[Congressional Record Volume 141, Number 160 (Tuesday, October 17, 1995)]
[House]
[Page H10084]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




           MORE COMPREHENSIVE DEBATE NEEDED ON MEDICARE PLAN

  The SPEAKER pro tempore. Under the Speaker's announced policy of May 
12, 1995, the gentleman from Illinois [Mr. Durbin] is recognized during 
morning business for 5 minutes.
  Mr. DURBIN. Mr. Speaker, if the Gingrich Republican plan to cut $270 
billion out of Medicare is such a good idea, why were there no 
committee hearings to speak of? Why was this bill not brought to the 
floor so Members could have an opportunity to amend it and debate it at 
length?
  In fact, this week on the floor of the House of Representatives in 
Washington, DC, we will consider this $270 billion cut in Medicare, the 
biggest cut in the history of this program, with only a handful of days 
of hearings in various committees, and a very limited opportunity for 
debate. It is no surprise that over the weekend, if you read the New 
York Times, you find that more things are starting to trickle out in 
terms of what is included in this Medicare change.

                              {time}  1300

  Some of the changes that are being proposed are absolutely horrible. 
One of the worst relates to the fraud and abuse of the Medicare system. 
Most of the people that we talk to, who are on Medicare, believe the 
system needs to be changed and improved. I certainly do.
  One of the first places they suggest that we turn to is to stop 
overbilling, stop the overcharging of the Government for medical 
services. We know that the vast majority of health care providers under 
Medicare are honest, ethical people. The doctors, the hospital 
administrators, those who provide various medical equipment and medical 
supplies are by and large very honest people, but 1 or 2 percent of 
them are not and they cost us as taxpayers dearly.
  The General Accounting Office estimates that about 10 percent of all 
the billing to Medicare each year is fraudulent, to the tune of about 
$18 billion a year, more than enough to make Medicare a sound system 
for years to come. Unfortunately, if we look closely at what Mr. 
Gingrich has proposed under his Medicare reform, we find instead of 
tightening it up to eliminate the fraud and to eliminate the abuse, the 
gentleman takes a step in the opposite direction. He lifts the burden 
now put on Medicare providers so that they cannot be guilty of self-
referral.
  What is self-referral? OK. A senior goes to the doctor, the doctors 
takes a look at the person and says, ``I think you need a test.'' Now, 
how many of us would argue with a doctor at that point? ``If I need a 
test, Doctor, and you think it is right, let us do it.'' But we found 
out something curious. If the doctor owns the laboratory that performs 
the test, the inspector general's office finds out that 45 percent more 
tests are ordered.
  The doctor is not only making money out of the examination, the 
doctor is making money out of the test. In fact, they are overtesting 
the patients, beyond what they need for good health care. We put in 
some regulations and said let us put an end to it. If a patient needs 
it, if a patient needs a test, let us do it, but this sort of self-
referral so that some doctors who own the labs can make more money is a 
rip-off.
  Well, guess what? Along comes the Gingrich Medicare proposal and the 
whole question of self-referral is pushed to the back.
  Then there is a question of kickbacks. We honestly found in the last 
2 years dramatic instances of kickbacks, where one group of physicians 
was referring to another group of physicians, when it was totally 
unnecessary, and the second group of physicians would kick back some 
money to the first group for the referral. In one instance, one group 
paid over $300 million in fines for these kickbacks under Medicare. In 
the second instance, over $150 million in fines.
  So what does the Gingrich Medicare bill do about this? Sad to say, it 
makes it easier for this kind of kickback to take place. It reduces the 
likelihood that any medical provider is going to be found of any kind 
of criminal penalty as a result of this kind of waste and abuse.
  Mr. Speaker, there should be things Democrats and Republicans agree 
on in this town when it comes to Medicare. The first and foremost of 
these should be that the seniors should not be ripped off, they should 
not pay more out-of-pocket for medical care than they ought to, but, 
more importantly is, taxpayers should not be ripped off.
  Why in the world at a time when we are facing these deficits should 
we allow this Medicare system to become so lax and so flabby that, in 
fact, it is overcharging taxpayers to the tune of more than $18 billion 
a year? So along come my Republican friends, having sat down and struck 
a deal with the doctors of America, the AMA, and they are going to 
relax the standards when it comes to waste and fraud. That is not fair. 
I do not think anybody in this country believes that is fair. It may be 
a sweetheart deal, but it is one that should see the light of day.
  Mr. Speaker, it should trouble everybody listening to this that the 
fact is we are going to consider the most significant change in 
Medicare this week by the Gingrich Republicans without the light of 
day, without an opportunity to bring these proposals before the public. 
We will hear about them, but I hope we hear about them before it is too 
late.

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