Senate Proceeding 04-28-09 on Apr 28th, 2009 :: 2:36:50 to 2:56:15
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2:36:42 to 2:37:02( Edit History Discussion )

John Cornyn: quorum call: senator from texas. mr. cornyn: mr. president, i'd ask unanimous consent that the quorum call be the presiding officer: without objection. mr. cornyn: and i'd ask unanimous consent to speak up to 15 minutes on the pending nomination. the presiding officer: the senator may proceed. mr. cornyn: mr. president,

2:36:50 to 2:56:15( Edit History Discussion )
Speech By: John Cornyn

2:37:03 to 2:37:24( Edit History Discussion )

John Cornyn: governor sebelius, who has been nominated for secretary of health and human services, testified before the senate finance committee that she would not refuse to use certain comparative effectiveness research as a tool to deny or delay american citizens access to health care.

2:37:25 to 2:37:45( Edit History Discussion )

John Cornyn: said another way about comparative effectiveness research of $1.1 billion of which was funded in the stimulus program, can be used for both benign purposes and purposes that are completely understandable as well as those

2:37:46 to 2:38:08( Edit History Discussion )

John Cornyn: that are, i think americans would find repugnant, that is for rationing of access to health care. comparative effectiveness research is the comparison of various treatments or approaches to garner better data on what works best least. comparative effectiveness research can be helpful, as i

2:38:09 to 2:38:29( Edit History Discussion )

John Cornyn: said, and beneficial, if it's used in informed health care decisions and individual health care decision making and as a guide to evidence-based medicine. without appropriate safeguards -- and these were the safeguards that governor sebelius refused to embrace -- the government could actually use comparative effeiveness research to delay

2:38:30 to 2:38:52( Edit History Discussion )

John Cornyn: treatment and to deny care based on a one-size-fits-all approh to health care. the economic stimulus package, as i mentioned, included $1.1 billion for comparative effectiveness research. this research should only be used to better-inform individualized decision making.

2:38:53 to 2:39:13( Edit History Discussion )

John Cornyn: that is, the his or her doctor to decide what's in that patient's best interest. it should not be used, convselyinglyings for the government to say, patient, we're not going to -- it should not be used, conversely, for the government to say, patient, we're not going to pay your doctor unless it meets our

2:39:14 to 2:39:35( Edit History Discussion )

John Cornyn: cookbook government model. despite assurances that stimulus money would not be used to effectiveness of various medical treatments, the national institutes of health is already undertaking steps to use the stimulus money to conduct that kind of cost-based research. as i indicated, governor

2:39:36 to 2:39:58( Edit History Discussion )

John Cornyn: sebelius was asked before the finance committee about how she effectiveness research. and as secretary of h.h.s., she will be in the driver's seat, in large part, to determine how the policies of this administration and of this congress will be implemented. my colleague, senator kyl from arizona, expressed his concern before the finance committee

2:39:59 to 2:40:19( Edit History Discussion )

John Cornyn: vote in these words, which i agree with: "unfortunately, governor sebelius's answers, made it clear that the administration is unwilling to support pro-pient?? safeards. she left me with no assurance that h.

2:40:20 to 2:40:41( Edit History Discussion )

John Cornyn: cares program or the federal coordinating council will not use comparative effectiveness research as a tool to deny care, and this should be of concern to all of us." instead of allowing the federal government to intrude further into personal decision making in medical cairks i believe that health care reform should enhance the individual

2:40:42 to 2:41:02( Edit History Discussion )

John Cornyn: relationships between doctors and their patients. and i'm concerned that using comparativeness effectiveness research to justify treatment denials based on cos will significantly limit patients' services for individual needs. it will also reduce" -- and this is very important -- "it will

2:41:03 to 2:41:25( Edit History Discussion )

John Cornyn: also reduce medical innovation and country." i would also point out, mr. president, that when asked, governor sebelius did not have any convincing answers to what i think is one of the most important questions in the health care debate, and that is how do we contain rising health care costs in this country, something that is going to

2:41:26 to 2:41:48( Edit History Discussion )

John Cornyn: render the medicare insolvent in this next decade? and as any employer will tell you, it makes it increasingly more difficult for employers to care to their employees. according to the congressional budget office, spending on health care will account for nearly 17% of the gross domestic

2:41:49 to 2:42:11( Edit History Discussion )

John Cornyn: product of the united states. in 2009, that will be as much as $2.6 trillion america spends more than twice what other industrialized nations spend per capita on health care. can we claim that our health care product is twice as good as anywhere else in the united states based on this increased spending?

2:42:12 to 2:42:32( Edit History Discussion )

John Cornyn: i doubt it, even though american health care is very good. but i don't thi that we get our money's worth by spending twice as much as other industrialized nation per capita on health care. health care insurance premiums have risen much faster than workers' wages in recent years, which means lower take-home pay

2:42:33 to 2:42:54( Edit History Discussion )

John Cornyn: for american workers. health care reforms must ensure that this trend is reversed or we will have failed, and i think one of the most important missions of health care reform. in the finance committee, i asked governor sebelius about her specific ideas, oi other than delaying treatment and denying care on how to contain costs.

2:42:55 to 2:43:15( Edit History Discussion )

John Cornyn: in my office i asked her, what about health care liability reform, which in my sta of texas has made health care much more accessible by moderating the growth of medical malpractice insurance premiums and providing a more level playing field when it comes to doctors and hospitals beingude. she basically did not have much of an answer for whether that

2:43:16 to 2:43:36( Edit History Discussion )

John Cornyn: should be included or not. i happen to believe it is one of the big cost drivers in health care costs and has to be addressed, and i would submit with a little modesty, that the state of this regard has been one that the feral government could learn from. while i don't doubt that some of the cost containment proposals

2:43:37 to 2:43:57( Edit History Discussion )

John Cornyn: in her answers -- governor sebelius's awers -- could be worthy of pursuing, governor sebelius failed to prove that they will provide substantial savings $2.4 trillion health care system. the congressional budget os office is also s the programs s

2:43:58 to 2:44:19( Edit History Discussion )

John Cornyn: result in any substantial savings. nally, and this should cause all of us to be concerned whether there will be cost containment or cost casks in health care reform, i'm puzzled by obama's budget actually asks for and, get t total price.

2:44:20 to 2:44:42( Edit History Discussion )

John Cornyn: that's for a down payment. well, i would sub mr. president, in your state and my state, the four peoplwho are accustomed to making a down payment for anything, they usually want to know what it is they're buying. the budget proposal by the president calls for $63 of additional spending as a down payment in order to control

2:44:43 to 2:45:03( Edit History Discussion )

John Cornyn: costs in the long run, which i think is based on nothing more than hope, and that is hardly a strategy. we know we're already facing an unprecedented level of debt, and unfortunately congress, under the new administration, has contributed greatly to the fact that we've seen mor 90 days than we have seen in

2:45:04 to 2:45:24( Edit History Discussion )

John Cornyn: iraq, afghanistan, and in hurricane katrina recovery. but we know that we have $36 trillion more in unfunded liabilities in medicare -- the medicare program alone. so at a time when we need to figure out how do we deal with the unfunded obligations of the

2:45:25 to 2:45:45( Edit History Discussion )

John Cornyn: federal government already, how do we more officiately spend the $17 billion of gross domestic product that makes us spend more than any other country per capita in the world, we're ignoring some of the huge unfunded liabilities of the federal government. and we're asked to take as a matter ofaith that these

2:45:46 to 2:46:07( Edit History Discussion )

John Cornyn: proposals will result in savings without any concrete plan, which can bagessized and the -- which can be analyzed and evaluated in the light of day. i believe this country is spending enough money on health care today. what we need are innovative ideas about how to spend it more wisely. and i've not heard any

2:46:08 to 2:46:29( Edit History Discussion )

John Cornyn: innovative ideas from governor sebelius or the current administration. what causes me even more concern, mr.resident, is governor sebelius has made it clear that she supports a new government-run -- quote -- "public plan" for health care that is unequivocally a gateway to a single-payer system.

2:46:30 to 2:46:50( Edit History Discussion )

John Cornyn: a new government-run public plan option will devastate private insurance markets by competitor, regulator, and funder. how in the world can the private market compete when the federal government comes in and sets prices which will cause employers to give up their employer-proded health insuranc

2:46:51 to 2:47:12( Edit History Discussion )

John Cornyn: their employees to get coverage under the public plan? and, indeed, the public pla-- much like medicare today -- be relied on to allow denial of treatment, rationing, in order to contain costs. the independent lewin group analysis found that a new public plan could mean that americans will lose their

2:47:13 to 2:47:34( Edit History Discussion )

John Cornyn: current health care coverage and 130 million americans could end up on a government-run health care plan. that's what i mean, a gateway through this which will run competion out, will undercut it and make it impossible to have the benefits of a compe

2:47:35 to 2:47:56( Edit History Discussion )

John Cornyn: we've seen on medicare part-d, the prescription drug coverage plan, which actually in an amazing feat actually has a high public satisfaction and came in under proposed cost. mainly through a market-based mechanism that creates a market for insurance companies that provide prescription drug coverage. that's the kind of model we should be looking at to learn

2:47:57 to 2:48:18( Edit History Discussion )

John Cornyn: from in order to contain costs, not by government delaying or denying access to health care under the guise of a -- quote -- "public plan." "the wall street journal" recently wrote, "because federal officials will not -- will run not only the new plan but also the market in which it competes with private programs, like playing both umpire and one of

2:48:19 to 2:48:39( Edit History Discussion )

John Cornyn: the teams on the field, they will crowd out private assume the health care monopoly." that's the "wall street journal." a public plan will also increase the cost of private health care. a report by the act wary m. lliman "the hidden tax that

2:48:40 to 2:49:01( Edit History Discussion )

John Cornyn: taxpayers pay to subsidize the cost of medicare and medicaid equals roughly $89 billion per year. this means that the average health care proam is 10.6% more annually per family than it would be without the cost-shift." a new so-called public play

2:49:02 to 2:49:24( Edit History Discussion )

John Cornyn: option, which is a government-run program, would exacerbate the cost shift and drive up the cost of private health care at a time when we are seeking -- when we must seek to lower health care costs. and then there's the "washington post" that wrote that -- quote -- "president

2:49:25 to 2:49:45( Edit History Discussion )

John Cornyn: obama's nominee for secretary of health and human services, kathleen sebelius, says she wants a public plan to 'challenge private insurers to compete on cost and quality' but recognizes the benefit of a playing field."

2:49:46 to 2:50:06( Edit History Discussion )

John Cornyn: "the washington post" said "we disagree. it is difficult to imagine a truly level playing field that would simultaneously produce benefits from a government-run system." mr. esident, i would ask unanimous consent that at the close of my remarks that this editorial from post" be made part of record. the presiding officer: without objection.

2:50:07 to 2:50:27( Edit History Discussion )

John Cornyn: mr. cornyn: mr. president, throughout the campaign last year, the president promised americans care like members of congress receive. the irony is that members of congress do not have access to a public as a matter of fact, we don't need one because there's private plans that provide the coverage that we receive. an i'm concerned sebelius is not up to the

2:50:28 to 2:50:48( Edit History Discussion )

John Cornyn: challenge of finding -- and this is final point -- more than $90 billion of waste, fraud, and abuse in the medicare and medicaid program each year. now, there's some who've said that what we need for all. well, right now medicare, as i indicated -- and medicaid -- have roughly $90 billion in

2:50:49 to 2:51:10( Edit History Discussion )

John Cornyn: fraud, abuse, and wea hope that's not what they mean, that we need to carry over that kind of fraud, abuse, and waste into a medicare or a single-payer system. according to an article in "the washington post" last year, than $60 billion was lost each year to medicare fraud alone. that's just medicare.

2:51:11 to 2:51:31( Edit History Discussion )

John Cornyn: $60 billion of money that could go medicare recipients that is lost to people who cheat and steal the federal taxpayer. medicaid services last year were estimated to be about $32.7 billion, similarly lost to

2:51:32 to 2:51:54( Edit History Discussion )

John Cornyn: fraud, waste, and abuse. medicare and medicaid fraud drive up the cost of health care and i believe represent an unacceptable mismanagement of taxpayer dollars. when about how she planned to fight fraud in her public program, she only gave the vaguest of answers to my questions. additionally, her record as

2:51:55 to 2:52:16( Edit History Discussion )

John Cornyn: governor tells me that she's not yet ready to tackle the kind of fraud, waste, and abuse a secretary of health and human services. the kansas state legislature is planning to have hearings on whether governor sebelius was involved in a decision to provide more than extraordinary medicaid funds to an organization linked to a

2:52:17 to 2:52:37( Edit History Discussion )

John Cornyn: number of her supporters. an article in the "kansas health institute" said that -- quote -- "regardless of the medicaid question, which isn't likely to be answered any time soon, many believe the medicaid director's decision was based on the political connections of those most closely involved." the article goes on to say,

2:52:38 to 2:52:59( Edit History Discussion )

John Cornyn: "som kansas officials are tk-blgt whether -- tk bt whether state oversight was strong enough. th debate focuses on the inspector general program created in 2007 within the kansas health policy authority to ferret out potential problems in medicaid. the first inspector general left in october.

2:53:00 to 2:53:21( Edit History Discussion )

John Cornyn: the scrutiny came after a legislative audit described $13 million in suspicious claims paid by medicaid in 2005 and 2006. before the authority took over the bulk of the program. in one case, auditors said the

2:53:22 to 2:53:42( Edit History Discussion )

John Cornyn: program paid a doctor $941 for a cesarean section when the patient was an eight-year-old boy. republicans and indeed us, i believe, want a new h.h.s. secretary to be someone committed to work with them to reform the health care system in a bipartisan process that will

2:53:43 to 2:54:03( Edit History Discussion )

John Cornyn: reach the best result for the american public. unfortunately, it is with a sense of foreboding, i read accounts that the democratic leadership wants to use the budget reconciliation process to jam a partisan health care reform bill through on an expedited basis without adequate

2:54:04 to 2:54:24( Edit History Discussion )

John Cornyn: debate or mr. president, i think that would be the worst of all possible outcomes. this is a serious that we need contribution to a workable health care reform. unfortunately, kathleen sebelius

2:54:25 to 2:54:45( Edit History Discussion )

John Cornyn: excluded representatives of people, the use of requisition that i mentioned. governor sebelius refused to say she would not support the use of reconciliation to pass health care reform. in h response to committee questions she wrote there are many tools available, and none of those tools, including reconciliation, should be taken off the table. i'm very concerned that using a

2:54:46 to 2:55:07( Edit History Discussion )

John Cornyn: partisan procedural trick to reform a system that comprises 17% of our gross domestic product is not in the best interest of the american people. the american people deserve an open and fulsome and honest debate about how to improve our health care system. not this kind of partisanship.

2:55:08 to 2:55:29( Edit History Discussion )

John Cornyn: and then finally -- and this is my final point -- governor sebelius failed to disclose relevant information to the finance committee during the consideration of her nomination. not only was there the matter of her tax returns -- something that unfortunately has become a trend, it seems like, in this she also failed to disclose

2:55:30 to 2:55:50( Edit History Discussion )

John Cornyn: contributions from a controversial abortion provider until pressed by the immediate kwrafplt the associated priss -- media. the ass the discrepancy became sebelius acknowledged getting additional money from tiller beyond the money she initially reported. while i appreciate her apology

2:55:51 to 2:56:15( Edit History Discussion )

John Cornyn: and her mention that it was only an inadvertent error, i'm concerned that a cabinet secretary should be held to a much higher and more standard. and so, mr. president, i am sad to say i will not be able to support governor nomination for secretary of