dr. barrasso, have you treated people under medicare advantage? mr. barrasso: i have. the people of wyoming know there's an advantage to being in this program. that's why they sign up. that's why citizens all around the country have signed up for medicare advantage because they realize there's value in prevention. and there's value in coordinated cavecare. there is value in having eye care, dental care, hearing care. there is -- there are advantages to want to stay healthy, to keep down the cost of their care. mr. mccain: even though it may cost more, the fact that you have a weller and fitter group of senior citizens, you in the long run reduce health care costs because they take advantage of the kind of care that over time would keep them from going into the hospital earlier or having to see a doctor more often. mr. barrasso: that's one of the reasons that medicare advantage was brought forth.

dr. barrasso. mr. arrasso: well, it just seems to me as we are here on the senate floor discussing this issue, wide open, any american can come in here, listen to us, hidden behind closed doors is the other party maybe sharing what's in the secret negotiations, maybe not because it sounds like a number of their members don't know, but what i do know from practicing medicine for 25 years and taking care of families around the state of wyoming is that people depend upon medicare for their coverage. there are seniors who depend upon medicare and medicare advantage, and the reason they call it medicare advantage is because there are advantages to being in it. it coordinates care, it helps with preventative care, which isn't part of the routine, the regular medicare program. i just heard my colleague from arizona say that there are those who want to shut down medicare advantage, aarp, he said, because they are the ones to benefit and profit if, in fact, medicare advantage is lost to the seniors of this count

dr. barrasso for my domain. and i'm wondering if they were there with me for just a minute or two to reflect something the minority leader said. and the senator from arizona, the minority leader, the republican leader talked about a historic mistake. there's not a lot of talk around here about making history on health care. the problem is there's many different kinds of history as the republican leader has pointed out in seems our friends on the other side are absolutely determined to pursue a comic odyssey of political kamikaze mission towards a mistake which will be disastrous for them in the elections of 2010, but much more important that for the country. i did a little research on historic mistakes. we've made them before in the united states congress and maybe we'd be wise to take governor schwarzenegger's advice and slow down and stop and learn from our history, rather than try to top our previous historic mistakes like the smoot-hawley tariff. that sounded pretty good at the time in 1930 with the idea was

dr. barrasso outlined with the 1.6 million estimate of jobs lost by the nfib. and that may be old data because who knows what the data is now? we haven't had a chance to look at it, because in 30 hours after the bill's introduced and the cloture petition is filed, we're going to vote on it. not sure it's a great way to run the country. what's in the bill. there's zero guarantees that taxpayers won't finance abortion. there's zero prohibitions on the rationing of health care. zero. there's not one shred of evidence that we're not going to ultimately ration health care under this bill. we are. and the only reason you would vote against a rationing amendment is because you intend to see rationing carried out. there's zero senators required to enroll in either medicaid or a government-run option, either through o.p.m. or medicaid. there's now ten new taxes created. there's 71 new government programs created. there's 1,697 times that the secretary of h.h.s. is going to write the regulations. and based on c.r.s. sal claitionzs.calculations, there'n 15,000 and 20,000

dr. coburn from oklahoma, and doctor barrasso from wyoming. i wonder if they would bear with me for just a minute or two to reflect on something that the majority leader said and the -- what the minority leader said. the minority leader talked about a historic mistake. there's been a lot of talk around here about making history on health care. the problem is there's many different kinds of history as the republican leader -- leader has pointed out. it seems our friends on the other side are absolutely determined to pursue a political come cozkamakazee mission for td states. i did a little research on historic mistakes. we made them before in the united states congress and maybe we'd be wise to take governor schwarzenegger's advice and slow down and learn from our history rather than try to top our previous historic mistake, like

dr. barrasso, in your experience, how is this going to affect the quality of health care? mr. barrasso: i'm very grateful for the senator from texas bringing this up. i had a town hall meeting last night, a telephone town hall meeting. and this specific amendment you're bringing here today came up with great praise for the people of wyoming, from the people of wyoming who said she's doing it right, leading the good fight. after i answer your question, i'm going to ask you how do we know the money's going to be there? that's the question that came up in the telephone town hall meeting. people in wyoming are concerned if this passes it's going to make health care harder for people in rural states like wyoming, like our sister state to the north -- montana. my colleague from montana is on the floor. doctor shortage will worsen. this is a headline news, front page of the washington tribune eagle. doctor shortage will worsen if this passes. a lot of folks concerned, communities where there's a sole hospital, maybe a sole physician provider, trying to recruit nursing and physician as

dr. barrasso is here as well. i'm not sure how -- a lot of americans have heard of the congressional budget office. i'm not sure many have heard of the centers for medicare and medicaid services which is part of the department of health and human services. aren't they the people whose entire focus is not on the entire budget, as c.b.o. is, but just on medicare and medicaid so that they can make determinations as to the future and impact the various pieces of legislation on the specifically medicare and medicaid? is that a correct assessment? mr. alexander: the senator from arizona is exactly right. if i -- i believe i have my figures right. i believe mr. samuelson said in his column the other day that in 1980, the federal government was spending 10% of all our dollars on health care. today it's 25%. and this is the agency that's in charge of that massive federal expenditure every year. mr. mccain: i thank my friend, because the findings of -- as of december 10, 2009, which is entitled "estimated financial effects

dr. barrasso has seen this morning's "new york times". my other favorite source of news, information, and opinion. on the front page this morning, "home care patients worry over possible cuts." the purpose, i understand, of health care refor [captions copyright national cable satellite corp. 2009] [captioning performed by the national captioning institute] >> the story in the paper is very similar to many of the patients i've taken care of and the families in wyoming who depend on this. there is a picture of her meeting with her nurse. she greets the nurse who has come to check her medication that she takes. and she says that those visits that been highly effective in keeping her out of the hospital. i mean, that's the whole idea -- keep them out of the hospital so they can lower the cost of care. the home care she receives could be lowered under the legislation passed by the house and pending on the senate floor today. now, the legislation would reduce medicare spending on home health services, which is a lifeline for homebound medicare

dr. barrasso said about the kennedy family.i have a close relationship develop over the years with senator ted kennedy and rework together on a variety of issues. there is a great irony from a constant the references to senator kennedy who always began legislation by getting members of the other side of the i/o committed to working to gather whether immigration reform, health care reform, one of the great achievements of president bush, no child left behind. every dealing i ever had with senator kennedy was to reach out and this established a fundamental base for agreement then move forward in a bipartisan fashion which is one of the reasons he has such an impressive legislative record. how did the other side do it? without one bit of serious negotiation or without bringing anybody on board. no one. now you have a 68/40 vote a pure partisan vote and the outcome when there has never been in history a single reform that was not bipartisan. that is why the american people are rejecting this. that is why the american people see thr

dr. barrasso has actually seen medicare advantage patients, he and dr. coburn are probably the only two. and maybe we could give him the benefit -- give us the benefit of his experience and also not only benefit of his experience, but i'm sure he's going to tell us what's the impact going to be on these -- on the low-income seniors from his state. mr. barrasso: i agree with the senator from arizona that people choose to be on medicare advantage. 11 million people have chosen to be on medicare advantage because it's a wise choice to make, because they get better benefits. they get dental care. they get the vision care. they get the hearing. they get the fitness thing. mr. mccain: as we do. mr. barrasso: just as we do. it works on preventive care and coordinated care. mr. mccain: i don't think they have as nice a gymnasium as we're going to get. mr. barrasso: it's also no surprise that when people read about it and learn about it that they would want to be on medicare advantage. what the senator from utah has said and the sponsor of this amendment, the mon

dr. barrasso have you treated people under medicare advantage? >> i have people and wyoming know that there is an advantage to this program. that is why they sign up and citizens have signed up for medicare advantage because they realize there is value in prevention and coordinated care. there is value in having the eye care, dental, hearing care, dental, hearing, there are a advantages to want to stay healthy to keep down the cost. >> even though it may cost more, the fact they you have a more well and fit group of senior citizens, dot dot in the long line at reduce health care costs because they take a vantage of the kind of car that overt -- kind of care that over time will keep them from going to the hospital earlier or see the doctor more often? five that is the reason it was brought forth for i know a lot of senators from the rural states supported because it allows people in small communities to have the advantage to be in a program like battered doctors to go into those communities and the 11 million people who are on medicare advantage i

dr. barrasso, doctor, can you think of any other thing that we could do in reforming health care that could save $100 billion and not diminish the quality of care in america? is there anything else? and how do your fellow doctors feel about that? mr. barrasso: when i talk talk to other doctors, they practice defensive medicine. tests that don't necessarily help a patient get better, get well, but just in case they are covered in case something happens and they're named in a suit. it is not unusual, when you look at the numbers, we're talking about $100 billion a year in tests that are done that don't necessarily help swb get better but they're doing it because of the legal atmosphere in this country. but, you know, here we are on the senate floor on a sunday afternoon, the president is less than 100 yards away, former member of this body, he ought to be involving all senators. he's meeting behind closed doors, possibly cutting deals, trying to come to arrangements, twisting arms, asking people to march -- follow his marching orders, right off a cliff i think is going to be coming for health

dr. barrasso mentioned about the kennedy family. it's well known that i had a very close relationship developed over the years with senator ted kennedy, and that we worked together on a variety of issues, so there is a great irony in the constant over there on the other side of the aisle references to senator kennedy who always began legislation by getting bipartisan -- by getting members of the other side of the aisle committed and working together, whether it be on immigration reform, whether it be on health care reform, whether it be on -- one of the great achievements of president bush ii, no child left behind. in other words, every dealing that i ever had with senator kennedy was to reach out, establish a fundamental base for agreement, and then move forward with legislation in a bipartisan fashion, which i think is one of the major reasons why he had such an impressive legislative record. so how did the other side do it? without a bit of serious negotiation, without trying -- really bringing anybody on board before moving forw

dr. barrasso, has got it right. 40% of the doctors won't take medicaid. 50% of the specialists. how is this health care reform? i know my colleagues here have a lot of experience on this issue. i see my colleague from mississippi looks likes he has a great chart that looks like it will talk about increased medicaid spending. mr. wicker: yes, i appreciate so many of our colleagues being here today. i'm glad we're really getting into the medicaid aspects of this bill. there's sort of been a feeling around this bill in the last couple of -- building in the last couple of days that if we take care of the medicare buy-in and the government-run option, that this deal with be ok. i think today today we're bursting that myth and pointing out the huge unfunded mandate that the medicaid portion would put on almost all of the states. every state in red here would be required, under this bill, to increase their medicaid spending. only the -- vermont and massachusetts would not have to be mandated by us in washington to do this additional spending. and, of course, with the unfunded mandate,

dr. coburn from oklahoma, and doctor barrasso from wyoming. i wonder if they would bear with me for just a minute or two to reflect on something that the majority leader said and the -- what the minority leader said. the minority leader talked about a historic mistake. there's been a lot of talk around here about making history on health care. the problem is there's many different kinds of history as the republican leader -- leader has pointed out. it seems our friends on the other side are absolutely determined to pursue a political come cozkamakazee mission for td states. i did a little research on historic mistakes. we made them before in the united states congress and maybe we'd be wise to take governor schwarzenegger's advice and slow down and learn from our history rather than try to top our previous historic mistake, like the smoot-halley tariff when it sounded like a good idea to buy american. there was the alien incidition act, we were going to keep the foreigners in our midst, mostly french, from saying bad things about our governmen