[Congressional Record Volume 143, Number 149 (Thursday, October 30, 1997)]
[Senate]
[Pages S11405-S11406]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




              MEDICARE BENEFICIARY FREEDOM TO CONTRACT ACT

  Mr. KEMPTHORNE. Mr. President, I am pleased to rise this morning in 
support of S. 1194, the Medicare Beneficiary Freedom to Contract Act. 
This legislation is another step in our continuing effort to give the 
Nation's senior citizens something they have lacked for far too long--
real choice in health care.
  I believe we are fortunate that a provision added to this year's 
Balanced Budget Act has served to focus our attention on a very 
important and basic freedom. I'm talking about the freedom of 
individuals, regardless of age, to choose how they are going to spend 
their health care dollars. When the Senate first debated this issue, I 
wholeheartedly supported the idea of ``private contracting'' for two 
reasons. First, I heard from numerous Idahoans who feel they are losing 
their choice of doctors because of Medicare's overly bureaucratic 
method of operation. As more and more health care providers refuse to 
accept Medicare, senior citizens are finding they no longer have access 
to the providers they wish to see. Allowing private contracting will 
provide seniors the chance to maintain the patient-provider 
relationships which are so important to them.
  Second, I support S. 1194 for an even more fundamental reason. I do 
not believe a nation, for which so many have sacrificed so much in the 
name of freedom, should tell senior citizens that they do not have the 
freedom to provide for themselves, even if they are perfectly able to 
do so. Many of our senior citizens are people who worked, and fought, 
during some of this century's most difficult times, yet current 
Medicare rules tell them we don't think they are capable of 
determining, for themselves, how to best meet their own health care 
needs. Mr. President, this implies that government bureaucrats don't 
feel those who survived the Great Depression and World War II, and 
helped make this Nation what it is today, are capable of understanding 
and meeting their own needs. What a ridiculous concept.
  Would we tell food stamp recipients that they could not use their own 
money to buy food, even if they worked hard to gather the financial 
resources needed to feed themselves? Would we tell someone in 
subsidized housing that they may not use their own resources to move 
into a home which they could call their own? The answer to both these 
question is, of course, no. In fact, I would be willing to guess that 
anyone suggesting such an idea would be laughed right out of this 
Chamber. Yet, there are those who don't believe senior citizens should 
be allowed to provide, voluntarily, for their own health care needs.
  Mr. President, the bill we are discussing this morning simply says 
that if you have the ability to take care of your own health care 
needs, and you wish to do so, you should be legally allowed to do so. 
Supporting it should simply be a matter of common sense.
  I have heard from numerous Idahoans who tell me they want the freedom 
to decide whether or not to use Medicare to pay for health care 
services. I have heard from numerous health care providers in my State 
who sincerely want their patients to have that choice. I trust the 
senior citizens of Idaho. I believe they are more than capable of 
making a decision about how to pay for health care services, and should 
be given the option to make that choice for themselves.
  The American people are intelligent. If you give them choices, they 
are certainly able to decide which option is in their best interest. 
During my tenure in the Senate, I have consistently worked to give 
Americans more choice, while reducing government intrusion in their 
lives. The Medicare Beneficiary Freedom to Contract Act accomplishes 
both of these goals, and I urge all of my colleagues to support it.
  Mr. CAMPBELL. Mr. President, today I join my colleagues in supporting 
the Kyl-Archer ``Medicare Beneficiaries Freedom To Contract Act.''
  When I first discovered that the version of this summer's Balanced 
Budget Act that was signed into law included such a drastic deviation 
from Congress' intent, which was to allow Medicare beneficiaries the 
choice to go outside the Medicare system for care, I was outraged. We 
agreed to ensure this freedom, not strangle it by kicking doctors out 
of the Medicare system for seeing Medicare patients on a private 
contract basis. By excluding physicians from Medicare for 2 years as a 
punishment for entering into a private contract, the law offers seniors 
a choice in one breath and takes it away in the next.
  If beneficiaries choose to pay for care out of their own pocket, that 
is their right. In no way does that constitute a criminal act. It is 
not an appropriate role for the Federal Government to be telling people 
how they can spend the money in their wallet--we already do enough of 
that with their tax dollars.
  The claims made for instituting such a restrictive law are unfounded. 
The assertion that seniors of significant means will be siphoned out of 
the system, creating an increased burden on the Medicare trust fund, 
makes several false assumptions. First, income and population 
statistics produced by the Social Security Administration indicate that 
nearly two-thirds of this country's over-65 population live at or near 
the poverty level, with less than 20 percent seniors earning more than 
$75,000 a year. Given that, it is doubtful that we'll see a wave of 
seniors rushing to contract privately and disrupting the Medicare 
system. Those same statistics also deflate the argument that droves of 
doctors will begin denying care unless patients agree to privately 
contract at a higher rate. The patients aren't there, leaving 
physicians strongly dependent--as they are now--on Medicare clients. 
Therefore, there is no threat of a two-tiered system of care, with only 
the wealthy having access to the best care. It is just not economically 
sound or feasible for a significant number of doctors to establish a 
``new tier'' of medicine.

[[Page S11406]]

  The concerns about rampant fraud and abuse resulting from private 
contracting seem to disregard some very compelling facts. For example, 
over the last 2 years, Congress has implemented strict penalties for 
Medicare fraud and abuse, including thousands of dollars in fines and 
jail time. We have seen people go to jail for committing Medicare 
fraud. I have medical professionals contacting me regularly because 
they are so fearful of inadvertently misbilling Medicare and winding up 
in jail or out of business. More importantly, however, Medicare 
beneficiaries are copied on all bills that Medicare pays for services 
they've received. If a doctor double-bills Medicare for services that a 
beneficiary has already paid for out of their pocket, that senior would 
be dialing Medicare's 1-800 fraud number faster than you or I could 
blink.
  Finally, Senator Kyl's bill would allow patients to terminate 
contracts at virtually anytime, which will force physicians who are 
interested in private contracting to offer services at reasonable and 
competitive rates. Consumers would finally be playing a role in the 
Medicare market.
  Choice and competition have emerged as the most viable and fair 
solutions for saving the Medicare Program and ensuring quality, 
affordable healthcare for generations of Medicare beneficiaries to 
come. This bill embodies those very concepts.
  Mr. President, I yield the floor and suggest the absence of a quorum.
  The PRESIDING OFFICER. The clerk will call the roll.
  The assistant legislative clerk proceeded to call the roll.
  Mr. LEAHY. Mr. President, I ask unanimous consent that the order for 
the quorum call be rescinded.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  Mr. TORRICELLI addressed the Chair.
  The PRESIDING OFFICER. The Senator from New Jersey.

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