[Congressional Record Volume 143, Number 146 (Monday, October 27, 1997)]
[Senate]
[Pages S11229-S11230]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    EFFECTS OF HEALTH CARE MANDATES

  Mr. GRAMS. Mr. President, I wanted to be here today just to make some 
brief comments in support of the Medicare Freedom To Contract Act, S. 
1194.
  During my first term in the 103d Congress, I witnessed President 
Clinton attempt a Federal takeover of fully one-seventh of our Nation's 
economy through a nationalized health care system. I was opposed to it 
then and I remain adamantly opposed to it today.
  Over the past 2 years we have seen a step-by-step encroachment by the 
Federal Government into the health care system.
  Despite overwhelming public opposition to his attempt to take over 
the health care system, President Clinton still seems to be intent on 
imposing his vision of socialized medicine on the American people.
  In fact, on September 15 of this year, the President admitted that he 
has not abandoned his goal of forcing a nationalized health care 
system. He stated, ``Now what I tried to do before won't work. Maybe we 
can do it in another way. That's what we've tried to do, a step at a 
time, until we finish this.''
  I am sorry to say that the Republican-led Congress has been a great 
service to the President by incrementally adopting and implementing 
more and more of his 1994 health care scheme. While I supported the 
heralded Kassebaum-Kennedy Health Insurance Reform Act, which did 
accomplish some needed reforms, I have concerns about how this law has 
since been implemented.
  In addition to its original mandate, we have a host of so-called 
``body part'' protections and coverage mandates which will create a 
precedent for total Federal control over health insurance packages and 
thereby ultimately a Federal health system. I have always believed that 
the American people should have the fundamental right to choose where, 
when and how they receive their health care services. If individuals 
choose to enroll in health maintenance organizations, let them. If they 
want to join a preferred provider organization, let them. If they would 
like to opt out of health insurance altogether or to pay for the 
services as they are received, then let them. Clearly, I am not in a 
position to determine what their needs are or what plan would best suit 
their family and their budget, nor is any bureaucrat in Washington able 
to determine the coverage best suited for each individual in the United 
States.
  Now, that brings us to the recently enacted Children's Health 
Initiative. I opposed the Balanced Budget Act in large part because of 
this grossly overfunded, new Federal entitlement. Again, another ``step 
at a time'' that the President says we need to take until we have a 
total Government-run health care system.
  Let me be very clear. I am very fully in support of ensuring access 
to health insurance for children. However, I have never believed that 
this was a Federal issue. As a Minnesotan, I witnessed the creation of 
a State program in 1992 which has provided access to health insurance 
to thousands of children in my State of Minnesota. It is called 
MinnesotaCare.
  Now, this State program gives access to State subsidized private 
health insurance to families up to 285 percent of the Federal poverty 
level. The Federal Children's Health Initiative provided no 
consideration to the States which have made a commitment to providing 
access to health insurance to children or their families. In effect, 
the Federal Government has now spent $24 billion on a program which 
clearly will not work in every State. In fact, it will penalize States 
like mine which have already made significant progress in covering 
children, and this illustrates my point very well. Washington cannot 
make the health care insurance decisions for everyone.
  One of the most important corrections needed in the Balanced Budget 
Act is the Medicare Freedom to Contract Act. This was introduced by 
Senator Kyl which I have cosponsored. This act tries to correct what is 
probably the most egregious example of what President Clinton's vision 
of Federal Government as provider and protector has in store for us.
  While the Balanced Budget Act included a provision which allows a 
Medicare beneficiary to contract for health care services privately 
with a physician, it effectively prohibits this from happening by 
forcing that physician to opt out of treating any other Medicare 
patients for 2 years. What the President has done is to blackmail 
doctors and to deny senior citizens the basic right of spending their 
money as they see fit.
  Even in the United Kingdom, which has had socialized national health 
service since 1948, it allows its citizens to pay for services outside 
the national system. Clearly, Americans can do better than that and at 
least Americans deserve the same option. This is unfair to seniors. It 
is unfair to physicians. And it must be corrected quickly.
  Opponents of the Medicare Freedom to Contract Act claim that it will 
force seniors to pay 100 percent of a physician's charge for their 
services, and it would mean an immediate and dramatic increase in out-
of-pocket costs for physician services.
  This is simply untrue. No Medicare beneficiary is required, nor 
implicitly encouraged, to contract privately with a physician. This act 
merely makes it possible for seniors to do so if they choose to do so. 
But the opponents are ready to come to the floor to filibuster any 
opportunity to discuss this issue or to get a vote on it. And President 
Clinton has also threatened to veto the bill should it pass.
  Now, he put the provision in the BBA in the middle of the night 
without debate, another step again toward the President's desire for a 
nationally run health care program. And he says he will veto any 
efforts to stop it. Is this what Americans want? The American people 
strongly rejected it in 1994, and they don't want it now.
  Mr. President, I find it completely amazing that there are 
individuals who believe it is wrong to allow seniors more options and 
more choices in how

[[Page S11230]]

they receive their health care services. Indeed, as the Balanced Budget 
Act aimed to provide more choices to seniors through the Medicare Plus 
Choice Program, the Medicare Freedom to Contract Act is the logical 
extension of the Medicare Plus Choice Program. It creates yet another 
option for our seniors.
  In fact, a case can be made that if seniors contract privately with 
their physician for services and do not bill Medicare, it will save 
money. It will extend the life of the Medicare Program beyond the 10 
years the Balanced Budget Act supposedly will do.
  Finally, Mr. President, we have many lessons to learn about the 
effects of health care mandates. However, denying seniors the option of 
using their own money to pay for their own health care is a lesson in 
Government that's gone mad, and that is a lesson we have all learned 
too well already. I urge my colleagues to support this needed 
correction.
  I thank the Chair. I yield the floor.
  The PRESIDING OFFICER. The majority leader.

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