[Congressional Record Volume 140, Number 54 (Friday, May 6, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: May 6, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
                         ADDITIONAL STATEMENTS

                                 ______


                    PUBLIC SERVICE RECOGNITION WEEK

 Mr. HARKIN. Mr. President, I rise to speak regarding Public 
Service Recognition Week. This week commemorates the millions of men 
and women who work on the Federal, State, and local levels to do the 
people's work.
  Public employees quietly serve the Nation in so many ways. They teach 
our children. They defend our Nation. They ensure the safety of our 
buildings, food, water, medicines, workplaces, and roads. They protect 
our families from crime, and search for cures to protect them from 
disease. They protect our retirements and our savings. Each of us 
relies on these public servants quietly doing their work every day.
  The predominant concern with Government spending at all levels means 
that this Nation's public servants are increasingly being asked to do 
more with less. Yet despite hardships of fewer personnel and scarce 
resources, the work continues to get done. It is a tribute to the 
ingenuity and ability of these dedicated workers that they continue to 
perform their duties effectively.
  Unfortunately, too often these public servants go unappreciated, or 
worse yet, are vilified. Some have seized on public servants as 
convenient targets, and as scapegoats for problems beyond their control 
in Government programs and services. Public Service Recognition Week is 
one way that our Nation can tell these workers that we appreciate them, 
and to thank them.
  Those of us in Congress should be thankful for our Nation's public 
servants. Without their tireless efforts, the laws we pass here would 
be completely hollow. I salute these dedicated men and women.
                                 ______


            TRIBUTE TO GEORGE HALVORSON: HEALTH CARE LEADER

 Mr. DURENBERGER. Mr. President, I rise to pay tribute to a 
Minnesota health care pioneer and visionary, George Halvorson. As the 
chief executive officer of HealthPartners, Minnesota's largest HMO, 
George continues to play a major role in the progress toward national 
health care reform.
  It is hard to summarize the impact this good friend of mine has had 
on the development of managed health care. I refer my colleagues to an 
article by Judith Borger in the St. Paul Pioneer Press dated May 2, 
1994.
  Referred to in Borger's article as a ``huge force in the Minnesota 
marketplace and a growing influence on the national scene,'' I can 
confirm with pride that George helped bring Minnesota into the 
spotlight as a model for national health care reform.
  George's endeavors in the corporate world of health care are 
noteworthy, but he is also an accomplished author. I highly recommend 
to my colleagues his influential discourse on the ills of the Nation's 
current health care system, Strong Medicine. Strong Medicine explains 
in very clear and understandable terms the problems facing America's 
health care system and outlines an insightful way to address them.
  I urge policy-makers, private industry leaders and my colleagues 
alike to familiarize themselves with the work of this Minnesota health 
care reform leader, and would ask that the May 2 St. Paul Pioneer Press 
article be entered into the Record.
  The article follows:

             [From the St. Paul Pioneer Press, May 2, 1994]

  Health Care's Heavyweight--HealthPartners CEO George Halvorson Has 
   Emerged as One of the Leading Forces in Changing the Shape of the 
                    Health Care System in Minnesota

                        (By Judith Yates Borger)

       George Halvorson, CEO of Minnesota's largest health 
     maintenance organization, is one of the state's most powerful 
     health care leaders--often revered, sometimes feared, and 
     generally credited with enormous foresight. But it wasn't 
     foresight that brought him into the health care industry just 
     as managed care started to boom.
       Halvorson, who heads Bloomington-based HealthPartners, came 
     to the Twin Cities in 1968 to attend graduate school at 
     night, and he needed a day job to support his young family. 
     Since he'd been a reporter for the Fargo Forum, he thought 
     he'd find work in public relations.
       Seeing an ad for an ``underwriter'' at Eagan-based Blue 
     Cross and BlueShield of Minnesota, he figured it meant 
     assistant writer and applied. The personnel interviewer was 
     amused at Halvorson's mistake, and, as luck would have it, 
     also had an opening in the public relations department. 
     Halvorson landed that job.
       It wasn't a very bright beginning for a man who today is 
     called brilliant by many of his peers. But it was momentous 
     for Minnesota, because the health care reform movement that 
     is under way here today is driven by the forces of business. 
     While it may appear that legislators and public policy wonks 
     are pulling the health care strings, the reality is that the 
     employers who buy health care for the majority of Minnesotans 
     will ultimately determine how much care most people will get, 
     and how much it will cost.
       Halvorson is a huge force in the Minnesota marketplace and 
     a growing influence on the national scene. His view of the 
     future has a direct effect on the health care that many 
     Minnesotans receive. If you're one of the 600,000 
     HealthPartners enrollees and have heart disease, for example, 
     his newest effort, called Partners for Better Health, may put 
     a scale in your bathroom to help you keep close track of your 
     weight. And if you're not a HealthPartners member, your 
     health plan certainly will be watching Halvorson's program 
     closely.
       ``He sticks his head farther above the horizon than anyone 
     else,'' said Steve Wetzell, executive director of the 
     Business Health Care Action Group, a powerful coalition of 22 
     of Minnesota's largest employers.
       ``He's a visionary,'' said Dr. Jim Reinertsen, co-president 
     of HealthSystem Minnesota in St. Louis Park.
       Halvorson's meteoric rise at Blue Cross was the first 
     indication of his talent. By 1980 he was senior vice 
     president for marketing with Blue Cross and felt he was in 
     line to be president. The board of directors instead chose 
     Andrew Czajkowski, who was ``10 years older and very 
     bright,'' Halvorson says today.
       Halvorson left the Blues, taking with him a ``thinly veiled 
     enmity'' for his former employer that continues today, 
     according to Don Wegmiller, president and CEO of Minneapolis-
     based Management Compensation Group/Health Care Inc.
       Halvorson went to work setting up an HMO for seniors under 
     a grant from the Wilder Foundation and Health One Corp., 
     where Wegmiller was then president. When the federal 
     government refused to pay more than the usual amount because 
     the program enrolled more very frail elderly, Halvorson 
     arranged for the sale of the HMO to a larger company that 
     could better absorb the cost.
       ``He transferred the seniors and everyone was taken care 
     of,'' said Wegmiller. ``You give George a problem and he's 
     quick to solve it. You give him an opportunity and he's quick 
     to take advantage of it.''
       One of those opportunities came in 1992. He has been 
     president of GroupHealth for six years when a few of the Twin 
     Cities' largest employers, fed up with the escalating health 
     care premiums for their employees, banded together to form 
     the Business Health Care Action Group. Together they decided 
     to buy health care the same way they buy any other raw 
     materials needed to do business: by listing specifications 
     and asking for bids.
       Halvorson wanted the contract, but Group Health didn't have 
     all the components the Business Health Care Action Group 
     wanted. So Group Health merged with St. Louis Park-based 
     MedCenters Health Plan, and named the new organization 
     HealthPartners. Then Halvorson formed an alliance with St. 
     Louis-based Park Nicollet Medical Center and the Mayo Clinic 
     in Rochester. HealthPartners got the contract, and a huge 
     boost in visibility.
       Halvorson's vision was apparent again at about the same 
     time, when Minnesota legislators were passing MinnesotaCare, 
     the state law that, among other things, establishes 
     integrated service networks (ISNs). Sort of super-HMOs that 
     are supposed to manage their members' entire health care, 
     from the first appointment to the last bill, ISNs generally 
     are supposed to have three parts: an insurance company, a 
     string of clinics and doctors, and a hospital.
       Of all the health plans in Minnesota at the time, 
     HealthPartners was the closest in structure to ISNs. Were 
     ISNs designed to look like HealthPartners, or was 
     HealthPartners designed to look like an ISN? Neither, says 
     Halvorson.
       Each year the senior management at HealthPartners puts 
     together a list of about 300 assumptions about what the 
     various players in the health care field--competitors, 
     legislators, federal officials--are likely to do. It also 
     compiles a corresponding list of moves for HealthPartners. 
     The practice has helped position HealthPartners to anticipate 
     the changes.
       ``About four years ago we asked ourselves what would be the 
     best possible design for a health plan, and that's what we 
     came up with,'' said Halvorson. ``I think we and the 
     Legislature were working on parallel tracks.''
       The only piece HealthPartners was missing was a hospital. 
     Halvorson took care of that in September 1993 when 
     HealthPartners surprised the health care community by merging 
     with St. Paul Ramsey Medical Center in what seemed like 
     record time. Just two days before the papers were signed with 
     Ramsey, HealthPartners had heard a presentation for a deal 
     from Health East and agreed to further discussion. Health 
     East executives were preparing for the additional meeting 
     with Halvorson when they learned he'd already signed with 
     Ramsey.
       ``If Health East had put a different proposal on the table, 
     it would have gone differently,'' said Halvorson.
       None of the executives at Health East was willing to 
     discuss Halvorson for this article. Neither was the Blues' 
     Czajkowski. That is an indication of the level of power 
     Halvorson has amassed in this marketplace. Few are willing to 
     risk angering him by saying something that might be taken the 
     wrong way.
       His name is in the newspaper almost daily, it seems, 
     because he always returns reporters' calls and usually says 
     something that furthers the story. On the other hand, when 
     President Clinton gave his address on health care last fall, 
     CBS News asked Halvorson to appear on camera to provide 
     reaction. He declined.
       ``I'm just not a TV type,'' he said.
       So what type is he? Focused, hard-driving, steadfast in his 
     beliefs, and a tough negotiator, say his friends. Plodding, 
     dull and cold, counter his critics.
       ``When you're dealing with George you've got to really do 
     your homework, because he's done his,'' said Reinertsen.
       ``What can one really say about a guy who takes a portable 
     fax machine along with him to the Boundary Waters?'' said 
     Gordon Sprenger, executive officer of HealthSpan Health 
     Systems, Brooklyn Center. ``About a guy who, at remote 
     retreats, continues to wear suits and wing-tipped shoes when 
     everyone else is in sweaters and jeans?''
       ``Halvorson says he's ``a child of the '60s who happens to 
     be an excutive of the `90s''--if not a terribly well-paid 
     one. In 1992, for example, Halvorson earned $316,000 to run 
     an organization that then had revenues of $864 million. By 
     comparison, Tim Hanson, president of HealthEast, was paid 
     $449,851 that year to run an organization with revenues of 
     $292 million. HealthPartners' revenues increased to $1.1 
     billion with the merger last fall of St. Paul Ramsey Medical 
     Center. Halvorson got a raise to $350,000.
       Nonprofit organizations such as HealthPartners typically 
     pay executives far less than for-profit companies. And while 
     for-profit public companies are owned by the stockholders, 
     HealthPartners operates like a cooperative, with a board of 
     directors elected by the members and physicians. The 18-
     member board of directors sets Halvorson's salary.
       Halvorson shrugs at talk about his pay.
       ``It's more money than I ever thought I'd make and 
     certainly sufficient for my needs,'' he said. ``If my primary 
     motivation were money, I'd work someplace else.''
       ``George is an idealist,'' said Reinertsen, who once took 
     Halvorson fishing to get to know him better. ``Personal 
     wealth is not a driver for him. It's not how he measures 
     winning. It irritates him when people who are doing a poor 
     job are paid three times what he is. He regards that as a 
     black mark on health care.''
       But for all his idealism, he can come off as just another 
     heartless executive. When Medicare refused to increase 
     reimbursement rates in Minnesota, HealthPartners raised 
     premiums on its Senior Plus plan 29 percent to $140 a month 
     and added a $10 co-pay. The seniors responded by picketing 
     HealthPartners headquarters in Bloomington. Weeks later, 
     Halvorson and a retinue of executives met with about 200 
     angry seniors to present a 20-page position paper and a host 
     of charts and graphs in an attempt to convince them the fault 
     lay with the federal government. It didn't work.
       Halvorson, who said he has raised money for the Senior 
     Federation for years, is frustrated with the whole affair.
       ``We're getting a bad rap from people who don't understand 
     the government payment system,'' he said.
       Dr. Richard Reece, publisher and editor of the Reece 
     Report, a newsletter offering ``political and economic 
     insights for physicians,'' has been a critic of Halvorson's 
     philosophy for years. But even he grudgingly acknowledges 
     Halvorson's success.
       ``He's a plodding, sound achiever who has stuck to his 
     principles, and the world has swung around to his thinking,'' 
     said Reece.
       Halvorson may be plodding, but right now he's absolutely 
     obsessed with ``Partners for Better Health.'' The program 
     targets five disease areas and sets goals to reduce their 
     rates among HealthPartners members. For example, the plan 
     wants to reduce heart disease among members by 25 percent by 
     encouraging them to cut smoking and switch to low-fat diets.
       But what if you don't want to stop smoking or lose weight? 
     Isn't this an intrusion on your privacy?
       HealthPartners is betting there will be enough motivated 
     people in the program that it won't run into much opposition 
     from the start. And, hopefully, by the time it has gotten to 
     the laggards, it will have learned enough to convert them to 
     the motivated.
       Clearly, the No. 1 convert to wellness is Halvorson 
     himself. It's become a personal mission for him. Fingering 
     his bottle of mineral water, Halvorson says he's lost 35 
     pounds in recent months--``without ever being hungry,'' he 
     said--and he shows off the excess inches of material in the 
     waist of his pants as proof.
       Halvorson lost the weight during the past year, he said, by 
     eating fat-free foods and squeezing in some kind of physical 
     activity whenever possible. To illustrate his point, he 
     points to one wall of the Health Partners' conference room, 
     now covered with labels from fat-free foods. Halvorson often 
     uses those foods to prepare meals for himself before luncheon 
     meetings, explaining at length to those around the difference 
     between high-density lipids and low-density lipids. He's even 
     convinced the Decathlon Club in Bloomington to serve his 
     favorite fat-free chocolate syrup.
       ``You can't be preaching this when you're 50 pounds 
     overweight,'' he said.
       If Health Partners actually does achieve its very ambitious 
     goals of improving the health of its members, it will be yet 
     another example of Halvorson moving several steps ahead of 
     the pack.
       ``He's 20 years ahead of the rest with that program,'' said 
     Wetzell.
                                 ______


                    FACES OF THE HEALTH CARE CRISIS

 Mr. RIEGLE. Mr. President, I rise again today in my continuing 
effort to put a face on the problems of unmet health care needs across 
our country. I would like to share the story of Nancy and Charles 
Sullivan from Port Huron, MI. In the mid-1980's, both Nancy and Charles 
were diagnosed with multiple sclerosis. Fortunately, Charles receives 
Medicare benefits through the Social Security Disability Insurance 
Program, but Nancy does not have any health insurance.
  Charles and Nancy are in their mid-forties and have three daughters 
between the ages of 19 and 23 who no longer live at home. For 21 years, 
Chuck worked in a wire manufacturing plant and rose to the position of 
assistant plant manager. Nancy stopped working outside the home when 
their first child was born. In 1980, while their three children were 
still small, Nancy began having health problems and was subsequently 
diagnosed with multiple sclerosis, or ``MS.''
  MS is a chronic disease of the central nervous system that can cause 
paralysis and loss of control over body functions. There is no cure, 
although medication and therapy can help some people control their 
symptoms. Symptoms vary dramatically--some people have only slight 
symptoms, while others become severely disabled.
  Fortunately, Chuck's employer provided health insurance benefits 
which covered the cost of Nancy's treatments and equipment. But then it 
1986, Chuck's health began to deteriorate and he was also diagnosed 
with MS.
  As a result of the MS, Nancy is paralyzed from the waist down and 
confined to a wheelchair. Chuck's health did not fail as quickly as 
Nancy's. As a result, Chuck was able to continue to work full time, but 
also assumed the responsibility of taking care of Nancy, the children, 
and the household. In 1989, Chuck's employer moved to Arkansas and 
Chuck and his family planned to follow his job after Nancy had back 
surgery. Although the manufacturer had agreed initially that Chuck 
could transfer after Nancy's recuperation, the company changed its mind 
and ordered Chuck to report to the plant in Arkansas with less than 1 
week's notice. Because Nancy's surgery was scheduled for that same 
week, the family could not move. His employer refused to negotiate with 
him, and Chuck was terminated.
  During 1989, the year that he was receiving unemployment 
compensation, Chuck paid $370 per month to continue his health 
insurance benefits so that Nancy could receive the care she needed. In 
1990, Chuck had an MS attack that put him in the hospital. His MS had 
progressed to the point of being totally disabling. Chuck could no 
longer control his muscle functions and was confined to a wheelchair. 
This attack came shortly after Chuck followed through on a potential 
job opportunity.
  Both Chuck and Nancy received SSI and Medicaid for a short time 
before Chuck became eligible for Social Security Disability Insurance 
benefits because of his many years of employment. Chuck's SSDI 
benefits, however, are high enough to make Nancy ineligible for SSI and 
Medicaid benefits. She is not eligible for SSDI because she worked as a 
homemaker, and therefore she has not been employed enough to acquire 
the necessary quarters to receive benefits. The only way that Nancy 
could get health care benefits through Medicaid is if she and her 
husband were to get a divorce.
  The Sullivans' barely make ends meet on their small monthly income of 
$1,200 from Social Security and veteran's pension benefits. Nancy does 
not go to the doctor when she is sick, because she doesn't have any 
insurance to cover the costs. They struggle to take care of themselves 
without any assistance in their home. Nancy and Chuck cannot afford the 
high cost of an individual health insurance policy to cover Nancy. They 
question whether or not they could even find a policy that would cover 
her preexisting MS condition.
  Mr. President, the Sullivans and all Americans deserve the security 
of guaranteed affordable health care coverage that will meet their 
needs regardless of pre-existing conditions. We need to enact health 
care reform legislation to make sure that families like Chuck and Nancy 
are able to purchase affordable health care for both, not just one of 
them. I will continue to work with my colleagues in the Senate and the 
Clinton administration to ensure the comprehensive health care reform 
is a reality this year.
                                 ______


                       WORLD ROWING CHAMPIONSHIPS

 Mr. LUGAR. Mr. President, I am very pleased that the Senate 
acted so expeditiously in adopting legislation providing a duty waiver 
for competitors in the 1994 World Rowing Championships which will be 
held in Indianapolis, IN.
  I was pleased to propose this legislation which became part of an 
omnibus event duty free bill for the World Cup, the 1996 Olympics and 
Paralympics, and the 1995 Special Olympics. For rowing, it is 
particularly important because it waives the requirement for posting 
bond for the equipment brought by competing international teams. Rowing 
shells and oars are expensive equipment and this relieves the competing 
teams of an unnecessary expense and eases their entry into the United 
States.
  As we all know, the world has changed significantly in recent years, 
and many countries barely have the resources to field a team. Waiving 
the bond requirement is an enormous help.
  The 1994 World Rowing Championships will be held from September 11-
18, the first time they have ever been held in the United States. Since 
their origin in 1893 as the European championships, championships have 
been held every year since.
  The races will be held at Indianapolis's Eagle Creek Reservoir, a 
beautiful site surrounded by the largest municipal park in the Nation. 
It is also home to the only internationally certified course in the 
United States. Competing will be over 1,000 athletes, men and women, 
from more than 40 countries.
  Rowing has a long history in organized American sport. The Harvard/
Yale race is the oldest intercollegiate athletic event in America, held 
annually for 142 years, since 1852. The National Association for 
Amateur Oarsmen, now the U.S. Rowing Association and headquartered in 
Indianapolis, was first established in 1872 and was the first national 
governing body for sport in America. Ironically, its purpose was to 
distinguish its members from professionals. Amateur rowing to this day 
remains a sport pursued more for love than for remuneration.
  Mr. President, I am thrilled to have this exciting event coming to my 
home city of Indianapolis, a place we Hoosiers like to think of as the 
Nation's amateur sports capital. I congratulate the organizers from 
U.S. rowing for their hard work in winning the bid for this event and 
invite all my colleagues and their staff, particularly those that were 
rowers in school, to come to Indianapolis in September for what I 
promise will be memorable competition in a splendid setting.

                          ____________________