[Congressional Record Volume 140, Number 70 (Wednesday, June 8, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: June 8, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
             AMERICANS WANT MARKET-PLACE HEALTH CARE REFORM

  The SPEAKER pro tempore. Under the Speaker's announced policy of 
February 11, 1994, May 23, 1994, and today, the gentleman from Georgia 
[Mr. Collins] is recognized for 15 minutes as the designee for the 
minority leader.
  Mr. COLLINS of Georgia. Mr. Speaker, I appreciate the time.
  Mr. Speaker, I rise today to discuss the issue of health care reform, 
but, more importantly, I want to discuss word that I have received from 
the Third District of Georgia, and particularly from a constituent by 
the name of Dr. Rodney Kreider. Dr. Kreider is an associate 
pediatrician in one of the largest pediatric practices in Atlanta, GA.
  He makes several comments and points about health care reform, and 
these are some of the same points and comments I have heard throughout 
the Third District of Georgia, throughout Georgia itself, and from many 
other places across this country.
  The first point that Dr. Kreider makes is that Government spending in 
the form of entitlements has failed to adequately address the needs of 
our Nation's poor. For the past several years, our Federal and State 
governments have spent record amounts of tax dollars on social 
entitlement benefits. But we have not seen a real return on those so-
called investments.
  The poverty rate has not declined, and infant mortality is still 
high. The social programs begun in the 1960's have been a tremendous 
failure because they have caused circular and increased dependence on 
the Federal Government. They have failed to help the individuals and 
families return to a position where they can live independently and 
contribute to the productivity of our Nation's economy. The trillions 
of tax dollars spent through these programs have not changed the 
poverty status quo.
  Now we face the possibility of installing what Dr. Kreider accurately 
calls the mother of all entitlement programs, through the passage of 
the Clinton administration's Government-based health care reform. If 
this or a similar reform package passes, we will install a tremendous 
bureaucratic spending machine that makes Government the final authority 
on delivering, spending, and regulating the health care industry. 
Federal spending, taxes, and intrusive interference in the private 
sector will continue to grow with the passage of a Government-based 
plan.
  The second point is that there is no health care access problem, but 
rather a health care insurance access problem. Everyone in the health 
care debate agrees that there are problems with the system. Those 
problems, consistently pointed to by the President, the leadership of 
Congress, and people all across the country, indicate that we need 
insurance reform. We need to increase the access to insurance coverage. 
We can do this through noncontroversial reforms, without changing the 
nature of the entire industry.

                              {time}  1250

  Eliminating barriers to job-to-job portability of coverage, ending 
preexisting condition limitations are both aggressive measures that 
will bring many of the uninsured into the insured fold.
  The third point: Current Government-based health care is a major 
reason for escalating health care costs.
  Dr. Kreider makes one very clear point in his letter: As a physician, 
he knows through first-hand experience that Government-based health 
care is already a major cause of the escalating costs of health care. 
Entitlements such as Medicaid have driven up costs by creating an 
insatiable demand for free health care. We all know this is true. That 
is why we have the major problem of cost shifting in the health care 
profession. And it is getting worse.
  The fourth point is: We won't know how expensive health care really 
is until it is free.
  Dr. Kreider makes the point: This is why we must oppose the Clinton 
health care plan or any other measure that is a Government-based plan 
promising health care benefits to everyone, with the real costs hidden. 
By demanding that the employer pay for 80 percent of all health care 
costs, the plan eliminates any accountability, and removes any 
incentive that individuals should have to ensure that they are 
obtaining the most cost-effective health care.
  Medicaid already does that now for our Nation's poor. Health care is 
currently free and accessible for these recipients. And even though 
clinics like Dr. Kreider's has never turned away a sick child on the 
basis of inability to pay, Medicaid recipients too often choose the 
most expensive avenue of health care services: the emergency room. It 
is free for those individuals, but as you and I know, in reality, 
emergency room health care is truly the most expensive.
  The fifth point is that installing a Government framework as the 
ultimate authority-manager of health care is only the beginning of more 
control to come.
  Dr. Kreider makes another very good point: If we allow the Government 
to get the foot in the door, then it will be easy for the bureaucracy 
to obtain more and more control of the health care system every year. 
Proponents of the Clinton approach are very transparent in their 
approach: Creating bigger, more intrusive Government means there will 
be a greater dependency or need among the masses for the Government. 
That means more Federal spending and of course that means a bigger tax 
burden on Americans in order to meet that demand for increased Federal 
spending.
  He asked, what about individual responsibility?
  The Clinton plans avoids individual responsibility. Proponents of 
this Government-based approach are writing a blank check for health 
care costs and encouraging the public to go shopping.
  Another excellent point that Dr. Kreider makes: ``The only managers 
in medicine should be the physician and the patient.'' Not the 
Government. The Government should have no role in dictating what 
benefits we will have access to; the Government should not dictate who 
will have access to what medical speciality procedures; or when you 
will no longer be able to receive dramatic treatments for dramatic 
illnesses.
  Reforms are needed--but only those that strengthen our current 
system.
  As Dr. Kreider and Americans all across this country point out: The 
American health care system is the envy of the world. We must not enact 
reform that will destroy the nature of our private health care 
industry. We must approach reform with common sense about our method; 
and sensitivity to the impact these changes will have on the quality of 
health care available to people across this country. This means we must 
give top priority to the impact any reform changes will have on all 
elements of our current market-based health care industry.
  So what is the best option? The best option is building upon what we 
have by strengthening weaknesses that cause barriers to health care 
insurance coverage. And we should address the problems in the system 
that contribute to the escalating costs of health care.
  America wants greater access to health care through market-based 
reforms that make the very necessary changes without weakening the 
structure or damaging the foundation upon which the current system is 
built.
  We can do this, Mr. Speaker, by creating greater tax fairness through 
increasing deductibility for health care costs; by reducing paperwork 
and administrative costs; giving States greater flexibility so that 
they can change their health care systems in a way that most 
efficiently meets the needs of the people within their regions; and by 
granting more individual control and responsibility for health care 
decisions through IRA-like medical savings accounts. This can be done 
without installing a new bureaucratic Federal program; and without 
placing unfunded mandates on States and on the private sector.
  In addressing the inflationary costs of health care, the legislation 
must contain medical malpractice reform components. By providing limits 
on noneconomic damages; limiting punitive damages related to medical 
product liability; placing a $250,000 cap on noneconomic damages; 
directing that punitive damages awarded by the courts be paid to States 
to assist funding their efforts to reduce medical malpractice; limiting 
attorneys' contingency fees; and through additional incentives we can 
adequately address the inflationary costs caused by a market that is 
overburdened by excessive litigation.
  Already there are market-place reforms taking place to address cost 
issues. Health care providers all over the country are forming 
networks, and joining in the effort to address the need to provide 
quality service at controllable cost levels.
  Less government, less costly malpractice litigation, and less 
regulatory control is what we must strive for. In health care we need 
greater access, but not mandated coverage and certainly we do not need 
the Federal Government exerting exclusive control over the delivery, 
insurance, and quality of health care in America.

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