[Congressional Record Volume 140, Number 107 (Friday, August 5, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 5, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]

 
        AN IN-DEPTH PERSPECTIVE ON AMERICA'S HEALTH CARE SYSTEM

  (Mr. SMITH of Michigan asked and was given permission to address the 
House for 1 minute and to revise and extend his remarks and include 
extraneous matter.)
  Mr. SMITH of Michigan. Mr. Speaker, Dr. Lanny Johnson of East 
Lansing, MI, recently gave me his perspective on our Nation's health 
care system. He makes a number of insightful observations including one 
I think everyone should note. He argues that we have had so many 
exciting technological advances that we simply do not have enough money 
to buy everything for everybody.
  Mr. Speaker, let me quote from the statement:

       The American health care system is the best in the world. 
     It also is the most expensive. It is no longer affordable.
       The health care system in the United States is in a state 
     of financial collapse. The demands for services and 
     increasing technological advances have outstripped the 
     ability of individuals, business, and government to afford 
     these services.
       Everyone has reached the same conclusion. It is not 
     affordable for me, so I must shift the expense to someone 
     else * * *.

  Mr. Speaker, I will include the rest of Dr. Johnson's statement with 
my remarks, and I would summarize first by saying, let us remember as 
we consider health care reform proposals that there is no magic tree 
that will grow enough money to buy every medical service for everybody.
  Mr. Speaker, the full statement by Dr. Johnson is included as 
follows:

                        Dr. Johnson's Statement

       The American health care system is the best in the world. 
     It also is the most expensive. It is no longer affordable.
       The health care system in the United States is in a state 
     of financial collapse. The demands for services and 
     increasing technological advances have outstripped the 
     ability of individuals, business, and government to afford 
     these services.
       Everyone has reached the same conclusion. It is not 
     affordable for me, so I must shift the expense to someone 
     else. The most wealthy American could not pay for an 
     extensive illness. Promises made by Corporate America which 
     were guaranteed through past union negotiations now exceed 
     their ability to pay the medical expenses of existing 
     workers, let alone the promises to their retirees. The 
     government now cannot pay for what its politicians promised 
     at election time.
       The obvious solution is for each group to shift the cost to 
     someone else. This is like a shell game. It works for a 
     while, but when the last shell is lifted, there is no coin. 
     The individual wants his company to pay industrial leaders 
     like the big three automotive manufacturers want socialized 
     medicine, because they cannot pay the bill and effectively 
     compete with foreign companies. The Clinton proposal would 
     reduce the Big 3 expenses by 20% and shift this expense to 
     everyone else in taxes. Many present day health insurers like 
     HMOs do not pay full price. They negotiate lower prices with 
     doctors and hospitals. The government Medicare and Medicaid 
     programs pay less than cost of services. These losses are 
     silently shifted to regular insurance companies like Blue 
     Cross, Aetna, Prudential, etc. They not only pay their share, 
     but the additional expenses shifted from the managed health 
     care industry and government programs. Perhaps now you 
     understand why your regular insurance costs so much.
       You may also wonder where all the money is going to. A 
     small portion goes for the common problems most of us 
     encounter. For instance, 3% of the national health care 
     dollar goes to all of orthopedic care, but almost 20% goes to 
     the costs of drug abuse. Most orthopedic conditions respond 
     to treatment. Unfortunately the outcomes of drug abuse are 
     poor. The patient just keeps coming back. This and other 
     sociological changes are major contributors to collective 
     expense of our national health care.
       One of the suggestions to correct cost of health care is to 
     reduce doctors fees. This is a small part of the problem. 
     Doctor fees account for 19% of the health care dollar. If 
     doctors were paid nothing starting today, and health care 
     costs continued to rise 10% per year, in two years time the 
     problem would return. Doctors are the convenient ``whipping 
     boys'', but only part of the problem.
       The next solution proposed by our politicians is National 
     Health Care Reform. In my view, this will not reduce the 
     cost. It has been often joked, that if you like our mail 
     service, you will love National Health Care. This shift of 
     personal responsibility to the government will result in 
     increased taxes. Americans always vote for something for 
     nothing, no matter how much it costs.
       The only way to reverse this trend would be to create a 
     tangible benefit for those who demonstrate personal 
     responsibility for their well being. This is unlikely. The 
     shifting of both personal responsibility and cost 
     consequences to someone else is too appealing.
       The ultimate solution under this scenario will be rationing 
     of health care. Joseph Califono's book subtitle ``Who lives, 
     who dies, who pays?'' will have to be answered.
       In the absence of assumption of personal responsibility, 
     unfortunately the ultimate solution will be rationing of 
     health care as initiated in the State of Oregon for Medicaid.

                          ____________________