[Congressional Record Volume 141, Number 126 (Tuesday, August 1, 1995)]
[House]
[Page H8143]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
THE MOST IMPORTANT CHALLENGE IN FIXING THE MEDICARE CRISIS: PREVENTING
THE PART A TRUST FUND BANKRUPTCY
The SPEAKER pro tempore. Under a previous order of the House, the
gentleman from Pennsylvania [Mr. English] is recognized for 5 minutes.
Mr. ENGLISH of Pennsylvania. Mr. Speaker, addressing the crisis in
Medicare by preventing the Part A trust fund from going bankrupt may be
the most important and the most difficult challenge for this Congress.
Mr. Speaker, Medicare is part of a social compact we have with
America's seniors. We in Congress serve as fiduciaries for this
program, charged with the ultimate responsibility for its solvency.
This spring the Medicare board of trustees, including three members
of the Clinton Cabinet, reported that Medicare will start running a
deficit next year, and will be broke by the year 2002. Medicare will be
broke in 7 years. Since then, we have been inundated with speculation
on why this crisis happened, whose fault it is, and even whether the
crisis is for real. Frankly, Mr. Speaker, sometimes in this debate
there has been more heat than
light.
Mr. Speaker, as a Member of the Committee on Ways and Means, I have
been seeking a legislative solution to the Medicare crisis which
simplifies and strengthens the program, while preserving it for future
generations. Congress must find this solution quickly and get it right,
or we will leave the public to face draconian budget cuts for seniors,
or punitive tax increases for working families.
With the extremely short period of time Congress has to formulate a
solution, I think it is vitally important to follow a three-step
approach: Item one, to clean up the fraud and abuse; item two, to
legislate a solution which preserves and protects senior benefits; and
three, make sure the crisis does not happen again.
With this in mind, I have introduced two separate pieces of
legislation to address the most overlooked aspects of the process,
cleaning up the fraud, and establishing a mechanism to allow for a
faster and less political approach to the threat of bankruptcy, to
ensure that we never get to this point again.
Mr. Speaker, the costs of fraud and abuse to the health care system
in general are staggering, with as much as 10 percent of the U.S.
health care spending being lost to fraud and abuse every year. Over the
past 5 years, estimated losses from health care fraud totaled about
$418 billion, or as much as four times the cost of the entire savings
and loan crisis to date.
Two of the most severely abused programs are Medicare and Medicaid.
An extensive report compiled by one of our Senate colleagues states
that for these two programs, the Federal Government pays out over $27
billion every year in fraudulent claims. These figures are even more
disturbing in light of the fact that only a tiny fraction of the bad
boys who rip off the Federal health care programs are identified and
prosecuted. Even when they are caught, they are often allowed to keep
right on doing business with the Federal Government, and with other
health care plans.
For example, an alarming number of allegations of fraud and abuse
have been leveled against agencies that provide services to homebound
elderly and disabled. In February of this year the HHS inspector
general proposed that ABC Home Health Services, Inc., which provides
home health care services in 22 States through 40 wholly-owned
subsidiaries, should be excluded from Medicare and State health care
programs for a period of 7 years for padding its cost reports with
false and fraudulent entries that were unrelated to Medicare patient
care. This is simply unacceptable.
Mr. Speaker, to combat this problem and to provide an initial
fundamental step in Medicare reform, today I introduced the House
version of Senate legislation to expand criminal and civil monetary
penalties for health care fraud, to ensure a stronger, better-
coordinated efort in deterring fraud. Mr. Speaker, looking ahead to the
future of Medicare, looking at ways to protect its solvency and provide
a faster, fairer, nonpartisan process for controlling costs, today I
introduced legislation to create an independent Commission on Medicare.
The Commission to Save Medicare Act of 1995 is designed to
permanently protect the Medicare trust fund. The Commission proposed in
my legislation would consist of seven members chosen in an entirely
bipartisan manner, appointed by the President, and subject to Senate
confirmation. The members would serve full time, and would consist of
people who are nationally recognized for their expertise in health care
policy. The Commission would report to Congress and to the President
annually on the per capita value of services delivered of the Medicare
benefits package and the projected growth in the program expenditures.
In April of each year, Congress would set a target for Medicare
spending for the upcoming year.
Mr. Speaker, I believe the combination of this Commission and the new
sanctions against fraud and abuse will make the Medicare Program
solvent in the long haul, and that has to be part of our solution.
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