WASHINGTON – Senator Chuck Grassley today asked for a full accounting of the standard ... Read More >>
MODERATOR: The following is an unrehearsed interview with Iowa Senator Chuck Grassley, speaking ... Read More >>
I sent a letter to the National Science Foundation's Inspector General requesting... Read More >>
GRASSLEY: Good morning, everybody. I want to talk about a
health care issue for rural America. Obviously, in rural America, we
have unique challenges when it comes to health care. Rural hospitals
are part of the backbone of the rural health care system, and rural
communities and, often, Medicare, doesn't recognize their unique
situation and vital role.
Hospitals in our rural communities not only are often sole
provides of health care, but they're also major employers in the area,
oftentimes. And these county hospitals are the biggest employer in
the county. These are jobs for spouses of farmers and second incomes
for farmers themselves.
When I became chairman of the Finance Committee way back in 2001,
I made it a priority to work to ensure quality, affordable, accessible
health care to rural residents. Since then, we've continued to build
on what I did in 2001. Late yesterday, I introduced legislation to
help improve and protect access to hospitals in rural America.
The bill improves payment formulas for rural doctors, improves
real ambulance payments, and continues support for rural hospitals.
The bill also works to protect access for rural residents and home
medical equipment and supplies to continue to lend support to critical
assets of hospitals, and I guess, lastly but probably not everything
that's in the bill, it would provide additional authority for
physician's assistants who provide valuable services, particularly,
extending it -- to extended care and to hospice services.
The policy changes in the bill go directly to these special
challenges that I often talk about facing health care in rural
America. The bill recognizes the high quality of health care
delivered by rural providers, embraces common-sense solutions, and
seeks equitable treatment for payment systems.
If I could quantify what a good job we do in rural America, I
don't know what Medicare costs. Let's say, $400 billion, maybe $500
billion? Let's say that if you take the United States from Wisconsin,
Lake Michigan, over to Idaho and from Kansas up to Canada, if you take
that part of the country, including Iowa, and they practice medicine
in the entire United States like we do in those states, we would
reduce health care costs for Medicare by one-third.
So you can see we do such a good job and efficiently that you can
understand why Medicare can be done in a better way and the practice
of medicine can be done in a better way if they follow the model that
we have.
Dan, Successful Farming?
Tom Rider?
QUESTION: Good morning, Senator.
Senator, I was wondering if you could talk about what crop
insurance changes that you're looking for for Iowa.
GRASSLEY: Well, what we're trying to do is not really changing
the law, it's getting people to consider what we have intended in the
law that we have and the extent to which preventive planning was not,
I think, done in a common-sense way -- very arbitrarily and hurt some
farmers in a very unusual year.
And Senator Harkin and I are trying to get rationale. And I
don't know whether, at this point, we're suggesting changes, but we
need to know why they arrived at it the way they did.
This is an opportunity for us just to review policies in light of
the flooding. And if we hadn't had the flooding, we probably wouldn't
be writing the letter we had.
Tom Steever?
Dan Skelton?
Tom Steever?
QUESTION: Yes. I see that Secretary Vilsack has put actively
engaged in farming -- but that issue back on the table again. What do
you expect to happen from that and how do you feel about that in the
first place?
GRASSLEY: Well, obviously, I'm very thankful to Governor Vilsack
doing that. And I think it gives us another opportunity to continue
dialogue, maybe not to get exactly what we want, but I think a
quantifiable measure of what being actively engaged in farming is.
And that quantifiable measure would be a very major victory for us.
But right now, you know, I wouldn't expect Governor Vilsack to
necessarily tell me right now what he wants to do. He needs time to
understand the issue. But a new -- a new administration and is a new
secretary of agriculture gives us a chance to maybe do better than we
did with the most recent rules that came out.
QUESTION: Thank you.
GRASSLEY: Dan Skelton?
QUESTION: Good morning, Senator. Two questions for you.
First, on your opening statement about rural health care, the
Obama administration wants to make a move toward electronic
recordkeeping. Do you support that?
GRASSLEY: The answer is I've supported it for a long period of
time. But let me tell you why we haven't done much in that area and
why, probably, it's a little more difficult to respond to for rural
America and that's directly related to the fact that we have a lot of
sole practitioners and they're probably a little older in rural
America. And it takes some investment and maybe people that are older
in rural America without quantity of people to serve, it's a
tremendous overhead.
So we have kind of restrained ourselves over a period of years
while still developing the concept of not forcing it on doctors. And
I wouldn't say that President Obama's going to force it on to doctors,
but through the stimulus package, we will have medical information
technology promoted through a $20 billion that would help incentivize
doctors to use it.
Now, we still have a problem beyond just getting the hardware out
there and getting people committed to using it. You've got several
different approaches. And we've got make sure that one system can
talk to the other system. And I'm not sure that that's finalized yet
because it wouldn't do Dr. Brown in New Hartford any good to have it
if Chuck Grassley went to Dr. Brown, but let's say I was wintering in
Florida and I go to Dr. Smith in Florida and I say, well, I got my
records with Dr. Brown, just get into your computer and find out what
he has prescribed for me. And Dr. Smith's system didn't talk to Dr.
Brown's.
So that's -- that's a major problem that we have to work on
without mandating a specific system.
QUESTION: On the ag front, back to Secretary Vilsack's press
conference yesterday. He talked about wanting to modernize the food
safety system. Do you see a change in the (inaudible) approach
coming?
GRASSLEY: Well, if he's going to look at it and he feels that
there's a problem, I would suggest there's going to be some changes.
But I haven't talked to him about it, so all I can say is that a new
secretary that has responsibility to make sure that the food I eat is
safe, I would expect him, if he thinks there's problems, to review.
And, you know, with salmonella and all, that sort of stuff, it's quite
obvious that things need to be looked at.
Go ahead.
QUESTION: (Inaudible).
GRASSLEY: Yes. Chris Clayton?
QUESTION: No questions today, Senator.
GRASSLEY: Gary in Arkansas?
QUESTION: Senator, tell us about wind energy and your amendments
for the economic stimulus package. Can you make the credit permanent?
GRASSLEY: Well, I might have a difficult time making it
permanent. I think we've got a fair chance of making it longer than
what they have in the bill. All of those things are very necessary,
but, you know, we're also trying to deal with the fact that there
doesn't seem to be a lot of capital available even with the credit.
So the industry is slowly shutting down, and solar is probably
shutting down faster than wind. And so we've got to have some way of
getting it. So we're talking about some grants or the federal
government purchasing credits through a bank that we would set up.
Because even if we extended it and made it permanent, it wouldn't be
-- it wouldn't revitalize the industry, which is down now because of
the recession we're in or maybe not because of the recession, but
because of a recession caused by the credit crunch. So the credit
crunch is the problem.
QUESTION: OK. Thanks.
GRASSLEY: Philip, Des Moines Register?
QUESTION: Yes, Senator. Boy, I'd like to find out a little more
about your -- follow up on that idea.
I also wanted to ask you another question about the stimulus.
With the increase in food stamp that in this bill, what's going to
happen to that after that increase? Is that increase going to
essentially be a permanent level for the program? And if so, where is
that money going to come from after the post-stimulus?
GRASSLEY: Well, all I can tell you is what I feel.
QUESTION: Uh-huh.
GRASSLEY: And what I suspect. First of all, let's get back to a
purpose of a stimulus. Spend money in the next two years in a massive
amount to get money to revitalize the economy. So money for food
stamps would be a good way of doing that.
But I'm urging my Republican caucus -- and I made this remark at
a couple of meetings yesterday -- that we've got to make sure that we
get something in the bill that these things aren't going to be in
baseline.
So to answer your question, I'm fearful it could get into the
baseline. It would up the level of expenditures for food stamps. And
I'm not saying that that's wrong per se, but it's wrong to do it
through a stimulus package. That should be done through the annual
appropriation bill.
And you will find other senators like Cochran making that point
not so much on food stamps but on a lot of other programs where
there's a suspicion that it gets into the baseline and becomes a
higher level of expenditure. And it's -- we're not going argue should
there be more money spent on these programs for the next ten years; it
just shouldn't be done through the instigation and the lack of
consideration that the stimulus is getting.
And when I say "lack of consideration," it's not getting the
consideration that it ought to because we've got to get something
passed quickly or there's not much point in passing it. So those
things ought to be well thought out in committees of jurisdiction, not
through a stimulus package.
QUESTION: Aside from it being in the baseline, regardless of
whether it's putting it in the baseline or not, how would you
politically reduce spending on food stamps? Isn't that politically
going to be...
GRASSLEY: Yes. Yes. And that's...
QUESTION: And isn't that money going to have to come from post-
stimulus -- come from some other programs?
GRASSLEY: Of course, it's going to have to or else -- there's
two places for money. One is borrow, and so you increase the debt or
you increase taxes. Or you can -- I guess, like you said, you can
take it from some other program.
Now, you're going to have to do one of those three things or all
of those three things. And that's what shouldn't happen because of a
stimulus bill. And maybe should happen if there's a need to do it
through the regular process.
OK. I've gone through the entire list. Anybody want to jump in?
QUESTION: Senator, can I follow up on the idea that you talked
about with the federal government purchasing credits on the wind --
back on the wind energy. You talked about dealing with the investment
-- lack of investment in wind right now.
GRASSLEY: Well, it's -- let me tell you what normally would
happen if we didn't have a credit crunch. These companies get these
credits. They go to a bank, borrow money on these credits, and
somebody that's paying taxes gets the benefit of those credits. So,
in a sense, they're selling credit and passing on credit to somebody
else to raise money to do the construction that they have to do.
Well, the credit is frozen up. So what do you do?
So the federal government is going to set up a bank to do what
the private banks aren't doing for a short period of time of to get it
back on track, to maintain the jobs that are going to be lost. Like,
for instance, you know in Cedar Rapids, that component of
manufacturing there -- I forget the name of it.
But, anyway, they just laid off, I think, 90 employees, as an
example. And I said it was worse in solar than it is in wind at this
point as well.
OK. Anybody else want to jump in? OK. Thank you all very much.