[Congressional Record Volume 140, Number 117 (Thursday, August 18, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


[Congressional Record: August 18, 1994]
From the Congressional Record Online via GPO Access [wais.access.gpo.gov]


                              {time}  1840
 
              WHO IS GOING TO RUN THE HEALTH CARE SYSTEM?

  The SPEAKER pro tempore (Mrs. Thurman). Under a previous order of the 
House, the gentleman from Michigan [Mr. Ehlers] is recognized for 5 
minutes.
  Mr. EHLERS. Madam Speaker, the previous speaker spoke about the 
desire for health care on a national level.
  Frankly, his desire is shared by many in this Chamber on both sides 
of the aisle. I suspect that is not the real issue.
  I think the real issues before us are, who is going to run the health 
care system and who is going to pay the bill. And it is the first one 
of those questions which I would like to address this evening. Who is 
going to run the health care system.
  Because, you see, the proposals submitted by the administration and 
most of the bills that we have had presented in this House and in the 
Senate have assumed that the Federal Government will have a major role 
in running the health care system. I think that is going to be a 
problem.
  I have in my hands this evening a document furnished me by a 
physician in my district. Notice the size of this. And this document 
was prepared in response to a survey, a request, a questionnaire by the 
Health Care Financing Administration, asking this physician and his 
colleagues to fill out this document, to let the Federal Government 
know what they were doing in their office. They were supposedly 
randomly selected. They were told they did not have to fill it out. But 
it was implied that if they did not, they might lose the Medicaid 
approval for their particular facility.
  That certainly is a strong arm approach to ensuring that they better 
fill it out. It took them over 120 hours of staff time. They had to 
work some weekends to get it done on time. They were given very little 
time. They estimated it cost them $10,000 in total to complete this 
survey form.
  When you look at the survey and you look as some of the issues that 
were dealt with, they had to, as an example, list all the supplies that 
were used in the various procedures done in that office. When you look 
at the things they had to list, they had to include disposable 
supplies, such as a tonopen tip cover for 25 cents; a temo probe cover, 
3 cents; chart forms at 11 cents each; gonio lens at 22 cents. They 
had to list pharmaceuticals. And in this case they used A-K Dilate, two 
drops, they estimated approximately 10 cents for that; Alcaine, 3 
drops, at about 12 cents. And then on to head covers at 6 cents, shoe 
covers at 15 cents a pair, masks at 30 cents, surgeons gloves at 48 
cents and on and on.

  I really wonder if this makes economic sense for a Federal agency to 
be requiring physicians to fill out forms in such great detail, with 
such minutiae. What is going to be done with that information? I hope 
something useful, but I would not be too sure of that.
  What is even worse is the information that was not asked for. 
Presumably this is being done to determine what the costs were for 
providing health care and trying to get a handle on this so that 
perhaps health care costs could be reduced. But, for example, they did 
not include information about whether or not the facility, cost of the 
facility was amortized or not. So these physicians, who have a 
relatively new facility and are still paying it off, are put in the 
same bag as other facilities which have their property totally paid off 
and depreciated. No differentiation was made on that score.
  That is a very important piece of information that should be 
included. The reason I bring this here and the reason I discuss this 
issue is getting at the question, who is going to run the health care 
system. My concern about a number of the proposals that have been 
proposed have nothing to do with universal access, which I think we 
should all have. They have nothing to do with deal with preexisting 
conditions, which I think we should ensure are covered by all insurance 
plans.
  The issue of who is running the system, I think, is crucial, because 
if we have a Federal Government running the system, it is going to 
involve more and more and more of this.
  I believe we have to stay with the type of system we have. We have 
to, in the legislation we develop, ensure that we continue to have an 
efficient, well-operating health care system that provides good 
service, as the current system does, and makes sure that it is 
available to everyone. That should be our goal.

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