[Congressional Record Volume 140, Number 146 (Saturday, October 8, 1994)]
[House]
[Page H]
From the Congressional Record Online through the Government Printing Office [www.gpo.gov]


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

 
                      OPPOSITION TO MEDICARE CUTS

  Mr. HATCH. Mr. President, while much attention has been given to 
health care reform issues during this Congress, next year we will 
return to debate many of the same issues. This year we discussed many 
aspects of reform: universal coverage, employer mandates, tax credits, 
insurance market reform, and medical liability reform to name a few. 
Today, I want to highlight one area of health care reform that received 
considerable focus, namely Medicare cuts. While I oppose generally the 
use of Medicare cuts as a financing mechanism for health care reform, I 
want to take a moment and describe two particular Medicare cuts that 
will affect patient care and quality.
  These cuts are made to laboratory services in the form of mandatory 
copayments to Medicare beneficiaries and the imposition of a 
competitive bidding proposal for regional laboratory services. Both of 
these provisions were included in President Clinton's Health Security 
Act and it is my hope that in the name of quality health care and 
fairness to our Nation's senior citizens, they are not included in any 
plan proposed during the next Congress.
  Let me begin by discussing the imposition of a mandatory copayment 
for laboratory services. This provision would save the Federal 
Government $8 billion over 5 years--however, that $8 billion will be 
paid by elderly Medicare beneficiaries, many of whom are least able to 
pay.
  In addition, the amounts in question to collect for individual tests 
are often so small that they do not merit collection. A coinsurance 
payment of 20 percent of a $20 lab charge is $4 dollars; on a $50 lab 
fee the payment is $10. Imagine the amount of record keeping and the 
cost of generating a bill to obtain $4 from a beneficiary. Laboratories 
estimate that the additional billing and collection requirements would 
average between $3 and $5 just to produce the additional invoice 
covering the coinsurance. And, we all know it sometimes takes more than 
one bill to be sent before payment is ever received. And, there are 
questions as to whether the laboratory can even waive copayment because 
of the limitations imposed by Medicare fraud and abuse statutes which 
may prohibit the waiving of such payments.
  These figures do not even begin to account for the confusion that 
could be created among seniors by the receipt of additional paperwork 
and bills. For seniors, a streamlined and simplified billing process is 
one of Medicare's important attributes.

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