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Senator John Breaux

Opening Statement
Medicare Commission Meeting
March 6, 1998

I am very pleased to bring to order the first meeting of the National Bipartisan Commission on the Future of Medicare. I am honored to be chairing a group of such knowledgeable and well-respected people for the important task of making recommendations to preserve and improve the Medicare program. That doesn't mean looking at the program only in economic terms or only in terms of solvency. It also means looking at the fundamental question of what we want Medicare to do and the kind of health care system we want for our elderly citizens while addressing issues of quality, equity, and efficiency.

I was appointed chairman of this commission 7 weeks ago today and in that time I have worked closely with Congressman Bill Thomas on establishing an operational framework for the commission. I am pleased to be working with Congressman Thomas and I think that our working together testifies to the bipartisan nature of this commission. Let me say from the outset that I am firmly committed to having this group work together in a bipartisan, inclusive fashion. That is the only way we are going to have an end-product that enjoys widespread support in the Congress, in the Administration and across this nation.

I am also very pleased that one of the first orders of business was asking Bobby Jindal to serve as our Executive Director. He was an asset to Louisiana as Secretary of the Department of Health and Hospitals and I know he will be an asset to this Commission. Congressman Thomas will be introducing Bobby shortly.

I have said before that everything will be on the table. We shouldn't begin our work by excluding one option and endorsing another. Every member of this commission should know that his or her views are going to be considered.

The statute creating the commission requires 11 of 17 votes in order to issue a report so this is not going to be a report that is supported only by Democrats or Republicans. In fact, I don't think we will be truly successful unless we have agreement among an overwhelming majority of the commission. As President Clinton said to the commission members yesterday, if there is not a consensus--don't let it be your fault.

The process we are suggesting with input from all of you is designed to be inclusive and to build the consensus we need to be successful. The suggested task forces are designed to help gather information and develop a range of options for consideration by the full commission.

Congressman Thomas and I sent out a survey to the membership about how to structure this process, including the task forces, and many of the comments and suggestions we received are reflected in the documents you have in front of you. You should look at these documents as a conceptual outline of the Commission's goals throughout the year. As we have stated--the time line we have presented to you is designed to be a tool, not a work plan or a final product, to help focus the Commission's decision-making and to measure its progress. We may find that it is necessary to have more meetings as we go through the year. We may also expand or delete topics depending on the Commission's interest.

I don't think anyone would dispute that we have a very difficult task ahead of us. We have been charged by the Congress and the Administration with making recommendations on ways to preserve and improve the Medicare program. To do that, we must first come to an agreement on the scope of the problem facing Medicare.

There will be some disagreement on this issue as there probably will be on most issues presented to the Commission. But I am convinced that if we work together in a bipartisan way and lay all the facts and suggestions on the table, we can have a constructive debate on this issue.

We can't afford to let these issues be politicized any longer. There is just too much at stake for the health security of our senior citizens and the fiscal well-being of this country.

We must put aside the old ways of dealing with Medicare--do away with "Medagoguery"--do away with the blame game where everyone scrambles to pin the blame for failure on the other party--do away with the shortsighted SOS - same old, same old, approach that is woefully inadequate when you look at the demographic realities facing this program.

I believe that there is no greater challenge facing this country right now than how to preserve Medicare for future generations. While we added a few years to the life of the trust fund in last year's balanced budget agreement, we did nothing to prepare for the 77 million baby boomers who will depend upon Medicare for their health care beginning in 2010.

In the context of overall entitlement reform, how to go about fixing Medicare is very complex. Unlike Social Security, which promises specific levels of income, Medicare promises specific health benefits which are susceptible to volatile increases in medical inflation and the high cost of advances in medical technology. Part of the problem with getting a handle on the scope of the problem is the unpredictability in estimates regarding such elements as health spending and economic growth. But the demographic realities will not change.

We all know how politically sensitive the issue of Medicare is. That is why the Congress and the Administration created this commission--to make the tough recommendations for fixing the program and to make it easier for elected officials to take the tough political step of enacting these recommendations into law.

For most of the things we do in Congress, the most important objective is to craft legislation that can pass. There are some people who would rather stand for what they believe is the ideal solution and never compromise, even if that means that nothing gets done.

The primary objective of this Commission should be to come up with the best proposal possible and then worry about how we're going to get it passed by the Congress and signed into law by the President.

We have a huge challenge of trying to help educate the American people about the seriousness of the problems facing Medicare but we must realize that nothing is going to pass that doesn't enjoy their support. I am hopeful the Congress and the Administration will act on whatever recommendations this commission puts forward. We, as elected officials, have a responsibility to future generations to fix this program so that our children and grandchildren can enjoy the same guarantee of health insurance that their parents did. I don't want the report of this Commission to simply gather dust on a library shelf. Let me close by saying that I am optimistic. I know there are a lot of people "inside the Beltway" who think that this issue is too politically sensitive to inspire meaningful debate. They think it is unrealistic to think that such a diverse group of people representing such a wide range of opinion on this can reach a consensus. But I believe that this Commission faces a unique and critical opportunity that cannot be squandered. Medicare has been a success for 33 years and is a vital part of our national fabric. We have an obligation to ensure that the success of this program continues for the next 33 years and beyond. Our parents and grandparents have reaped the benefits of health security afforded by Medicare since 1965--our children and grandchildren deserve no less. If we make this a truly bipartisan process, hear from everyone who has a stake in preserving this program for future generations, and focus we will succeed.

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