[Congressional Record Volume 143, Number 2 (Thursday, January 9, 1997)]
[Extensions of Remarks]
[Pages E89-E90]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   SUPPORT FOR H.M.O. PATIENT REFORM

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Thursday, January 9, 1997

  Mr. STARK. Mr. Speaker, on Tuesday, January 7, I introduced 
legislation to provide a comprehensive set of consumer protections for 
people in managed care plans.
  One of my proposals is that Medicare and Medicaid should not start 
monthly payments--which can amount to somewhere between

[[Page E90]]

$300 and $700 a month--for a new HMO enrollee until that HMO actually 
meets with the enrollee, shows them how to use the system, and 
establishes a basic health profile on the individual. Today, an HMO can 
receive thousands of dollars in payments before it ever sees a patient 
or tries to maintain their health.
  How can an HMO truly be a health maintenance organization, if it 
doesn't know what the health of the person is, whether the person is 
overweight, smokes, needs innoculations, has high blood pressure or 
diabetes, et cetera, et cetera?
  Last August, the Public Policy Institute, part of the Division of 
Legislation and Public Policy of the American Association of Retired 
Persons, issued an excellent paper entitled, ``Managed Care and 
Medicare.'' The paper--which does not necessarily represent formal 
policies of the association--recommended:
  Health plans should be required to conduct a comprehensive health 
assessment of new patients upon enrollment, followed by specific 
provisions for improved access to primary and specialty care on a 
routine basis.
  This is precisely the idea in my legislation, and I hope other senior 
and patient advocacy groups will consider this proposal and how it 
would help eliminate many of the abuses in the current enrollment of 
Medicare and Medicaid beneficiaries.

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