April 24, 1978
Page 11155
Mr. BELLMON. Will the Senator yield?
Mr. HARRY F. BYRD, JR. I yield.
Mr. BELLMON. First, Mr. President, let me say that the savings which are anticipated are largely in the entitlement programs. The medicaid program has waste estimated to be $2.3 to $2.6
about $2.2.billion AFDC $269 million, SSI $334 million, and social services $88 million.
Those, Mr. President, are all entitlement programs and they are all under the jurisdiction of the Finance Committee.
In past years the Senate Budget Committee has had the audacity, I suppose is as good a word as any, to suggest to the Finance Committee that they might make some savings in certain programs for which they have oversight responsibility. When we have done that, we have incurred the wrath of the Finance Committee. In no case have they agreed that they can make the savings and in no case have the savings actually resulted.
I think all we are saying here is the fact that the Inspector General is agreeing with the Budget Committee, and that the Finance Committee ought to take action to tighten down the way these programs are run and to eliminate some of the fraud, mismanagement, and abuse that the Senator from Virginia has very properly pointed out.
This year when we received the May 15 letter from the chairman of the Finance Committee, Senator Russell LONG, he includes on page 6 — and I believe the Senator from Virginia has a copy of this — a statement that says:
At the same time, the committee notes that the administration budget proposes a savings of $.7 billion in Medicare and Medicaid through its hospital cost containment proposal. The committee believes it would be unrealistic to base a congressional budget estimate on the expectation that this proposal will be enacted.
In effect, the chairman of the Finance Committee is saying to the Budget Committee, "Do not expect any significant savings in the medicare-medicaid program."
While I agree with the objective of the Senator from Virginia, I believe realistically we could not possibly expect the Finance Committee to come anywhere close to obtaining a $5.6 billion savings by cleaning up the programs it has under its jurisdiction in 1 year.
The budget resolution does assume a $700 million savings in medicare and medicaid over what the Finance Committee has recommended. They have recommended $300 million in quality control savings. We assume that, and then we go on and assume another $700 million savings in addition.
I believe the Budget Committee has been responsive to what we believe are realistic possibilities in the programs to which the Senator from Virginia has called our attention.
Mr. HARRY F. BYRD, JR. I thank the Senator. That does not in any way get to the fact that HEW has been granted more money than it has been able to properly spend. It does not get around the fact that HEW misspent between $6.3 and $7.4 billion. I think this budget resolution should take that into consideration and that the figures for functions 500, 550, and 600 should be reduced to reflect at least two-thirds of the amount which has been misspent. It does not reflect the total amount of funds misspent. It does not reflect the total at all. It does reflect about two-thirds of the amount which has been misspent. I think that is reasonable. As a matter of fact, I think it would be unreasonable for the Senate to approve a budget resolution which did not take into consideration the Inspector General's report showing just how great is the amount of funds being misspent by that Department of Government.
Mr. MUSKIE. Mr. President, I have just a couple of observations, adding to what my good friend from Oklahoma has already said.
In the first place, I am sure all of us are outraged by any evidence we ever get of fraud, waste, and abuse in Government programs. I do not think the report to which the Senator from Virginia refers is accurately characterized when he describes it only as evidence that HEW has misspent public funds. The fraud, waste, and abuse described in the report goes much further than that. It goes into the health delivery services in this country in the private sector.
It goes to the standards of individual citizens, whether they are students receiving education loans or other people eligible in one way or another under entitlement programs. This is not evidence only of Government abuse; it is evidence of citizen abuse:
If I may read from page 74 of the report, just to give something of the flavor of what this report undertakes to describe for us all:
"It includes moneys paid to ineligibles."
Well, who are ineligibles? They are senior citizens, other citizens, students. Those are the people who are eligible under entitlement programs, and there are others. If ineligibles are getting money or have received money under these programs, how do we, in the Budget Committee, get that money back in order to reduce the Government's total needs for this purpose? Education programs, for example, are forward funded. To the extent that these abuses took place in the student loan program last year, for example, that money has already been paid out. How does the Budget Committee, may I ask the Senator from Virginia, get that money back in order to reduce the Department's needs for funds in fiscal 1979?
If there have been overcharges by those who deliver health services, those overcharges have been paid and are disclosed by post-audit procedures. How do we get the money back?
I am sure the Senator, as a member of the Committee on Finance, is more of an expert on those kinds of procedures than we on the Budget Committee, because it is the Committee on Finance which oversees some of these entitlement programs and which has the responsibility for trying to find ways to eliminate fraud, waste, and abuse. We rely upon the Committee on Finance to tell us how and to what extent savings can be realized that we can reflect in our budget recommendations.
I remember 1 year, 2 years ago, our recommendation in that respect was challenged on the floor by the chairman of the Committee on Finance, who said we were expecting miracles of him that the Finance Committee could not produce. Yet Senator BYRD, as one member of the Committee on Finance, expects the Budget Committee, somehow, to produce that miracle and to find a way to realize $5.6 billion in waste so that we can reduce the requirements for next year
I know of no way to get those savings except by putting the pressure on the Finance Committee. The Senator from Oklahoma has already stated that we followed the recommendations of the Finance Committee with respect to the savings that can be realized in quality control and other savings. If the Senator from Virginia can assure us that the Finance Committee will find a way to recover this $5.6 billion so that we can apply it to the program needs for 1979, I should be delighted to accept his amendment and count on those returns, but I do not know of any such way.
The mere fact that these abuses have taken place, to me, suggests that we have a management problem here; maybe also a policy problem. Maybe there is a way of putting together legislative policy to improve the management of these things so that students will not lie about their eligibility — if they do lie; I do not know. Or that they will repay their loans if they do not repay them, and I guess they do not always repay them; or that doctors will not overcharge, or that ineligibles will not apply for benefits.
If there is a magic answer that would eliminate these human weaknesses that are represented in so much of this report, I should be glad to know what it is and I should be glad then to take advantage of it and thence to reduce the budget. But to suggest that the Budget Committee, because this report exists, is at fault for somehow not converting that report into actual dollar savings on the order of $5.6 billion that we can use to fund the program for fiscal year 1979, I think, is going beyond the bounds of reason. I do not think there is any reason for us to do it. I do not think there is any way we can be expected to do that.
The Senator assures the eligibles that they would not be hurt, that his amendment would not hurt them at all; that it would not hurt the senior citizens benefits under social security; that it would not hurt the beneficiaries under the student loan program; that it would not hurt medicare beneficiaries. Why would it not? If there are $5.6 billion missing from these functions that is needed to fund social security or to fund medicare where is it going to come from if we cut it out now? I should like to know the answer to that question. Either entitlement benefits are going to have to be denied contrary to law or programs like health research, that are not entitlement programs and which are a small part of the total, would have to be eliminated altogether. In other words, programs financed by straight appropriations that are under the jurisdiction of this Department would have to be decimated in order to absorb the $5.6 billion if we do not want to cut the benefits of those entitled to benefits under the entitlement laws.
You cannot have it both ways. The Budget Committee does not have a special bank account labeled "fraud, waste, and abuse" out of which we can draw checks to pay for these benefits.
We ought to welcome this report for what it does point out to us. This is a red flag. This tells us where there are abuses. This is a challenge to the Finance Committee. This is a challenge to other committees of Congress to find out where those abuses exist and to do everything possible, legislatively and administratively, in a management way, to eliminate it.
Even then there is going to be an irreducible minimum. I tell you, average human beings have ways of getting around laws and administrative procedures and practices that the genius of legislators cannot confound. And there is an irreducible minimum in that errors are going to happen in any case. That amounts to a few million dollars of this $5.6 billion.
I say to my good friend from Virginia that I applaud his bringing this important matter to the attention of the Senate. I certainly do not object to his offering his amendment, because I think maybe, in that way, he drives these points home to our colleagues in the Senate that this problem does exist and maybe we can meet the challenging of meeting it. But I do not think we can meet it by arbitrarily reducing funds necessary in this function to meet legitimate needs of people that our laws say are entitled to social security benefits, medicare benefits, education benefits, and so on.
Why should we punish the innocent, those who have not abused the law, in an ill-conceived attempt to get at those who have abused it? I am for getting at the abuses, but let us work through the committees that have jurisdiction to find out who they are, where they are, how they can be blocked and frustrated; what new law we need to do it and how, administratively, we can do it effectively. If we can do all that, we will have met a tough challenge. But I do not think we can do it by just cutting down the top number on the income security function and the health function and the education function in this budget resolution. It just is not going to work. If the Senate does it that way, we know we are bound to hurt some people that this Congress intends to help.
Mr. HARRY F. BYRD; JR. Mr. President, the fact is that the Department of Health, Education, and Welfare spent approximately $7 billion, or misspent approximately $7 billion through mismanagement and waste. Taking that into consideration and in reducing the budget recommendation by $5.6 billion, which is two-thirds of the amount which the Inspector General said was misspent, does not take away from those functions and from those individuals who, by law, are entitled to the appropriation.
What it does say is that HEW has been getting too much money. It cannot appropriately spend that amount of money and, as a result, has been misspending it.
Unless an amendment along those lines is approved by the Congress, HEW will continue to get such huge amounts of funds that additional large amounts will be again misspent through waste, mismanagement, and fraud.
I was at a meeting with a group of 500 or 600 citizens not long ago — just a few days ago, as a matter of fact. This subject came up and one of the citizens addressed this question to me. He said: "Can't the Congress do anything about the misspending of public funds?"
Maybe my reply was wrong, but I said,"Yes, the Congress can, if the Congress will."
I realize it is difficult to try to get Government spending under control. I understand that eliminating waste in the Executive Department is not easy. But if we are going to take the view that it is impossible, then we are condemning taxpayers to go on forever paying billions of dollars year after year in funds that will be misspent.
I realize that I have a minority view in regard to Government finance. I realize that I am in a minority position in the Congress of the United States when I say that the American tax funds are not being used as a public trust. They are not being handled as a public trust.
I realize I am in a minority position when I take the view that we are appropriating to the departments of Government too much money, such vast sums that they cannot be appropriately spent.
I must say that even though I have held that view for a while, even I was shocked by the Inspector General's report. I could not conceive of such gigantic figures, such huge amounts of tax funds, being misspent through waste, mismanagement, and fraud.
Now, they can take the view in the Congress, "Well, that's too complicated. It's very difficult. I don't know how we are going to get hold and get Government spending under control. We just have to coast along."
That is an approach this Congress has taken for many years now. I suspect it will go on for a while yet, although as this inflation increases — and it is going to increase — as this inflation increases the working people of this country one of these days will rise up and demand that something be done.
There is an interesting Gallup poll which was published this morning. The results of the poll taken by the Gallup organization showed that by a ratio of 9 to 1 — 9 to 1 — the American people would prefer that the Government get inflation under control rather than to give a reduction in taxes.
To me, that is quite significant. I would think most American citizens would like to have and would want a reduction in taxes, and I think they do. But the individual citizen and the working people of this country can understand that in order to get a tax reduction that means anything, in order to get a tax reduction without stimulating inflation, it is necessary to get Government spending under control.
This amendment is just one effort to do that. This amendment is addressed to areas of the budget which, through investigation by the Inspector General of the Department itself, presents evidence that between $6.3 billion and $7.4 billion appropriated by the Congress has been misspent.
There is no way, of course, that anyone can force the Congress to take steps to attempt to get such misspending of funds under control. But I felt it was worth the effort to present the amendment.
I would have no hesitancy at all in being the only Senator on the floor to vote for it. I would be glad, as a matter of fact, to be in that position, in a way. The only reason I would not be glad to be in that position is because I would like to see it passed.
This Congress cannot go on month after month, year after year, spending more and more money, running more and more deficits, without all of that being paid for.
Many of my colleagues say, "Don't worry about the deficit, just add it to the debt. No one has to pay the debt. Just add it to the debt."
The American people, I am convinced, do not believe that. The American people, I am convinced, realize that this huge Government spending, including the waste, must be paid for either by direct taxation or by the most vicious tax of all — inflation, and that is the way it is being paid for now.
That is the way the fiscal 1978 budget deficit is being paid for. That is the way the 1977 budget deficit was paid for; the 1976 budget deficit; the 1975 budget deficit. And that is the way the 1979 budget deficit will be paid for, through the cruel and hidden tax of inflation.
Mr. President, I ask for the yeas and nays on the amendment.
The PRESIDING OFFICER. Is there a sufficient second? There is a sufficient second.
The yeas and nays were ordered.
Mr. MUSKIE. Mr. President, I assure my good friend the Senator from Virginia that I am as concerned about eliminating fraud, waste, and abuse in Government programs as he is, and I am sure of his commitment. I doubt that any Member of this body would not join us in that concern.
Second, I say to my good friend from Virginia that my response to his amendment by no means constitutes running away from the problem, because I think it is too hard to handle. If that were my test, I would have rejected this Budget Committee responsibility 4 years ago. But if one really wants to get at problems of this kind, one must find a way to do it.
On page 169 and following pages of this report, to which the Senator has referred, there is a list of the kind of abuses that were referred to U.S. attorneys in calendar year 1977. I am going to refer to a few of them, so that one might have an appreciation of the difficulty of converting this report into cash that can be cut from a budget resolution.
These are some of the cases, and I read them off briefly:
One, billing for services not rendered. This presumably was a health professional who billed for services not rendered.
Two, billing for services not rendered.
Three, bribery and kickbacks to providers.
Four, billing for services not rendered.
Five, billing for services not rendered.
Six, excessive payments.
Seven, billing for services not rendered.
Eighth, billing for services not rendered.
Nine, falsifying records recertification for participation in medicare program.
Ten, falsifying medicare recipient claims.
Eleven, falsifying records documents.
Twelve, bribery.
And so on, page after page of this kind of abuse.
These are all criminal abuses which subject the perpetrators to prosecution under the criminal laws of this country.
How does HEW convert these lists of cases in the Federal district courts into cash to pay medicare benefits or social security benefits or to make student loans?
If one wants another description of the kind of abuses to which the Senator's amendment is addressed, I refer him to page 86 of the document, and I read:
We identified four cost centers related to hospital inpatient services where we believe $2 billion in Federal funds may have been lost due to fraud, waste and abuse.
That is $2 billion of the Senator's $5.6 billion, and there are just four items.
What is the first one? Excessive hospital beds, $1.130 billion. These are hospital beds scattered throughout the country in communities which, I suspect, resist and resent any effort on the part of HEW or even State medical authorities to cut back on those beds. Beds in a hospital are considered surplus when the annual occupancy rate falls below 80 percent.
What does the Senator propose — that we give HEW the authority to arbitrarily eliminate hospital beds in any part of the country where that test is not met? That is what needs to be done in order to save that $1.1 billion. How does the Senator's amendment equip us to do that? That is a responsibility for the legislative committee. That is part of the $2 billion.
Second, unnecessary surgery, $655 million. I read from the report:
The Subcommittee on Oversight and Investigations of the House Committee on Interstate and Foreign Commerce performed an in-depth examination into the area of unnecessary surgery and concluded, in a report dated January 1976, that an estimated 17 percent of all procedures funded by Medicare and Medicaid during fiscal year 1974 were unnecessary.
Making the same assumptions as above — namely that 17 percent of the procedures are unnecessary — and applying this same percentage to FY 1977 costs, we estimate $468 million of Medicare funds and $187 million of Medicaid funds were spent on unnecessary surgery that year.
How does HEW go about eliminating unnecessary surgery? You would have to find a way to do it and do it quickly, before fiscal year 1979, in order to achieve the savings the amendment of the Senator from Virginia would ask us to achieve.
The third category: Unnecessary hospital stays. Without reading that at length, doctors are ordering unnecessary hospital stays. How does HEW get an instant answer to that problem in order to satisfy the Senator from Virginia?
Fourth, excessive physicians' cost:
A study funded by HCFA, shows that physicians on a percentage system of reimbursement make more money than salaried doctors doing the same type of work.
The message in these statistics is that consumers and taxpayers are being over-charged by as much as $215 million a year because doctors are making exorbitant profits from percentage contracts with hospitals.
What, then, should we do — prohibit doctors by law from entering into percentage contracts with hospitals? If you do not have some such change in the laws, how are you going to eliminate that fraud, abuse, and so on?
I say to the Senator from Virginia that, as I look over this report — and my curiosity has been stimulated by his amendment — I find that the achievement of his objective is not a simple matter of changing a number in a budget resolution but is a task of hard, nitty-gritty work for appropriate committees of the Senate and the House, and hard, nitty-gritty administration, and then some changes in policy by States as well as by the Federal Government.
If the Senator thinks he can achieve all that by an amendment on the Senate floor this afternoon, I think he is being over-simplistic, and he certainly is not going to be effective in achieving what he wants to achieve — with all respect.
(Mr. SARBANES assumed the chair.)
Mr. MOYNIHAN. Mr. President, will the Senator yield?
Mr. MUSKIE. I yield.
Mr. MOYNIHAN. Mr. President, as a member of the Finance Committee, I state that I am ultimately persuaded by the careful argument which the Senator from Maine has made about the difficulty of applying the concerns of the Senator from Virginia to the budget resolution.
As a member of that committee and as one who holds him in the highest regard I wholly share his indignation and his concern. I do think this is a responsibility which we must carry forward in the Finance Committee, as the Senator from Maine has said.
To the degree that the Senator from Virginia takes the lead in this enterprise, I hope he will consider me as one who will follow him, and I will feel honored to do so.
There is a question of the integrity of the public purposes with respect to these laws, and those who do not care about that integrity do not care about these issues, either.
I thank the Senator.
Mr. MUSKIE. I thank the Senator from New York.
Mr. BELLMON. Mr. President, , the HEW inspector general's report, which has been referred to, points out that the loss in the AFDC program is $669 million. This consists largely of overpayments and payments to ineligibles, and it is certainly a loss that should get our attention and the attention of the appropriate committees, and the program should be tightened down to eliminate it.
But I point out that since 1973 when the AFDC quality control program was started by the previous administration the dollar losses from overpayments and payments to ineligibles have dropped from 16.5 percent down to about 8.5 percent. So there is an ongoing effort being made to reduce the waste and the overpayments under the AFDC program.
Congress, on the recommendation of the Finance Committee, has endorsed a goal of 4 percent dollar loss. So we are trying to get from 16½ percent down to 4. We are already more than halfway there. It is unlikely that we will ever be able to get the error rates down to zero, and that is what the Inspector General's report would assume, and it is a totally unrealistic assumption.
The budget resolution assumes that there will be continued improvement in. program management, and we hope that the Finance Committee will take the lead insuring faster progress in trying to eliminate the overpayments that still exist in this program.
I wish to make it clear, Mr. President, that I am not at all opposed to the objective of Senator BYRD'S resolution. The only problem is that it is really the responsibility of the oversight committees to move in that direction and, as I have said before, when we tried to assume they would, the Budget Committee has been criticized for having made that assumption, and this year we did not go as far as the Senator wants to go, although we did assume savings of over $700 million in the health function, over and above those recommended by the Finance Committee.
The Inspector General's study found that most of the fraud and abuse in health was from inappropriate or unnecessary services; only about 25 percent was from provision of services to ineligible recipients. This suggests that large savings can best be achieved by legislation designed to provide proper incentives to providers to reduce unnecessary or inappropriate care. Such legislation is the responsibility of the authorizing committees, especially the Finance Committee which has jurisdiction over medicare and medicaid. That committee must act before the Budget Committee can assure that these savings are going to accrue.
One act, the medicare anti-fraud and abuse bill, has just been passed by Congress. This act addresses some of the problems identified in the Inspector General's report. For example, it makes medicare fraud a felony and it strengthens enforcement efforts, and I wish to say for the record that the Senator from Oklahoma supported this anti-fraud and abuse bill. This legislation should help to reduce fraud and abuse. However, it is going to take some time to implement the act, and we cannot achieve savings of the magnitude suggested by the Senator's amendment in 1 year.
Mr. President, on this matter of reducing fraud and abuse in medicare and medicaid, I would be very happy to support an amendment that is more realistic. I do not know whether the Senator would find it possible to reduce the amount of savings anticipated, but I would say that if we can speed up the action or the work under the anti-fraud and abuse bill it would be, I think, a very good thing for us to attempt to do.
Mr. President, on the higher education-student aid programs, the Budget Committee recommendation is $1.4 billion below what the administration requested and $1.6 billion below the Human Resources Committee request. So we have, we think, been extremely careful not to provide excess funding in that mission. I hope the budget restraint reflected in the Budget Committee's recommendation will help to promote the kind of good management the Senator from Virginia is recommending.
No Member of the Senate wants the student aid money or any other program benefits to go to people who are not eligible. All of us in Congress and the executive branch need to step up the oversight of these programs, but again that is primarily the responsibility of the authorizing committees.
I suggest to the Senator from Virginia that he push the Finance Committee to exercise this oversight, and I agree with our chairman that arbitrary budget cuts of the magnitude suggested by the Senator from Virginia are excessive and that it is not the way to improve the management of the program. I think a more reasoned approach would perhaps get the results that the Senator from Virginia wants, not all in one year, but over a period of years.
Mr. HARRY F. BYRD, JR. Mr. President, if the Senator will yield there, he feels this figure is excessive. Does the Senator have a figure in mind that would be acceptable?
Mr. BELLMON. I would suggest to the Senator from Virginia that that figure should come from the Finance Committee. The oversight committee, the Budget Committee, in the past has attempted to produce figures that we thought were reasonable but until we can get the cooperation and support of the authorizing committees our figures are not acceptable here on the floor.
Mr. HARRY F. BYRD, JR. I misunderstood the Senator. I thought he had in mind supporting the amendment if the figures were changed slightly.
Mr. President, I ask unanimous consent that Senator ROTH of Delaware be named a cosponsor of this amendment.
The PRESIDING OFFICER. Without objection, it is so ordered. .
Mr. HARRY F. BYRD, JR. And I shall take only a moment or two.
I think the importance of putting the—
Mr. BELLMON. Mr. President, will the Senator yield for one comment?
Mr. HARRY F. BYRD. I yield.
Mr. BELLMON. I wish to point out, as I tried earlier, that the budget resolution does assume a savings of $1 billion in the health mission. That is already in our—
Mr. HARRY F. BYRD, JR. How much has the Budget Committee increased the HEW appropriations exclusive of social security? I think the answer is $7 billion.
Mr. BELLMON. As I understand it, our increases are to account for the costs of inflation and normal expected increases.
Mr. HARRY F. BYRD, JR. I understand that. But regardless of the reason — if I am wrong, correct me — the fact is that the budget resolution provides for a $7 billion increase in the operation of HEW exclusive of social security.
Mr. BELLMON. But from that the department must pay the increased costs due to inflation, which I think the Senator will agree are certainly substantial.
Mr. MUSKIE. For instance, indexing social security benefits every year adds $5 to $6 billion.
Mr. HARRY F. BYRD, JR. This is exclusive of social security, I will say to the Senator.
Mr. MUSKIE. We are talking about programs where indexing is of that order of magnitude.
Mr. HARRY F. BYRD, JR. We are talking about programs exclusive of social security being increased according to this budget resolution for HEW $7 billion.
Mr. BELLMON. But those are entitlement programs. The costs of medicare and medicaid delivery are going to rise as inflation goes up, and the Budget Committee would be highly irresponsible to ignore that fact.
Mr. HARRY F. BYRD, JR. I am wondering whether Congress would not be irresponsible to ignore the fact that $7 billion has been wasted. So they did not need that $7 billion last year. This is an increase of over and above that $7 billion.
Mr. MUSKIE. Mr. President, if the Senator will yield, he says they did not need the $7 billion: How in heaven's name when HEW processes the application for a student loans HEW to anticipate that that applicant is ineligible, that he is applying fraudulently? Or how is HEW to anticipate when it is paying a doctor's bill for a patient covered by medicare or medicaid that that particular bill was fraudulent, for services not required, or for excessive surgery? How does HEW control that, by denying payment at that point? Will the Senator tell me?
Mr. HARRY F. BYRD, JR. I think the answer is what the Senator from Oklahoma said a moment ago, that there needs to be a great management responsibility in. HEW. Apparently what HEW has been doing is just trying to get rid of the money that Congress has been appropriating to it.
Mr. MUSKIE. Is the Senator suggesting that nobody in America is defrauded except the Government? What the Senator is saying is that the Government somehow has to anticipate now that it is going to be defrauded to the extent of $7 billion, should anticipate that in advance and not pay the money. But not pay to whom at that point?
Mr. HARRY F. BYRD, JR. Maybe it is not realistic to feel that $7 billion of tax funds should pot be misspent by HEW. Maybe I am being unrealistic.
Mr. MUSKIE. The Senator is putting words in my mouth which I resent deeply because the Senator offers an over-simplistic way of getting at the problem. He accuses me of not caring about the problem.
Mr. HARRY F. BYRD, JR. I did not accuse the Senator of not caring. I was speaking of myself.
Mr. MUSKIE. The Senator was referring to me.
Mr. HARRY F. BYRD, JR. I am speaking of myself. I said maybe I am unrealistic.
Mr. MUSKIE. May I say to the Senator he is a member of the Finance Committee.
It is clear that the responsibility for handling this problem rests in the Finance Committee. If the Finance Committee will tell me, through you as its spokesman, or through its chairman, that it can take this Department by the scruff of the neck and shake $7 billion of fraud, waste, and mismanagement money out of it this next year, I will be glad to cut this deficit by $7 billion or by$5.6 billion, whatever.
Mr. HARRY F. BYRD, JR. Only the Congress—
Mr. MUSKIE. The Senator is a member of the committee.
Mr. HARRY F. BYRD, JR. I do not speak for the committee. Only the Congress can deliver a message to HEW; only Congress can do that. You start cutting HEW's budget — not cutting it but stop giving them such tremendous increases as are envisioned by this budget resolution, and then that will get the word to them. They will begin to tighten up their operation.
The first thing they have to do is tighten up their operations.
Mr. MUSKIE. The first thing to do to eliminate all citizens who are tempted to commit fraud, to overcharge, to apply for benefits they are not eligible for; the only way you can eliminate such concerns is to strike the programs from the law books of the country. Then you do not open them to temptation, you do not bring temptation within the reach of the average citizen — the doctor who overcharges, the citizen who applies for benefits he is not eligible for. That way you will legislate virtue not only for the Department of Health, Education, and Welfare but for all of our fellow citizens all over the country.
Mr. HARRY F. BYRD, JR. I will say to my dear friend I would take it from the opposite direction. I would tackle it by the Congress demanding greater competency on the part of the Administrators of HEW.
I will yield to the. Senator from Idaho.
Mr. McCLURE. I thank the Senator from Virginia for yielding. I compliment the Senator for raising this issue. I think it needs to be highlighted.
I understand the concerns of our Members on the Budget Committee and with the desire to demand good and efficient administration. I think this is what we should demand, good and efficient administration.
The Finance Committee does not administer these programs; HEW administers these programs.
It seems to me that to say the Finance Committee has to find a way of administering the program flies in the face of the government organization that says Congress passes the laws and creates the programs but the executive branch administers the programs. It was not in the creation of the programs but in the administration of the programs that the waste occurred.
I think the Senator from Virginia is exactly correct in focusing on a problem that does exist and says that it is our responsibility, as the Congress, as the legislative branch, to require of the administrative branch to clean up their act, to stop the waste of the taxpayers' money that ought to be flowing through to legitimate beneficiaries of programs created by Congress.
I think it might be well to compare for a moment the relative efficiency or lack thereof. It has been suggested that 16 percent waste was too much, and that a $7 billion waste is, perhaps, too much, and it can be reduced, but that $7 billion waste is 7 percent of their budget.
It is worthwhile noting that social security recipients, a broad spectrum of American citizens, a much larger program than these HEW programs, in that case the loss in maladministration of social security programs is less than 1 percent; and for my colleagues to indicate that a 7-percent inefficiency, a 7-percent wastage, is acceptable when we can look at another program that has less than 1 percent waste seems to me to fly in the face of reality, and also to obscure the responsibility which we in Congress have to try to require better administration of these programs.
I appreciate the initiative of my colleague from Virginia. He is doing his usual fine service in this body and to the people of this country in focusing on fiscal mismanagement of this country. Certainly that is one of the basic problems.
Mr. HARRY F. BYRD, JR. I thank the Senator from Idaho. I will take just one moment, and then, if it is the wish of the other Senators, I would have a vote.
I just want to say I think it is important if we are going to reduce waste in Government — and I do not see how anyone can deny that there is waste, and I do not know that anyone does really — here is the time to start by reducing the vast amount of money that is permitted as a result of this budget resolution.
Mr. BELLMON. Mr. President, will the Senator from Virginia yield for a question?
Mr. HARRY F. BYRD, JR. Yes.
Mr. BELLMON. Does the Senator, who is a member of the Finance Committee, the committee that has oversight over these programs, genuinely believe this kind of savings is possible?
Mr. HARRY F. BYRD, JR. I think if this Congress would tell HEW, if it adopts this amendment, that there will be a $5.6 billion reduction, HEW can manage its affairs where that would not hurt any recipients who really are entitled to receive the appropriation.
Mr. BELLMON. So the answer to the question is, yes, you feel that the savings of $5.6 billion are possible in the administration of these programs?
Mr. HARRY F. BYRD, JR. I think, based on the funds that HEW has in the past mishandled, yes, I think it is appropriate.
Mr. BELLMON. Does the Senator further believe that the Finance Committee would not be offended if the Senator from Maine and I joined in this resolution and helped pass it here on the floor?
Mr. HARRY F. BYRD, JR. I do not speak for the Senate Finance Committee. I am only one member of the Senate Finance Committee. I personally would welcome the Senator's support and that of the Senator from Maine, and I hope he will support it. That is the most hopeful news I have heard all day — as a matter of fact, it is the most hopeful news I have heard all year.
Mr. BELLMON. We have undertaken this on our own — the Budget Committee has brought in a resolution assuming savings not of this magnitude, but at a level which has incurred the opposition of the Finance Committee.
Mr. HARRY F. BYRD, JR. I do not know about that. I think if you will check the record — Senator MUSKIE does not have to check the record, because he is aware of it — I voted against every single effort to increase what the Budget Committee did. What I am trying to do is reduce what the Budget Committee brought in.
Mr. BELLMON. Our position is that the Budget Committee over the years has been very close to the proposal that the Senator from Virginia is offering, not in magnitude so much as in thrust and direction.
Mr. HARRY F. BYRD, JR. Fine I am delighted to be in such good company. That makes me feel real good.
Mr. BELLMON. If the Senator from Virginia can persuade his own chairman, the Senator from Louisiana, that this is a good approach, he might be surprised at how much support he would get from the members of the committee.
Mr. HARRY F BYRD, JR. If I can persuade the chairman of the Budget Committee and the ranking Republican member of the Budget Committee, I am sure we can make some headway in other areas.
Mr. MUSKIE. That I would doubt considerably, may I say to my good friend, but before I vote I would check with Senator LONG.
Mr. HARRY F. BYRD, JR. Mr. President, I ask unanimous consent that the Senator from Nevada (Mr. LAXALT) be added as a cosponsor.
The PRESIDING OFFICER. Without objection, it is so ordered.
Mr. HARRY F. BYRD, JR. Mr. President, I have three tables showing the deficit in Federal funds and interest on the national debt, the unified budget receipts and outlays, and the national debt in the 20th century. I ask unanimous consent to have these tables printed in the RECORD.
There being no objection, the tables were ordered to be printed in the RECORD, as follows:
[Tables omitted]
Mr. BELLMON. Mr. President, before we vote I would like to make the record clear that I do not want to seem, and I do not think any member of the Budget Committee wants to seem, to try to be providing funds for waste or mismanagement or abuse. Our resolution already has assumed some $1 billion savings in the medical programs which we took to be realistic, and to be about the limit which we could realistically hope to achieve, and hope to see the oversight committees achieve and HEW achieve.
If the Senator from Virginia has reason to believe that that figure is inadequate, then certainly it ought to be reconsidered. But the budget resolution we have before the Senate at this time does assume some savings and in the out years perhaps we can reach a figure of something like that which the Senator from Virginia has in mind.
Mr. HARRY F. BYRD, JR. I move the adoption of the amendment.
The PRESIDING OFFICER. Do the Senators yield back their time?
Mr. HARRY F. BYRD, JR. There is notime involved, is there?
Mr. MUSKIE. Yes, there are 2 hours on each amendment.
Mr. HARRY F. BYRD, JR. I yield back my time.
Mr. MUSKIE. I yield back my time, Mr. President.
The PRESIDING OFFICER. All the time has been yielded back. The question, therefore, is an agreeing to the amendment of the Senator from Virginia. The yeas and nays have been ordered on the amendment, and the clerk will call the roll.
The assistant legislative clerk called the roll
The result was announced — yeas 28, nays 48, as follows:
[Roll call tally omitted]