[Congressional Record Volume 143, Number 139 (Wednesday, October 8, 1997)]
[Senate]
[Page S10715]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              MEDICARE BENEFICIARY FREEDOM TO CONTRACT ACT

 Mr. MURKOWSKI. Mr. President, I rise in support of the Medicare 
Beneficiary Freedom to Contract Act of 1997. This legislation protects 
the right of the elderly to be treated by the physician of their 
choice.
  Great reform of Medicare was achieved during the 1997 Balanced Budget 
Act: regulations were streamlined, greater flexibility was given to 
rural health care, and, most important, the Medicare trust fund--on the 
verge of bankruptcy--was salvaged for an additional 10 years.
  However, due to the administration's threat to veto the entire 
Balanced Budget act, the conference committee to the act added a 
requirement clearly infringing on the rights of senior citizens. The 
President's provision prohibits providers who privately contract from 
treating Medicare patients for a period of 2 years. Therefore, upon 
enactment of the 1997 Balanced Budget Act, it is now unlawful for a 
doctor to take a private payment from a Medicare-eligible patient if 
during the previous 2 years he has billed Medicare for any service 
rendered to a patient over the age of 65.
  What is the reality of the President's provision?
  The reality is that it will be almost impossible for a senior citizen 
to contract privately for medical services because few or no physicians 
are going to be able to make ends meet if they can't accept Medicare 
patients for 2 years. The reality is that, unlike every other insured 
American, senior citizens have no option but to receive the services 
that their insurance carrier, Medicare, recognizes and is willing to 
pay for. In essence, upon turning the age of 65, you have now lost a 
significant right--a right of choice in who provides your health care.
  Mr. President, even in the socialized medical system of Great 
Britain, choice is offered to the elderly. In Great Britain, a senior 
citizen has the choice to pay privately for his or her medical 
services. Don't the elderly of America deserve that same choice?
  To remedy this situation, I have sponsored legislation introduced by 
Senator Kyl of Arizona and Senator Nickles of Oklahoma. This 
legislation explicitly provides that any Medicare beneficiary can enter 
into an agreement with the physician or practitioner of their choice 
for any health care service and for any length of time when they choose 
to pay for such services out of their own pocket. In brief, the bill 
will ensure that Medicare-eligible beneficiaries who choose to pay out 
of pocket will have an unrestricted right to the health care provider 
of their choice. I cosponsored a similar bill two years ago.
  The American Medical Association has strongly endorsed this 
legislation. In a letter dated September 18, 1997, the AMA executive 
vice-president writes:

       The AMA believes that it is essential that Medicare-
     eligible seniors have the unfettered right to spend their own 
     money to buy health care if and as they so choose, 
     irrespective of coverage under the Medicare program. * * * 
     (this) bill is an urgently needed clarification of the law 
     and would greatly further the goal of providing Medicare 
     beneficiaries with more choices in their pursuit of health 
     care.

  I ask my colleagues to join me in support of this important 
legislation.

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