[Congressional Record Volume 144, Number 2 (Wednesday, January 28, 1998)]
[House]
[Page H75]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                MORE CHOICE IN MEDICAL TREATMENT NEEDED

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Pennsylvania (Mr. Klink) is recognized for 5 minutes.
  Mr. KLINK. Mr. Speaker, I rise today to say to my colleagues, I was 
so happy last night to hear the President in his State of the Union 
speech talk about giving our constituents, the people of this country, 
the opportunity to choose the doctor of their choice and, together with 
that doctor, decide what kind of treatment they want.
  Over the past week and a half, back in the Fourth Congressional 
District of Pennsylvania, which is around the city of Pittsburgh, I 
have been holding some fact-finding sessions on health care. The reason 
we did this is because we kept getting calls, either from doctors or 
other health care providers, who were distraught, and that is the only 
way to describe them, because they could not be included in an HMO 
network where their patients had purchased the insurance.
  On the other side you had patients who, because of the high cost of 
insurance, are being herded into HMOs, thinking that they have the 
choice of their doctor, only to find out that they have a primary care 
physician that they can choose among a group, or one is assigned to 
them, and only that physician can decide whether they can go to another 
doctor, whether they can see a specialist, or what hospital they can go 
to. And all of a sudden, particularly for those of us who live in the 
Pittsburgh region, where Dr. Jonas Salk 4 decades ago solved the 
solution to polio, where, during the 1970s and 1980s, great doctors 
like Thomas Starzl developed transplant surgery and antirejection drugs 
so that people can get new organs, they can have their bodies repaired.
  What a great time to live in and what a great geographic region to 
live in, where people from all over the entire world would come to our 
Pittsburgh region for this medical treatment. Yet people who live right 
across the street from those hospitals, a block away from these 
doctors' offices, do not have access to those doctors, because their 
health care plan will not let them go there.
  So when the President said last night this is a decision that should 
be up to the person, as to where they get their health care, what 
doctor they see, it should be up to the doctor and patient together to 
decide how long you are in the hospital, what kind of medication you 
take, I was pleased to see Members on both sides of the aisle rise and 
applaud. It tells me that this Congress is serious about not acting as 
just Democrats or not acting just as Republicans, but acting as 
Americans, to give people the choice of the health care that they need.
  I saw people come into my hearing who had tears streaming down their 
face saying that their husband passed away. Now I do not have 
insurance, I am not old enough for Medicare yet. I have got a 
preexisting condition. I have got diabetes. I am going blind. What are 
my choices? Where do I get insurance?
  How about the 23-year-old kid, not any longer on their parents' 
insurance policy, out in the workplace, but in this day and age only 
capable of getting a part-time job? That is the new style in America 
today, work people 30 hours, 35 hours, 36 hours, just enough under the 
40-hour workweek so they do not get benefits. Then the insurance 
companies refuse to deal with an individual, just selling them an 
insurance policy.
  Back in 1993 and 1994, we had a debate on what was then called the 
Clinton health care policy. It was a very large, massive piece of 
legislation. I was on one of the committees of jurisdiction.
  I did not support that legislation. It seems that after we had that 
debate and we failed in a bipartisan fashion to decide how that 
trillion-dollar industry called health care is going to be operated, 
that the insurance companies now have taken it upon themselves. They 
now control the purse strings. It is not managed care; it is managed 
dollars. We are not managing the care, where we are telling people that 
you have access to that care; we are managing the amount of resources.
  So a primary care physician is appointed by a health insurance 
company. They know that he or she will only be successful if they give 
a limited amount of referrals out of network, or a limited amount of 
referrals to specialists. So those kind of referrals, in many 
instances, are very hard to come by.
  We heard story after story of people who were released from the 
hospital too early. One gentleman in his seventies, with a Medicare 
HMO, was in an automobile accident. His wife was in the car accident 
with him. She had trauma to her heart in the accident. She was not hurt 
as seriously as he was though. He had kidney damage, had to have a 
catheter, had the orbit bones in his face broken. They took him from 
Westmoreland County into the city of Pittsburgh to the University of 
Pittsburgh Medical Center, where all the wonderful transplant 
procedures are done. Because they did not know how they were going to 
treat these broken orbit bones, they released him from the hospital on 
a stretcher in an ambulance.
  Those stories are too frequent, they are too sad. People must have 
the choice. Health care must be affordable.

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