[Congressional Record Volume 144, Number 99 (Wednesday, July 22, 1998)]
[House]
[Page H6173]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




             RESULTS OF GOVERNMENT MEDDLING IN HEALTH CARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Tennessee (Mr. Duncan) is recognized for 5 minutes.
  Mr. DUNCAN. Mr. Speaker, we will soon pass some type of patients 
rights bill, and we need to do this. But it is really sad that it is 
necessary to do this.
  Prior to the mid-1960s, medical care in this country was of high 
quality and very low cost. The cost was low and flat for many, many 
years. Then the Federal Government got into medical care in a big way 
and costs exploded and we got things like HMOs.
  The government took what was then a very minor problem for a very few 
people and we turned it into a very major problem for everyone. Almost 
everyone, with the exception of Bill Gates and Warren Buffett, could be 
wiped out by some type of major medical catastrophe.
  All the government has done is to do what it has always done best, 
make a very few filthy rich at the great expense to the very many.
  Look at nursing homes. Those few who were lucky enough to get into 
the nursing home business, those favored enough to get nursing home 
licenses, have gotten rich because of government restrictions on the 
number of nursing homes and the overregulation that always drives small 
operators out.
  The result: The cost of nursing home care is probably double or 
triple what it would be if the government had stayed out and had let 
the free market operate.
  Medical care is the only thing we are paying for through a third-
party payer system. If we bought cars this way, a Yugo probably would 
have cost $300,000. When someone else is footing the bill, cost no 
longer matters and everyone wants the most expensive product or 
treatment available. Thank goodness most of us are not paying for food 
through a third-party paying system.
  A few years ago, I asked a hospital administrator in my district what 
would happen if the government got totally out of medical care. He told 
me that prices would go down 50 percent within days, and probably 
another 50 percent over the next 6 months. So, they would very quickly 
be 25 percent or less of what they are now.
  Obviously, though, we cannot dismantle this overpriced and unfair 
system that we have now. Too many doctors, hospitals, and medical 
businesses would scream to high heaven if we did. So what should we do? 
Realistically, all we can do is reform around the edges and hope the 
system does not become even worse and even more expensive.
  Medical savings accounts or medical vouchers would help some, because 
they would give people some incentive to shop around. But what I really 
want to do tonight is read a portion of a column from yesterday's 
Washington Post by James K. Glassman, who is consistently one of the 
very best commentators on the political scene today.
  Mr. Glassman wrote, ``Employers today foot most of the bills for 
health insurance, so they determine the policies their workers get. As 
costs soared in the 1980s, employers turned to HMOs and managed care, 
restricting their workers' choices.
  ``Health insurance policies aren't really 'insurance'; their purpose 
is to prepay medical costs that are predictable or inexpensive, like 
checkups and flu visits. This is like auto insurance paying for an oil 
change. But since Uncle Sam is footing a big part of the bill, it makes 
sense for health `insurance' to be all-inclusive, with low deductibles.
  ``Employees have little incentive to self-ration the care they get. 
Imagine a tax subsidy for food insurance, provided by your employer. 
You would naturally buy steak instead of chicken. Soon, however, the 
insurer would respond by limiting your steak-buying to once a month, or 
by forcing you to buy all your food at a specific grocery chain with no 
steak in its coolers. Given this restricted choice, you would probably 
rush to a politician to complain.
  ``The solution for health insurance is to end the tax subsidies, 
which currently cost the Treasury more than $100 billion a year. 
Instead, give that money back to individual Americans either through 
tax credits or rate reductions that would leave more money in their 
pockets. We should probably require everyone to have some type of 
catastrophic insurance (say, for expenses over $2,500), and the 
government should foot the bill for the poor through insurance vouchers 
(like food stamps).
  ``Then we would have a real market with far less paperwork and with 
people buying the sort of insurance they really want . . . not just 
what their employers force them to take. The final insult of the tax 
exclusion is that it mainly benefits those who need it least. The Lewin 
Group found that 64 percent of subsidies in 1996 went to families 
making $50,000 a year or more, while 11 percent went to those making 
less than $30,000.
  ``Instead of pandering to fear,'' Mr. Glassman wrote, ``politicians 
should level with voters. End the tax exclusion and let people buy 
their own health policies. Insurance companies, which benefit from 
billions in subsidies, might howl, but choices would broaden, costs 
would fall, and paperwork would be drastically reduced and the 
destructive cycle of excess, cutbacks in care, and political 
intervention would end.''

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