Senate Proceeding on Dec 5th, 2009 :: 1:48:00 to 1:57:10
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1:47:56 to 1:48:16( Edit History Discussion )

Max Baucus: the vote is forced. and the american people are o the presiding officer: the senator's time has expired. the senator from monta it's very frustrating becse we have the senators lined up and they control the

1:48:00 to 1:57:10( Edit History Discussion )
Speech By: Max Baucus

1:48:17 to 1:48:37( Edit History Discussion )

Max Baucus: their points, and then they flee the senate floor we cannot get into a colloquy and we cannot make points that rebut the points they make because they've all left t floor. cork coirnlg a glad to stay here. the presiding officer: the senator montana has the floor. mr. corker: well, i can get them all back. senator: we a

1:48:38 to 1:48:58( Edit History Discussion )

Max Baucus: mr. baucus: glad, i'm glad he stayed because i want him to hear this. both of us might learn something by being here. first of all, clearly care about home health care. i mean, let's -- you know, let's obviously agree, we all do. i see the senator from arizona nodding his head in agreement. he does care care.

1:48:59 to 1:49:21( Edit History Discussion )

Max Baucus: this senator cares about home health care. the senator from wyoming, senator barrasso, a doctor -- there he is over here -- he cares about home health care. he's talked about home health care. we all care about home health care. we all know rather be home than in the hospital or nursing that's medically appropriate. i know that personally.

1:49:22 to 1:49:43( Edit History Discussion )

Max Baucus: my motion tother was in the hospital a week -- two weeks ago now, praise lord, is i out of the hospital. we have a person that comes home to s my mom. when i'm there with the home health care person many very impressed. they do a super, superjob. it is really something to go home.

1:49:44 to 1:50:04( Edit History Discussion )

Max Baucus: my mother loves it and i love it and we're clearly not going to do anything to cut home health care. but another point, though, i would assume all my colleagues agree with, that we want to cut waste, if there is waste. we want to cut waste out of the health care system.

1:50:05 to 1:50:26( Edit History Discussion )

Max Baucus: why should we allow, as representatives of our people, the taxpayers, allow waste? we want to cut out i see the senator from arizona nodding his head yes, that it's -- clearly we want to cut out waste that may or may not occur in the system. now the is a queion -- and there are lots of forms of waste.

1:50:27 to 1:50:47( Edit History Discussion )

Max Baucus: there's -- the peoe -- one is fraud. people j off and ripping seniors off. that's clear. just a lot of waste there. and let me just take one small example in the home provision that's in the senate bill. and that's this: the general accountability

1:50:48 to 1:51:08( Edit History Discussion )

Max Baucus: office found that in the home health industry there are a lot of outlier expenditures which are fraudulent. th agencies classify their expenditures for home health as outliers, as extra payments, for very, very sick people.

1:51:09 to 1:51:30( Edit History Discussion )

Max Baucus: there's one county in florida which counts for 60% of all outlier they provide health care for only 1% of the nation's people. and g.a.o. has done lots of examples where the outlier portion of home health is abused. it's fraud. it's abused.

1:51:31 to 1:51:51( Edit History Discussion )

Max Baucus: well, guess what? the home health care industry came to us and got some ideas how to stop this, because we -- gee, we've got some ideas how to because we apples spoiling our brel. we want to stop this fraud that exists with excessive outlier payments. so they came to us with some ideas.

1:51:52 to 1:52:13( Edit History Discussion )

Max Baucus: i know it's easy to think their suggestions might be classified as deals or what not. but that's not happened here. they came here with an idea how to cut excessive costs from outliers. that's in this bil there are a lot of other provisions with respect to home health care. i know the senato senators have letters from their home states. i don't know if they're

1:52:14 to 1:52:35( Edit History Discussion )

Max Baucus: referring to a home health care bill which is very aggressive or whether they've read the most recent language in the senate bill which essentially is much, much less aggressive, talking to the agencies and they say, yes, we can live with these changes like rebasing and market basket updates.

1:52:36 to 1:52:57( Edit History Discussion )

Max Baucus: phasing them in instead of immediately. again, the idea of getting rid of excessive payments and fraudulent payments. i say "excessive" because the home health care industry is joined by 11% growth rate annually as it is rig and -- in dollars.

1:52:58 to 1:53:20( Edit History Discussion )

Max Baucus: dollars relative to -- well, some think it is 17%. the chart i have says 11%. it may be on spending rate in the country for all care goes up year, about nationwide. home h between 11% and 17%.

1:53:21 to 1:53:42( Edit History Discussion )

Max Baucus: you know, that's almost double. under this legislation, spending will be about 8%. remember, national health spend something 6% and the home health industry did write a letter saying, yeah, we can live with that. my approach on legislation is to

1:53:43 to 1:54:03( Edit History Discussion )

Max Baucus: work with groups, work with industries, talk to them, don't just be draconian, don't be arbitrary talk to them. see what accommodations you can make consistent principles. one of my principles is getting -- stopping a lot of the fraud. it's to see if there's a way to

1:54:04 to 1:54:27( Edit History Discussion )

Max Baucus: cut excessive spending because sometimes there is excessive spending around here and that's what we've done in the home health industry. i can go into greater detail. but i would like my colleagues to know there is a real sound reason for these changes in home he judgment - the home health care industry that this will not hurt home

1:54:28 to 1:54:48( Edit History Discussion )

Max Baucus: a very important points to here. and the same is with the other industries, with, say, the hospital industry. they -- we worked with them. okay, we know we should be cut. i talked to a lot of hospital streashts and said, what do you think? th cut.

1:54:49 to 1:55:09( Edit History Discussion )

Max Baucus: our hospitals should be cut. you sometimes go to the and you see, good gosh, why do they have that big mountain out front in this is like a taj mahal. you know, you don't need all that for health care. then they crank this become in their need for their

1:55:10 to 1:55:30( Edit History Discussion )

Max Baucus: so some hospitals say, the executives should be some reductions in hospital payments. so we go to the hospitals a ask what's reasonable. rerks it's owe a ten-year period. they say we can take $155 billion cut but they say that in part because they know that they might lose on the margin, they can make up

1:55:31 to 1:55:52( Edit History Discussion )

Max Baucus: because everybody has health insurance. that means too, we can get health reform. it is hard to get the health industry to work with us if there's not health insurance for most americans. if there's not health insurance for most americans, then the health insurance industry is inclined to revert back to their old ways of underwriting

1:55:53 to 1:56:14( Edit History Discussion )

Max Baucus: insurance, based on preexisting conditions, et cetera. so these points -- the whole effort here is to work with groups work with consumer groups, with labor, with hospital, with doctors, insurance industry, pharmaceuticals, talk to them to that's democracy to try to get

1:56:15 to 1:56:37( Edit History Discussion )

Max Baucus: some kind of broad-based, kind of rough justice agreement to put this together. and i just -- that's the effort we'v legislation. now, i hear criticism, well, gee, we're cutting this and cutting that. but let's rember -- i know nigh colleagues agree with this -- the waste in the american system, health care system, is

1:56:38 to 1:57:00( Edit History Discussion )

Max Baucus: somewhere between $300 billion a year to -- the upper estimate is $8 billion. it is waste. we've got -- the upper estimate is $800 billion. we've got to ge without sacrificing care and at the same time improving the quality of care. that's what the major goal here is. so when you see reductions in some of the payments to

1:57:01 to 1:57:10( Edit History Discussion )

Max Baucus: providers, a lost that is an honest attempt to get rid of the waste or excessive let's take medicare advantage.