[Congressional Record Volume 144, Number 4 (Monday, February 2, 1998)]
[Senate]
[Pages S247-S248]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             MEDICARE BENEFICIARIES FREEDOM TO CONTRACT ACT

  Mr. KYL. Mr. President, I want to provide a brief update for my 
colleagues this morning on the Medicare Beneficiaries Freedom To 
Contract Act.
  This is the bill which has 46 cosponsors in the Senate, 150-some 
cosponsors in the House, led by the chairman of the House Ways and 
Means committee, Bill Archer, to restore the freedom to America's 
senior citizens to seek the medical care they desire rather than to be 
dictated to by the Medicare Program to only receive that care under 
Medicare that they may desire.
  Here is the situation as it evolved. Mr. President, up until January 
1st of this year, senior citizens in this country had always had the 
right under Medicare to go to the doctor of their choice, and if they 
wanted to be treated outside of Medicare they could do that. Of course, 
Medicare couldn't pay the bill. But that freedom always existed. As of 
a couple of years ago, the administration began to threaten physicians 
saying that they had to submit all bills for senior citizens to 
Medicare. The rationale was that anybody over 65 was ``Medicare 
eligible'' because they were 65, and if they were ``Medicare eligible'' 
then a doctor had to submit the bill to Medicare. So physicians began 
being concerned that they couldn't treat people outside of Medicare 
even though that had always been the patient's right and the 
physician's right.
  To ensure that situation wouldn't continue, I introduced an amendment 
last year during the negotiations--during the time we were negotiating 
the balanced budget amendment--and it passed here under a vote of 64 to 
35 to ensure that patients had the right to ``privately contract,'' as 
it is called, and go to the doctor of their choice; not necessarily to 
go to Medicare, if they didn't want to. That amendment passed. It 
became part of the Medicare portion of the balanced budget amendment. 
But in the middle of the night some negotiators from the House and 
Senate caved in to the President's demands that if the Kyl amendment 
stayed in then the entire balanced budget amendment would be vetoed 
and, therefore, caved into his demands that a special limitation be 
placed on any physician providing this care; namely, that the physician 
had to get rid of all of his or her Medicare patients for a 2-year 
period in advance or you couldn't treat the person outside of Medicare. 
That is what went into effect January 1st.
  This legislation that I just reported on will remove that 2-year 
requirement so that the patient has the freedom to go to the doctor of 
his or her choice. Even though you are over 65 years old, you don't 
have to be treated under the Medicare system if you do not want to be, 
and the physician has the right to take care of you without getting rid 
of his or her other Medicare patients.
  When did this situation arise? There are a lot of different 
situations. Take for example the psychiatric patient who doesn't want 
the records in Medicare to reveal the kind of treatment that patient 
has been receiving. Under the current administration plan--Medicare or 
no care--you either do it under Medicare or you don't get the 
treatment. No doctor can take care of you. Our bill would say no. You 
can go outside of Medicare and be treated. Again, you have to pay the 
bill--not the taxpayer. But you can do it.
  Another case: You are in a small town. There are not that many 
specialists. You need specialty care. You go to a doctor who says, ``I 
am not taking any more Medicare patients. The President and the 
Congress have cut our payments so much that it don't pay me anymore. In 
fact, I lose money on every one. I will take care of the ones that I 
have, but I am not going to see any more new Medicare patients.'' This 
enables the patient to say, ``Fine. Just bill me. I will pay you. We 
will save Medicare the money.'' And that will be the end of it.
  Another situation: You want to go to that specialist. Maybe it is a 
person who is on a university faculty who is not taking Medicare 
patients, and you want to be treated by that person because it is the 
one person that can save your life or your spouse's life. You ought to 
have the right to do that in this country. Under the current law that 
wouldn't be possible.
  So our legislation restores the right of senior citizens--and all the 
rest of us have this right--to go to the doctor of their choice, and if 
they want to be treated outside of the Medicare system have the right 
to do that. It does not enable the doctor to charge more money to 
Medicare. Whatever the doctor charges they have to pay outside of the 
Medicare Program.
  So this is not going to be used very often, I suspect. But in those 
situations where people really want to take advantage of their freedom 
in contract they ought to have the right to so.
  Mr. President, in conclusion, this is not something that is just of 
concern for America's senior citizens, because all of us should be 
concerned about a fundamental right being taken away from us--the right 
to provide the health care that we want for ourselves or our families.
  As the President is talking about making Medicare available to more 
and more people at younger and younger ages, I would have to ask them: 
Is it such a good deal to buy into Medicare when the first thing that 
happens when you do that is you give up a basic right that you have 
today--that every one of

[[Page S248]]

us has today--but doesn't exist for somebody who is 65 years old or 
older because they are Medicare eligible? It is not a good bargain.
  So what I am hoping is that the Finance Committee will hold hearings 
later this month--those hearings have already been set, I understand, 
by Senator Roth--and that there will be legislation coming to the 
floor, and our bill coming to the Senate floor very soon thereafter. 
And sometime in the early spring we can pass on to the President a bill 
which will restore the right of all seniors in this country to go to 
the doctor of their choice without being told by Medicare that they 
can't do that; that, in effect, it is either Medicare or no care. That 
is un-American. It is wrong. It denies the basic right of all 
Americans. And we need to ensure that we can correct that problem 
through the passage of the Medicare Beneficiaries Freedom Contract Act.
  In closing, if any one of my colleagues who have not done so already 
would like to sponsor the legislation, please see me because we will be 
moving forward on this very quickly.
  Thank you.
  Mr. GRAMM addressed the Chair.
  The PRESIDING OFFICER. The Senator from Texas.
  Mr. GRAMM. Mr. President----
  The PRESIDING OFFICER. I might say that under the order the Senator 
from Oklahoma reserved time at 12:30.
  Mr. GRAMM. I think I have sufficient time between now and then, Mr. 
President. Thank you.

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