennessee. We are very sure of seniors in Idaho, to see through this hearing. It is very clear the people in Idaho that what we see is a planned massive growth of the federal government of more than $ 2500000000000 when they are fully implemented, that is financed on the back the American taxpayers and seniors through cuts in Medicare. In fact, in addition to those who see me, which are their health benefits lost contact , I've been contacted by a number of providers. We look forward to those home care or hospice care, skilled nursing facilities and hospitals are talking about and the like.
You make a very interesting point. My point is that not only senior citizens – in particular, Medicare Advantage – literally to losing their benefits dramatically, but that other seniors who are in traditional Medicare will also lose access to and quality of care. What is the case? We know from the details of this law we are bigger cuts in hospice care, home care, skilled nursing facilities to see and hospitals.
The points made to me by these vendors that they were already a number of very deep cuts, cuts come to the point that in Idaho for at home Health care, we lost something like 30 percent of our systems already. The way one of them said it seemed to me that if you reduce the reimbursement we receive, then have something we reduce our budget. He said: "We can not begin simply, rocks out of our building. What are we going to do at the end, to reduce personnel costs. The would be the nurses and the doctors and other care providers are out there that provide assistance for these people. We need the number of people We are working to reduce or equipment that we offer. In the end it will be a reduction of benefits and access available to seniors, including a Reduce the quality of care they are able to provide.
Mr. Alexander. In discussing the Medicare cuts, any other provision of law which we will be this month and next month, spoken as we go through the health care debate, what about the problem of payment of doctors and Hospitals to see Medicare patients. You get paid more than 83 percent of the interest rate, to pay them to see if they were a private patient care would be. Each Years Congress has to adapt to something we have a few years ago, which automatically cuts make the amount of money that we pay doctors who are seeing Medicare patients.
This is a big problem for Medicare patients. Because if not, the doctors can be paid, they will not see the patients, and Medicare patients are increasingly able in the condition that Medicaid patients find that low-income Americans who are covered by the state program – that is our greatest state-run program – where about 60 percent of the doctors who will pay what private patients to pay and can not see about half of the doctors new Medicaid patients to see. I ask the Senator, he sees everywhere in this bill a provision for the $ 4.1 trillion is required to pay a doctor 10 years from now, what they do today? If it is not in the bill, go where the $ 1 / 4 trillion, about him? Will it come from Medicare cuts, or will they represent the sum of the deficit ? Come
Mr. Crapo. Of course, it is of cuts in Medicare or increased taxes or more debt just come on the federal level.
The Senator raises a very interesting point. This question of fixing the compensation rates for physicians in Medicare is a huge issue that we have been fighting for a number of years to try to find a solution because we will pass each year delay of the expected cuts. I have about this factor as part of being in a household Gimmick said this bill. What do I do that? Those who say this bill reduces the deficit in a position to say, only because it is over $ 500,000,000,000 new taxes, about 500 billion U.S. dollars of Medicare cuts, and has delayed a number of budget lines gimmicks that the implementation of the expenditure side of the bill or, in this Case, even with all the most important issues that must be accommodated, and must also This is the fix for physician compensation. If one of these things were not in this bill, This law would drive the deficit is huge.
What we will see, in addition to these tax effects on the federal treasury in the form of huge increases in the debt huge increases in taxes or is more, even more than we speak with this bill we will see the very real potential that access to medical care for Seniors again, because this factor can be reduced.
Let me say a few statistics. In its report in June 2008, the Medicare Payment Advisory Commission, or Medpace said, that 29 percent of Medicare beneficiaries who were interviewed were looking for a family doctor and had trouble finding one to treat them. In other words: over 30 percent of Medicare beneficiaries now have trouble finding a doctor to take a Medicare patient. This is above the 465 billion U.S. dollars of cuts and just not before, including doctors at all in this legislation.
A survey of 2008 by the Texas Medical Association found that only 58 percent of the state Medicare patients new doctors participated, and only 38 percent of family physicians accepted new patients. Again, it is shows an example from Medpace and from a country which is what we know across the country, happens, namely, that the doctors in increasing numbers are no longer under new Medicare patients, as with Medicaid patients done in years. However, we see these massive cuts Medicare is proposed that the same impact on hospice and home health services and have skilled nursing facilities and hospitals, and we see that The doctors did not even include all, ie they are now to receive great discounts, projected. I think it is over 20 percent reduction in their remuneration for among Medicare patients.
The solution here is to create a massive new federal entitlement program, not to cut Medicare. I would like to repeat something both the senator from Arizona and Tennessee have already said, is that important. Reducing the Medicare budget of 464 billion U.S. dollars, by any number, is something which was funded in terms of trimming the growth of Medicare. This is has something looked at this Congress in the past. But it was never intended by those who these need to predictions made on the control the spiral costs of Medicare, the fiscal realities that we address in Medicare with the purpose of creating another new and massive federal entitlement program that the Federal Government in the course of 2000000000000 $ – we talked about the numbers, the full 10-year period is 2.5 trillion $ – And allow Medicare to these dramatic cuts, this loss of service and loss of benefits to the recipients while they see this new government growth with a new government program. That was not in the mind of all those who ask us, it was concerned with the solvency issues in Medicare, and do not believe it, It was in the minds of all those who we have asked some kind of deal health sector reform with the rising costs of premiums.
Mr. Alexander. Mr. President, how much time remains on the Republican side?
The Acting President pro tempore. The senator has 8 1 / 2 minutes.
Mr. Alexander. If the Chairman let me know if 4 minutes.
The Senator from Idaho to conclude our comments at this time.
The Senator from Idaho has an important point made, anticipating our democratic friends in the next 30 minutes and a few other things they have to say, the rest of the day. It was much talked yesterday about the CBO report on the effect of this 2500000000000 $ suggestion for the premiums. Rather than take my word for it, let's Go to news section The Wall Street Journal today, which has the headline: "Some increase contributions to health insurance."
That means up. That is, the Cost of your insurance for some Americans.
So my question is, why should we spend $ 2500000000000 cut over 10 years, Medicare, taxes and the debts run up on some of the contributions to health insurance increase to increase? , I thought the whole exercise was to determine the cost of health insurance contributions lower.
The article says: The analysis released Monday by the nonpartisan Congressional Budget Office and the Joint Committee on Taxation – We are to some pay attention to these outfits as nonpartisan – painted a complex and uncertain picture. He said people who would pay for their own insurance higher Bill, though for higher power – that is approved by the government you are forced to buy insurance. If they are low paid, for a new government Tax credit to qualify.
Where is the money will come for those of subsidies? It will come from grandma. It will come from Medicare. It will come from taxes. And it will come through an increase in debt.
Those are facts.
Employees of small companies – says the Wall Street Journal – would effectively see their insurance premiums unchanged – that is for small business, we spend $ 2500000000000 cut over 10 years, Medicare, taxes cut, and run until Premiums for millions of Americans, so your insurance will also continue to rise at about the Rate it already was. Why should we do that?
during Workers at large companies would see something between unchanged and slightly lower premiums under the bill – compared to what would already be done – After analysis.
We must change the debate. We have to start from scratch. Instead this comprehensive 2,000-page bill, which is full of taxes, mandates and is a general effect, bonuses and raises taxes and cuts in Medicare, we should set a clear goal of reducing costs, and start, step by step on this Objective – To reduce junk lawsuits against doctors go, so that health care is purchased through the state lines to increase competition, so that small businesses in health plans combine so that they can offer more insurance for employees at lower costs.
These three bills I have mentioned offered and rejected so far by the majority of Democrats. We should be more flexibility in the areas of health savings accounts, efforts to waste, fraud and abuse in the force are encouraging Medicaid – the largest program of the government – and Medicare – the second – and more aggressive steps to wellness and prevention.
A Approach, the comprehensive 2,000-page bill, Washington-takeover approach, Americans are very suspicious. In my respectful opinion after, is this law in its historical arrogance to think we have a system that nearly all 300 million Americans, 16 percent of the economy, and has to change take it all at once.
Instead, why do not we go step by step to earn back the trust of the American people? Republicans will make the proposals on the ground this month and to the next month and as long as try to see that we have received real health care reform. Cutting grandmaâ € ™ s $ 2.1 trillion from Medicare and spending to a new program at a time when Medicare is broke is not real health care reform.
Mr. Crapo. Mr. President, how much time remains?
The Executive President pro tempore. It is 4 1 / 2 minutes remaining, Senator.
The Senator from Idaho.
Mr. Crapo. Thank you, Mr. President. I want our Time to close this morning by focusing on the bigger picture a little bit like my colleague from Tennessee has made in his closing remarks.
If you ask Americans whether they want health care reform, the overwhelming majority would say yes. If you ask them what they mean, the vast majority say in the polls and in my personal experience: we want the rising cost of health care and our health insurance brought under control and see reduced and we want better access to quality health care for those who do not have access today, and for those who have limited access to today . See
This bill is not central to these two points. What this law does not, but instead, the size of government expenditure of $ 2500000000000 new the federal government, creating massive new federal controls over the economy and even the creation of a federal insurance company. It raises taxes by about 500 billion $, And so-called not only to the rich. The vast majority of these taxes are taken to the square said President Obama is not taken to be: those who less than $ 200,000 per year and make honest, all the way down the income chain.
It cuts through Medicare 464 billion U.S. dollars. It provides a wide new unfunded mandate on our states, already in their fiscal budgets. As my colleague explained, this leads to the price of insurance premiums for the individual go to market, to go in the small group insurance market and are essentially unchanged in the large insurance market after the CBO study.
By the way, one of the things that is not pointed in the CBO study is very much in this large market, it is the only part of the market that does not see insurance premiums will rise will be one of the reasons, because their health care will go down. In other words, there is a tax on these larger, high costs to insurance premiums, will either be passed on and cause their insurance to go up or will be avoided by reducing the cost of insurance and the reduction reporting on the performance in these policy areas. Such an or the other, are all Americans go to see her rise in health insurance contributions or the major groups see their health insurance contributions will have held the same by reducing the quality of the insurance.
If you back wanted to go to these two reasons, American health care reform, we have seen premiums go? No. Did we see increasing quality, or access to care? Well, there are some that go for a grant in this program for this new program for massive Federal Republic. But at what price? Mr. President, 2500000000000 $ $ 464 billion of cuts in Medicare, the establishment of a large new government program, financed largely on the back of a massive new tax hikes will be massive tax increases and Medicare cuts Federal, and in the end we are still in a system in which we see spiral increases the cost of health care be. For me this is not the kind of reform we need. My colleague from Tennessee indicated there are a number of reforms on which we agreed that the cost of health care are able to reduce. There are a number of reforms to which we can find common ground to help us, access to quality health care can be increased. That is, where would be our focus. That is why I stand here today in support of my colleague John McCain's amendment, which is a movement about that right to commit to the Finance Committee. As already indicated, it could be done in 1 day, to simply the Medicare cuts that are included in it. Let's fix that a part of this law, and then let us work forward.
I see my time is up. I urge this Senate, particularly on legislation and let us work together in a bipartisan fashion instead of acceleration before and tried to legislation that has had no opportunity for that kind of bipartisan efforts to develop a good work product for the American people going to happen.