[Congressional Record Volume 143, Number 144 (Thursday, October 23, 1997)]
[Extensions of Remarks]
[Page E2067]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          REPEAL OF PRIVATE FEE-FOR-SERVICE PLANS IN MEDICARE

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                       Thursday, October 23, 1997

  Mr. STARK. Mr. Speaker, I am today introducing legislation to repeal 
the option of private fee-for-service plans under Medicare+Choice which 
was enacted this summer as part of the Balanced Budget Act.
  These plans make no sense whatsoever. The CBO did not assign any 
costs to them, because they basically assumed no one would be foolish 
enough to join one. But the plans hold some potential for further risk 
segmentation and consumer abuse and should therefore be repealed.
  This proposal, which came from the Senate, provides an individual 
with the equivalent of an amount of money equal to the amount that 
would be spent on them if they joined an HMO in their area and allows 
them to use that voucher to buy into an unmanaged fee-for-service plan, 
which has none of Medicare's billing or utilization protections. In 
terms of out-of-pocket expenses, the sky would be the limit and the 
insurance nature of Medicare would be gone.
  Who would be nutty enough to want to buy into one of these plans, you 
ask? The very, very rich who don't have to think about medical bills 
might be interested. It could be a sort of boutique status symbol and 
sold as a plan which attracts the very best doctors who would like to 
charge more. If this Beverly Hills policy were the only danger, one 
could look the other way. But there is the danger that salespersons 
could convince some vulnerable senior to join such a plan without 
understanding the tremendous extra liability they would face. There is 
a danger that in certain rural or isolated communities a group of 
doctors could force patients to accept this plan as the only option--
thus increasing their income while destroying Medicare' protections.
  This proposal is the brainchild of some in the right-to-life 
community who believe that Medicare payment rates are so strict that 
some doctors may not provide adequate care under traditional Medicare. 
Therefore, to avoid euthanasia one can join one of these plans and let 
your doctor charge you extra. It is too bad that those who care about 
killing seniors spend so much time helping the rich find fire escapes, 
and so little time helping the uninsured and those who are not rich 
live in a good system.
  Mr. Speaker, there is no evidence of access or quality problems in 
the current Medicare system. Indeed, the latest data from the Physician 
Payment Assessment Commission shows that the major access problem 
facing seniors is lack of money to pay the 20 percent co-payment--not 
the fact that we pay doctors on a fee schedule.
  The private fee-for-service option is a mischievous amendment that 
does not good and has potential for harm. Repeal would remove a wart 
from the Medicare Program and ensure that we all--rich and poor--seek 
to keep the system a quality system.

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