[Congressional Bills 103th Congress]
[From the U.S. Government Publishing Office]
[H.R. 257 Introduced in House (IH)]

103d CONGRESS
  1st Session
                                H. R. 257

          To establish a Health Care Crisis Policy Commission.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 5, 1993

  Mr. Neal of North Carolina introduced the following bill; which was 
referred jointly to the Committees on Energy and Commerce and Ways and 
                                 Means

_______________________________________________________________________

                                 A BILL


 
          To establish a Health Care Crisis Policy Commission.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Health Care Crisis Policy Commission 
Act''.

SEC. 2. CONGRESSIONAL FINDINGS.

    The Congress finds that--
            (1) the people of the United States will find it 
        increasingly difficult to pay for their medical care if the 
        cost of such care continues to increase;
            (2) in 1988, an estimated 37,000,000 individuals in the 
        United States lacked health insurance and another 50,000,000 
        were underinsured, leading to high levels of uncompensated 
        medical care;
            (3) there exists a tremendous need in the United States for 
        access to basic medical care services;
            (4) as the average age of individuals in the United States 
        increases, there will be a growing demand for health care;
            (5) in 1988, the average cost of a stay of 1 year in a 
        long-term health care facility was $25,000;
            (6) adequate long-term health care insurance is 
        unavailable;
            (7) the medical care system of the Department of Veterans 
        Affairs is not adequate to deal with the health care needs of 
        American veterans;
            (8) 11 percent of the gross national product of the United 
        States is made up of spending for medical care;
            (9) medical malpractice tort reform is necessary because 
        the high cost of malpractice insurance inflates medical costs;
            (10) there is a shortage of prenatal, infant delivery, and 
        well-baby care services in the United States even though it has 
        been proven that such services reduce medical costs over the 
        long term;
            (11) a large percentage of health care expenditures are 
        made for extraordinary medical procedures performed near the 
        end of individuals' lives rather than for preventative measures 
        early in their lives;
            (12) Federal income tax incentives for employer-paid group 
        health insurance need to be improved;
            (13) businesses that offer only self-insured health care 
        coverage for their employees need to have such coverage 
        regulated to guarantee adequate coverage, as such coverage is 
        the fastest growing segment of health care insurance;
            (14) concern exists regarding the continued solvency of the 
        medicare system with physicians becoming reluctant to 
        participate because Federal payment rates are too low; and
            (15) health care in many rural areas is inadequate and some 
        rural hospitals are closing.

SEC. 3. ESTABLISHMENT.

    There is established a commission to be known as the ``Health Care 
Crisis Policy Commission'' (in this Act referred to as the 
``Commission'').

SEC. 4. DUTIES.

    The Commission shall conduct a study of the problems of the cost 
and delivery of medical care in the United States. In conducting the 
study, the Commission shall--
            (1) examine the escalating costs of medical care and health 
        care insurance and its effect on the availability of medical 
        care to individuals in the United States;
            (2) investigate alternatives for providing medical care to 
        individuals who do not have health care insurance or who do not 
        have adequate health care insurance;
            (3) evaluate how the private sector could most effectively 
        offer adequate health care insurance to all employed 
        individuals in the United States;
            (4) review the demands that will be placed on the Nation's 
        health care system in the future as the population of the 
        United States ages;
            (5) examine the costs of long-term institutional and home 
        health care and the affordability and availability of insurance 
        for such care;
            (6) evaluate the health care delivery system of the 
        Department of Veterans Affairs;
            (7) investigate reforms that could be made to the medical 
        malpractice liability system and the effect such system has on 
        medical malpractice insurance and on the cost of health care;
            (8) examine the need for prenatal, delivery, and well-baby 
        health care and how such care impacts on the cost of health 
        care in the long term;
            (9) review the Federal income tax incentives used by 
        businesses for employer-sponsored group health insurance;
            (10) research the trend of businesses to be self-insured in 
        their health insurance coverage and how such coverage is 
        regulated;
            (11) examine the delivery of health care in the rural areas 
        of the United States and the reasons for the closing of many of 
        the hospitals in those areas;
            (12) evaluate the financial stability and effectiveness of, 
        and physician reimbursements from, title XVIII of the Social 
        Security Act (42 U.S.C. 1395-1395ccc; commonly known as 
        medicare);
            (13) investigate financing options and costs for each 
        health care delivery system recommended by the Commission as an 
        alternative to the systems used in the United States as of the 
        date of the enactment of this Act;
            (14) investigate systems of organizing and delivering 
        health care and types of incentives that could be used to 
        improve the efficiency of the provision of health care while 
        improving the quality of care; and
            (15) investigate other areas relating to the efficient and 
        cost-effective delivery of health care that the Commission 
        believes it is necessary to investigate.

SEC. 5. MEMBERSHIP.

    (a) Number and Appointment.--The Commission shall be composed of 15 
members appointed as follows:
            (1) 5 members appointed by the President.
            (2) 5 members appointed by the Speaker of the House of 
        Representatives.
            (3) 5 members appointed by the majority leader of the 
        Senate.
    (b) Qualifications for and Limitations on Appointment.--Each member 
shall be knowledgeable about the delivery or the financing of health 
care, or both, or in the economics, administration, or legal aspects of 
health care. Each member shall be selected from among consumers of 
health care, health care providers, employers, health care financial 
institutions, or organizations that represent such persons. Not more 
than 1 member appointed under each paragraph of subsection (a) may be--
            (1) an officer or employee of the Federal Government;
            (2) an officer or employee of a State or local government; 
        or
            (3) a Member of the Congress.
    (c) Vacancies.--A vacancy in the Commission shall be filled in the 
manner in which the original appointment was made.
    (d) Political Affiliation.--Not more than 3 members of the 
Commission appointed under each paragraph of subsection (a) may be of 
the same political party.
    (e) Terms.--Each member shall be appointed for the life of the 
Commission.
    (f) Basic Pay.--
            (1) Rates of pay.--Except as provided in paragraph (2), 
        members of the Commission shall each be paid at a rate equal to 
        the rate of basic pay payable for level IV of the Executive 
        Schedule for each day (including travel time) during which they 
        are engaged in the actual performance of duties vested in the 
        Commission.
            (2) Pay of federal employees and members of congress.--
        Members of the Commission who are full-time officers or 
        employees of the Federal Government or Members of the Congress 
        shall receive no additional pay, allowances, or benefits, 
        except those provided in paragraph (3), by reason of their 
        service on the Commission.
            (3) Travel expenses.--Each member of the Commission shall 
        receive travel expenses, including per diem in lieu of 
        subsistence, in the same manner as is permitted under sections 
        5702 and 5703 of title 5, United States Code.
    (g) Quorum.--8 members of the Commission shall constitute a quorum, 
but a lesser number may hold hearings.
    (h) Chairman and Vice Chairman.--The chairman and vice chairman of 
the Commission shall be elected by the members of the Commission.
    (i) Meetings.--The Commission shall meet at the call of the 
chairman of the Commission or a majority of its members.

SEC. 6. STAFF; EXPERTS AND CONSULTANTS.

    (a) In General.--The chairman of the Commission shall, in 
accordance with the provisions of title 5, United States Code, 
governing appointments in the competitive service, and other applicable 
laws and regulations, hire such staff as is necessary to carry out the 
duties of the Commission.
    (b) Pay.--The staff of the Commission shall be paid in accordance 
with the provisions of chapter 51 and subchapter III of chapter 53 of 
title 5, United States Code, relating to classification and General 
Schedule pay rates.
    (c) Experts and Consultants.--The chairman may procure temporary 
and intermittent services of experts and consultants under section 
3109(b) of title 5, United States Code.
    (d) Staff of Federal Agencies.--Upon request of the Commission, the 
head of any Federal agency is authorized to detail, on a reimbursable 
basis, any of the personnel of such agency to the Commission to assist 
the Commission in carrying out its duties under this Act.

SEC. 7. POWERS.

    (a) Hearings and Sessions.--
            (1) In general.--The Commission may, for the purpose of 
        carrying out this Act, hold hearings, sit and act at times and 
        places, take testimony, and receive evidence, as the Commission 
        considers appropriate.
            (2) Open meetings.--The Commission shall be considered an 
        agency for the purposes of section 552b of title 5, United 
        States Code (relating to the requirement that meetings of 
        Federal agencies be open to the public).
    (b) Powers of Members and Agents.--Any member or agent of the 
Commission may, if so authorized by the Commission, take any action 
which the Commission is authorized to take by this section.
    (c) Obtaining Official Data.--All officers and employees of Federal 
agencies shall cooperate with the Commission in the performance of the 
duties of the Commission. Subject to sections 552 and 552a of title 5, 
United States Code (relating to the availability of information of 
Federal agencies to the public), the Commission may secure directly 
from any Federal agency information necessary to enable it to carry out 
this Act. Upon request of the Chairman of the Commission, the head of 
the Federal agency shall furnish the information to the Commission.
    (d) Gifts.--The Commission may accept, use, and dispose of gifts or 
donations of services or property.
    (e) Mails.--The Commission may use the United States mails in the 
same manner and under the same conditions as other Federal agencies.
    (f) Administrative Support Services.--The Administrator of General 
Services shall provide to the Commission on a reimbursable basis such 
administrative support services as the Commission may request.

SEC. 8. REPORT.

    The Commission shall transmit to the President and to the Congress 
a report not later than 2 years after the date of enactment of this 
Act. The report shall contain a detailed statement of the findings and 
conclusions of the study conducted pursuant to section 4, together with 
the recommendations of the Commission for such legislation and 
administrative actions, at the Federal, State, and local level, and for 
actions that should be undertaken by the private sector, as the 
Commission considers appropriate.

SEC. 9. TERMINATION.

    The Commission shall cease to exist 10 days after submitting its 
final report pursuant to section 8.

SEC. 10. BUDGET COMPLIANCE.

    Any spending authority (as defined in subparagraphs (A) and (C) of 
section 401(c)(2) of the Congressional Budget Act of 1974 (2 U.S.C. 
651(c)(2)(A))) authorized by this Act shall be effective only to such 
extent or in such amounts as are provided in appropriation Acts.

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