On the recordMarch 31, 2014
before he yields the floor, through the Chair, I would pose a question to the distinguished Senator from Virginia. The Senator from Virginia has, as usual, gotten right to the heart of the long-term challenge with respect to entitlements. I have always tried to describe it as the challenge of protecting the Medicare guarantee because what seniors have is a guarantee. It is not something that is up for grabs. It is a guarantee. It is inviolate. Protecting their guarantee means that in the days ahead we are going to have to figure out new ways to hold down costs. What I have heard the Senator from Virginia talk about very eloquently is one of the key ways to do that is what the Senator from Virginia and I have sought to do, which is to start having Medicare-- start having Medicare pay for value rather than just staying with this volume-driven fee-for-service system, which largely rewards inefficiency. I think it is my sense that the Senator from Virginia believes it is very hard to start the kind of real entitlement reform we need, where we protect the Medicare guarantee and hold down costs, unless we make the kind of approach we are advocating in this repeal- and-replace strategy with SGR.…





