[Congressional Record Volume 144, Number 140 (Thursday, October 8, 1998)]
[Senate]
[Pages S11892-S11896]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
MEDICARE BENEFICIARY FREEDOM TO CONTRACT ACT
Mr. KYL. I thank the Senator from Utah.
Mr. President, I rise with several of my fellow Senators in support
of S. 1194, the Medicare Beneficiary Freedom to Contract Act. S. 1194
currently has 48 Senate and 192 House cosponsors.
We believe that Medicare beneficiaries should have the same right to
obtain health care from the physician or provider of their choice as do
Members of Congress and virtually all other Americans.
It is dangerous to have the government control health care decisions
in a free society.
What is the problem addressed by this legislation?
The problem is simply one of health care choice for seniors--a
problem which has been brought to our attention by countless
constituents all over America.
As I have mentioned on the Senate floor several times, this problem
was first brought to my attention in a letter I received from Mr. and
Mrs. C.B. Howard of Prescott.
Mary Ann Howard is a diabetic. The medicine she was taking was not
working, and she wanted to change doctors to one who specialized in
treating diabetics.
Her doctor told her that this was not possible. Amazed, Mary Ann
asked why, and her original doctor replied that, due to the regulatory
and administrative burdens of the Medicare system, the specialist
cannot afford to take any more Medicare patients.
When Mary Ann--who had recently turned 65 and enrolled in Medicare--
asked the specialist if she could pay for the treatment out of pocket,
the specialist said no. ``If I accept you as a patient, I would be
accused of Medicare fraud.''
Yes, it's true: Because of a flawed interpretation of the Medicare
law, the government has barred Medicare beneficiaries from using their
own money to receive treatment from the doctor of their choice. It's
Medicare or no care!
To end this unfairness, the Senate passed the Kyl amendment to the
Balanced Budget Act of 1997 that would allow health care choice for
seniors.
But the Administration threatened to veto the entire budget over this
provision, and forced the Senate-House conference committee to include
a poison pill:
In order to enter into a private contract, a physician or other
provider would have to sign out of Medicare for two years.
The two-year exclusion presents your doctor with a difficult choice:
He can either treat you, his patient of 30 years, on a private contract
basis, and drop his other Medicare patients for two years; or refuse to
treat you in favor of his current Medicare patients.
Over 96 percent of doctors accept some Medicare patients and would
not likely be willing to impose such a hardship on their current
patients.
So your options will likely be reduced.
To remove this ``two year'' limitation on patient-choice, House Ways
and Means Chairman Bill Archer and I introduced the Medicare
Beneficiaries Freedom to Contract Act.
The bill removes the two-year exclusion and ensure that any Medicare
beneficiary can enter into an agreement with the provider of his or her
choice for any health care service.
In his 1998 State of the Union address, President Clinton said that
all Americans ``should have the right to choose the doctor they want
for the care they need.''
We could not agree more. But as of January 1 of this year, seniors no
longer have this right because, as I mentioned, the President insisted
last year's Balanced Budget Act be changed to effectively preclude
seniors from going outside of Medicare--even if they are willing to pay
for the care themselves.
S. 1194 could also be referred to as the Senior Citizens ``Medicare
Point of Service Option.''
Just as with a Point of Service Option in a private plan, this
``Medicare Point of Service Option'' would allow seniors to go outside
of the Medicare network to obtain care from the doctors of their
choice.
The only real difference is that the senior-patient would pay 100
percent of the cost of exercising this right, whereas the private plan
would subsidize this choice to some degree.
Sandra Butler, president of United Seniors Association, represents
the organization's 640,000 members who strongly support this bill.
United Seniors Association members believe that the government's view
of private contracting ``violates a basic--no, the basic--principle of
American life: freedom.''
In addition, a broad array of organizations have expressed support
for the case to overturn current law.
This group includes the Christian Coalition, the American Civil
Liberties Union, the Heritage Foundation, the American Enterprise
Institute, National Right to Life Committee, the American Medical
Association, the American Conservative Union, Citizens Against
Government Waste, and the National Center for Policy Analysis.
Opponents of the bill make three basic arguments: the bill will
increase fraud, will put seniors at the mercy of doctors and other
providers, and will hurt Medicare.
1. With respect to fraud, the bill contains extensive anti-fraud
measures, including the requirement of a written contract with clear
terms, such as the fact that the service could be paid for by Medicare.
2. Others believe that unethical doctors would take advantage of
vulnerable seniors.
Common experience with medical professionals who save lives without
reimbursement in emergency situations, and seniors who read and
question virtually every line in their Medicare bill, clearly refute
this claim.
Further, a senior can for any reason terminate the contract
prospectively and return to Medicare for the covered benefit.
3. Some believe private contracting will destroy Medicare.
However, private contracting will result in fewer claims being paid
out of the near-bankrupt Medicare trust fund.
We believe that the right of seniors to choose the health care
provider and benefits that suit their individual needs is essential to
our Nation's concept of liberty.
[[Page S11893]]
In fact, there is no more fundamental principle at stake in any
legislative issue before the Congress.
We must not be the Congress that denied seniors the right to spend
money they may have saved for years on a medical procedure needed for
themselves or a loved one.
Imagine a law that made it illegal for seniors to supplement their
Social Security check with private funds!
In sum, Mr. President, we believe that the Congress should enact
legislation that ensures that seniors have the right to see the
physician or health-care provider they want, and not be limited in such
right by the imposition of unreasonable conditions on providers who are
willing to treat seniors on a private basis.
Even Great Britain's system of socialized medicine gives its
beneficiaries this freedom.
Senators and their staffs have this freedom. Surely, America should
do no less for its seniors.
Mr. President, I take this opportunity to express my appreciation for
my colleagues' willingness to work with me to ensure seniors the
critical right of health-care choice.
I am joined by many of my colleagues in the Senate to ask the
Majority Leader, Senator Lott, and Senate Finance Committee Chairman
Roth, to work with us and the numerous outside organizations to address
this issue of Medicare freedom of health-care choice as soon as is
reasonable in the 106th Congress.
As we know, President Clinton and some of our colleagues on both
sides of the aisle want the government to continue to control all
medical decisions of seniors.
We must not rest until seniors are granted this basic civil right to
choose the doctors and benefits that best address their particular
health needs.
Mr. ROTH. Mr. President, I thank the majority leader and my
colleagues for bringing the important issue of Medicare private
contracting to my attention in this constructive way. The individual
stories described today on the floor illustrate why private contracting
has generating intense interest and deserves careful study.
Organizations including the United Seniors Association, American Civil
Liberties Union, Christian Coalition, American Conservative Union,
Heritage Foundation, National Right to Life Committee, CATO Institute,
and Citizens Against Government waste share the concerns with current
law and the belief that Medicare beneficiaries should be provided more
freedom-of-choice in Medicare. In the months ahead, I intend to work
closely with my colleagues here in the Senate to review the private
contracting provisions of the Balanced Budget Act of 1997.
(At the request of Mr. Kyl, the following statement was ordered to be
printed in the Record.)
Mr. HOLLINGS. Mr. President, I want to express my continuing
support for S. 1194, the Medicare Beneficiary Freedom to Contract Act.
It is ironic that the Balanced Budget Act--which purported to expand
seniors' freedom of choice--took away most of the rights they already
had to spend their own dollars to purchase health care of their
choosing. Many senior citizens and disabled individuals in my state are
outraged at this loss, and justifiably so. I must concur with the
comments made recently by Art Spitzer, legal director of the American
Civil Liberties Union of the National Capitol Area in an amici curiae
brief in United Seniors Association vs. Donna Shalala:
``. . . the government should be able to say `We are going
to provide a certain amount of health care, and that is how
much we will provide and we are not going to provide more
than that.' But it seems quite outrageous to us . . . that
the government could say `and you may not get any more health
care than we are willing to provide you, even if you and your
doctor agree that it would be good for you, even if you are
able to pay for it with your own funds.' ''
I ask that a letter I recently sent to the ranking member of the
Senate Finance Committee be printed in the Record.
The letter follows:
U.S. Senate,
Washington, DC, October 5, 1998.
Hon. Daniel Patrick Moynihan,
Ranking Member, Senate Finance Committee,
Washington, DC.
Dear Pat: As you know, the American Civil Liberties Union
of the National Capital Area has joined as an amici curiae
participant in the United Seniors Association vs Donna
Shalala lawsuit to enjoin enforcement of Section 4507 of the
Balanced Budget Act of 1997. I support the views expressed in
this lawsuit that Congress made a mistake in the Balanced
Budget Act by disallowing seniors from making the broadest
array of physician and medical point-of-service choices in
instances where they want or need services out of the
Medicare system badly enough to spend their own money. It
stepped far over the bounds of ``protection'' into erosion of
freedom.
I strongly supported requirements that physicians file
Medicare claims on behalf of beneficiaries. We've gotten the
program so complicated that hardly anyone understands it, but
doctors are better able to fight complex coding disputes and
coverage rules than their patients. Also, not getting paid
adds the incentive to resolve claim disputes while keeping
money in beneficiaries' pockets. Little did I realize this
protection would be used to restrict access to care. Section
4507 is an unwarranted intrusion on freedom of choice for
physicians and Medicare beneficiaries and adds unnecessary
costs to the Medicare that is already suffering financial
problems that scream for resolution.
While most of us are able to find satisfactory care for
which we are glad to have Medicare pay, many of my
constituents have given reasons why an individual may choose
to go outside the Medicare system from time to time. Take the
example of a Federal employee who retired to the Charleston
area after living sixty years in Washington. She wanted to
return to have eye surgery at the Wilmer Eye Institute at
Johns Hopkins but was prohibited from doing so because the
surgeon did not accept Medicare patients. She wrote me that
she is not wealthy and has chosen to live frugally so that
she has something left over after living expenses to spend as
she sees fit. ``What right does the Government have to tell
me I can't spend my own money to buy the health care that I
think I need,'' she asks. I have to agree that the Federal
Government telling us senior citizens what we can do with our
own money is simply unacceptable.
A great deal of confusion about Section 4507 remains. I
continue to believe we can reach a consensus that will permit
private contracting for seniors who choose to do so while
providing adequate protection for Medicare beneficiaries and
request that you give this matter your much respected expert
consideration early in the 106th Congress. If I can answer
any questions or be of any help, please don't hesitate to
call on me.
With kindest regards, I am,
Sincerely,
Ernest F. Hollings.
Mr. HOLLINGS. Mr. President, we clearly cannot move forward with
Medicare+Choice until the confusion over Section 4507 is resolved, and
I join my colleagues in urging your earliest consideration of this
matter in the 106th Congress.
Mr. GORTON. Mr. President, I speak today in defense of an essential
freedom--the right to make health care decisions outside of the
governmental bureaucracy. Yet there is a segment of our population--our
seniors--who have lost that freedom. At the administration's insistence
a provision was included in the budget reconciliation bill of 1997 that
prohibits physicians from participating in the Medicare program for two
years if they accept private payment for services normally covered
under the Medicare program from a patient who is eligible for
Medicare--essentially trapping our seniors in a government controlled
health care program.
It is clear that the provisions included in the Balanced Budget Act
are hurting seniors. One of my constituents stories was featured in the
Reader's Digest. Ray Perry wanted to pay for routine screening tests
for he and his wife because years before, prior to enrolling in
Medicare, the Perry's had conducted a similar series of tests and were
able to detect his wife's lymphatic leukemia very early when it was
still treatable. Medicare decided not to pay for the tests because the
Perrys didn't have certain symptoms that would indicate these tests
were required. But, when the Perrys offered to pay out of their own
pocket, the doctor still wouldn't order the tests for fear of being
penalized by Medicare. While both the Perrys and their doctor wanted
medical services that were clearly reasonable, and the Perrys were
willing to pay for these services, the restrictions currently found in
Medicare prevented them from getting the kind of health care they
needed.
It is unconscionable that in a nation founded on the principles of
freedom that we would limit the freedom of the Perrys and millions of
American seniors just like them.
Mr. CRAIG. Mr. President, I rise today to make a few remarks
concerning the Medicare Beneficiary Freedom
[[Page S11894]]
to Contract Act. Most Americans believe that should control their
health care to the greatest extent possible. Others continue to favor
comprehensive federal control of seniors, health care which results in
rationing. All patients should be able to choose their own doctors and
have complete freedom to supplement their insurance, including
Medicare, as they see fit. The right of seniors to pay out of their own
pocket for the health care of their choice is an essential element of
our nation's concept of liberty.
Under this Act, Medicare would pay the standard fee for the standard
procedures by the standard practitioner with private contracting
reserved for more specialized procedures. While it would be a right
that--because of economics--would be exercised only in special
circumstances, private contracting is a basic right every senior should
have. And importantly, it would provide a safeguard from government
manipulation--something which under the Clinton Administration is an
all-too-real possibility.
Under this act, seniors would be even less likely to privately
contract than they are to go to nonparticipating physician, because
with private contracting they agree to pay the full cost of the service
themselves (just as they historically have.) In fact, if the desire to
pay out-of-pocket were widespread, seniors wouldn't join Part B (which
is voluntary) at all. But seniors overwhelmingly choose Part B
insurance--just as most other Americans do in choosing doctor-visit
coverage in their health plans.
President Clinton said in the State of the Union that all Americans
must have the right to doctor choice, and assess to specialists without
referral. Why not seniors, too?
Mr. President, I believe that Americans are right when they tell me
in letters and phone calls and personal visits that they do not want to
be trapped by a one-tiered Medicare program. I think I am correct in
stating that senior citizens over age 64 are right in being angry at
all members of Congress and the Clinton Administration for denying them
their right to make any medical choice for themselves, to see any
physician they want for any service they want if they want to spend
their own money. It is for this reason, that I ask all my colleagues to
work with us to restore to seniors their right to privately contract
for any medical service with physicians of their choice. I look forward
to working with the distinguished Chairman of the Senate Finance
Committee, Senator Roth, and other Members of the Senate toward that
goal.
Mr. NICKLES. Mr. President, I thank the Chairman for his work and
support of this very important legislation.
I also thank Senator Kyl for his dedicated work on this issue. I was
pleased to join him as an original cosponsor of this bill, because I
believe that this is a fundamental issue of freedom for all senior
citizens. Every senior citizen should have the fundamental right to pay
out of their own pocket for the health care they want from the
physician they choose.
President Clinton has repeatedly stated, most recently in his State
of the Union address, that ``all Americans should have the right to
choose the doctor they want for the care they need.'' But apparently,
the administration does not believe this should apply to Medicare
beneficiaries. In fact, during the debate on the Balanced Budget Act
(BBA) of 1997, the administration repeatedly stated their opposition to
giving his unfettered freedom to senior citizens.
Finally, the administration agreed to drop their objections to this
provision if the BBA would grant seniors only limited freedom with
certain restrictions. In the spirit of compromise, the BBA included a
limited provision to allow physicians to enter into private contracts
for Medicare-covered services. Unfortunately, the provision in the BBA
did not go far enough.
Under BBA 97, in order to enter into these contracts, a physician or
other provider would have to opt out of Medicare for two years and sign
an affidavit, approved by HCFA, to ensure that no Medicare patients
were treated. But the two-year exclusion presents the doctor with a
difficult choice: either treat the patient on a private contract and
drop all other Medicare patients for two years; or refuse to treat the
patient in favor of current Medicare patients. This is a difficult
decision that neither a physician or beneficiary should be required to
make.
Now, one can argue that the reforms in the BBA were a step forward
for Medicare private contracting. If is true that HCFA had interpreted
Medicare law, prior to the passage of BBA 97, as effectively
prohibiting private contracts. In fact, HCFA had gone as far as
threatening physicians and other providers with fines and exclusion
from Medicare and even criminal prosecution. So if HCFA's
interpretation was correct, perhaps the provisions included in BBA 97
were a step forward.
On the other hand, many respected Medicare experts have suggested
that HCFA did, in fact, misinterpret the Medicare statute. In other
words, Medicare law did not prohibit private contracts, but rather it
was silent on the issue. As I read the Medicare law, prior to BBA, I
see nothing that prohibits Medicare beneficiaries and providers from
entering into these private arrangements. So if this interpretation is
correct, the provisions included in BBA could be viewed as a step
backward.
In either case, the right thing to do is to allow seniors unfettered,
unrestricted access to the doctor of their choice. The Kyl legislation
does just that. It would extend this right to Medicare beneficiaries
with no limitation, allowing Medicare beneficiaries to be treated for
Medicare-covered services by the physicians of their choice on a
``case-by-case'' and a ``patient-by-patient'' basis. No doctor who
chooses to enter into a private contracting arrangement with a senior
would be faced with fines or expulsion from the Medicare program.
Opponents of private contracting make two primary arguments against
this legislation: unethical doctors will take advantage of seniors to
increase their income; and it will result in excessive fraud and abuse
in the Medicare program.
The argument that perplexes me the most is the concern that unethical
doctors would take advantage of vulnerable seniors and use private
contracts to increase their annual income. If I were a Medicare
beneficiary I would be offended by the notion that I am unable to make
my own financial and medical decision. Senior citizens are some of the
most frugal and well informed health care shoppers in the country.
Additionally, if I were a physician, I would be offended by the
assumption that most doctors are unethical in their professional
activities. Any physician that were to engage in unethical or coercive
practices faces tremendous risks, including the loss of their medical
license for ethical violations.
I assume that those who believe physicians will use the Kyl
legislation to line their pockets would also be concerned with new
federal coverage mandates on private health insurance. Every federal
coverage mandate we place on health insurance providers increases the
cost of health insurance and increases the revenues of physicians. But
I haven't heard many members who are concerned that federal mandates
which require insurance companies to pay for a variety of treatments
may increase the profits of physicians. Do we assume that physicians
and other practitioners will be ethical when an insurance company is
paying the bill and unethical when a vulnerable senior is paying the
bill? The fact is that the opponents of this legislation simply want
more control over the health care of senior citizens.
The bill also contains strong consumer protection standards to ensure
that Medicare beneficiaries are not exploited. Private contracts must
be in writing, signed by the beneficiary, and identify the services
covered by the contract. It prohibits private contracts in emergency
situations, unless the contract was entered into before the onset of
the emergency medical condition.
Private contracts may only be entered into on a prospective basis and
may not apply to services rendered prior to the signing of the
contract. Such contracts must also notify the beneficiary that Medicare
is not responsible for the payment of any services covered under the
contract and that the beneficiary has the right to have such services
provided by other physicians or practitioners to whom Medicare payment
would be made.
[[Page S11895]]
Other opponents of this legislation argue that private contracting
will result in double billing and outright fraud. Perhaps the opponents
haven't looked closely at the extensive anti-fraud measures included in
this legislation. The legislation prohibits double payments by
requiring physicians and practitioners entering into private contracts
to submit to the Secretary such information as may be necessary to
avoid any payment under Part A or Part B for services covered under the
contract. Fraudulent billing would be detected and punished through
existing fraud and abuse laws and standard auditing procedures used by
Medicare and private plans. If Medicare did pay for a service, the
patient would receive a statement and could easily notify Medicare of
the payment error.
Mr. President, this legislation adequately addresses the concerns
that have been raised by the opponents. The integrity of Medicare
system is not at issue here. The defining issue is really quite simple.
This is a fundamental issue of individual freedom. Do you support
giving senior citizens the freedom to pay out of their own pocket for
the health care they want from the physician they choose? Or do you
support limiting that freedom and restricting the health care choices
available to senior citizens? I hope my colleagues will join Senator
Kyl in supporting this legislation and supporting individual freedom
for every senior citizen.
Mr. ALLARD. Mr. President, I rise today in support of Senator Kyl's
initiative to provide more choice for our nation's senior citizens. I
encourage the majority leader and Senate Finance Committee Chairman
Roth to continue to work to address the issue of private contracting so
that S. 1194 can be enacted into law.
I believe that our seniors should have the right to make their own
decisions when it comes to matters of their health. Somewhere along the
way, it has been mistakenly assumed that once a person reaches 65, they
no longer are able to make their own decisions and do not desire the
freedom of choice that others enjoy. Since when did the seniors of our
nation become so helpless? Shouldn't seniors be afforded the same
rights that the rest of us enjoy--to determine what is in their best
interest?
Current law does not permit seniors to purchase their own health care
services if those services are covered under Medicare and provided by a
physician who accepts Medicare payments. This is ludicrous. Not only
does this law take away rights of senior citizens, but these types of
regulations within the Medicare system also discourage the
participation of doctors. If a physician decides to accept a private
contracting fee, the doctor must give up all Medicare patients for two
years. In effect, this law has the potential of limiting physicians who
participate in the Medicare program. This could consequently decrease
the quality of physicians in the Medicare system because doctors refuse
to be part of such an oppressive system.
This issue is one of fundamental rights. No other government program
restricts the participants as does Medicare--including Medicaid and
health programs for government employees. Medicare beneficiaries should
be given the right to pay out-of-pocket and to choose their own health
care provider.
One of the guiding principles of this nation is individual freedom.
Congress should not support measures that clearly restrict freedom. I
urge the enactment of S. 1194, the Medicare Beneficiaries Freedom to
Contract Act.
Mr. MACK. Mr. President, I am pleased to be a co-sponsor of the
Medicare Beneficiary Freedom to Contract Act. I want to commend the
efforts of Senator Kyl, who introduced this important legislation and
who has worked so hard to secure its passage.
The central questions with respect to the issue of Medicare private
contracting are clear. It is the proper role of the Federal government
to deny Medicare beneficiaries the ability to use their own money to
get the health care services they believe they need? Is it good public
health policy to force doctors who treat Medicare beneficiaries on a
private-pay basis out of Medicare for two years?
I think these questions must be answered with a resounding ``no''. If
a Medicare patient--or any patient, for that matter--wants to spend his
or her own money to pay for a health care service, it should be their
decision and not the government's decision. I also believe it is wrong
to put a doctor in the position of having to decide between treating a
Medicare patient who chooses to pay out-of-pocket, or stop treating all
their other Medicare patients for two years.
The administration makes the argument that its opposition to this
legislation is based upon its desire to ``protect senior citizens''. I
certainly don't question the sincerity of their concern. However,
judging from the response my office has received, seniors neither want
nor need the Federal government to ``protect them'' from themselves.
Florida is home to the second largest Medicare beneficiary population
in the nation. My office has been deluged with thousands of letters,
telephone calls, faxes, postcards and telegrams from Medicare
beneficiaries who are, quite frankly, outraged that the Administration
is opposed to this legislation.
The communications I have received from seniors in Florida all have
common themes--How can something like this be happening in America? Is
this not a profound assault on the freedom of American citizens? What
right do you people in Washington have to tell me what I can and can't
do with my own money when it comes to my own health care? Who asked you
to make this decision for me?
I couldn't agree with them more. It is clearly wrong to take
important health care decisions out of the hands of patients and put
them into the hands of the Federal government. Moreover, this policy
results in a two-tiered system for those Americans who receive their
health care from the Federal government. Patients who are beneficiaries
of Medicaid, CHAMPUS, the Indian Health Service and Federal workers who
participate in the FEHBP, which includes most of us in Congress and our
staffs, may legally enter into private contracts with physicians of our
choice. But this is not the case for Medicare beneficiaries--because
the government supposedly knows what is best for them.
Isn't it also ironic that a citizen of Great Britain, with its
socialized health care delivery system, has the ability to privately
pay for medical services, but Medicare patients in the United States
are denied the ability to make this decision for themselves unless
their physician is willing to opt-out of Medicare for two years?
To me, this issue exemplifies one of the most fundamental differences
I have with this Administration when it comes to either health care
policy or the proper role of the Federal government in general. This
absurd policy is simply another example of big government run amok, and
it's time to put a stop to it. The Senate should pass the Medicare
Beneficiary Freedom to Contract Act now.
Mr. GRASSLEY. Mr. President, the issue of private contracting in the
Medicare program is very important to my constituents in Iowa. I have
received hundreds of letters asking Congress to repeal the provisions
in the Balanced Budget Act of 1997 requiring physicians who enter into
a private contract with beneficiaries to opt out of the Medicare
program for two years. Seniors in my state believe it is not the role
of the federal government to interfere with relationship with their
physician. They want to have as many choices and options as possible. I
want to make sure their freedom is protected. That is why I want to
thank the majority leader, Senator Lott, and the chairman of the Senate
Finance Committee, Senator Roth, for recognizing the importance of this
issue to our nation's seniors and for agreeing to address this problem
next Congress. I want to offer my support to help with these efforts as
a cosponsor of Senator Kyl's legislation and as the Chairman of the
Senate Special Committee on Aging and senior member of the Senate
Finance Committee.
Mr. BENNETT. Mr. President, I rise to thank my colleague from
Delaware, Mr. Roth, for his commitment to look further into the issue
of medicare private contracting and to thank the honorable Senator from
Arizona, Mr. Kyl, for his leadership as the sponsor of S. 1194, the
Medicare Beneficiaries Freedom to Contract Act. As one of 48 cosponsors
of Mr. Kyl's bill, I believe that we need to take steps to maximize
choice, access and care for Medicare
[[Page S11896]]
patients, not restrict them in the name of patient protection. I have
been contacted by hundreds of seniors from my state who understandably
expressed outrage that Congress had passed a law that will inevitably
restrict access to health care from the provider of their choice even
when they are willing to pay for the care out of their own pocket. We
have been told that this provision was included in the Balanced Budget
Act as a protection for Medicare patients. However, I believe we can
protect Medicare patients from fraud and abuse without restricting
their access to desired care.
Mr. President, I thank my colleagues, once again, for their
commitment and leadership and I look forward to working with them in
the near future to address this important issue.
Mr. INHOFE. Mr. President, I, too, rise in support of S. 1194, the
Medicare Beneficiaries Freedom to Contract Act.
You and I, Mr. President, and all other Americans not covered under
Medicare, may obtain health services without informing the federal
government. However, our nation's senior citizens must first seek out
Washington's approval--even when they prefer to pay for those services
out of their own pocket.
Congress intended to correct this situation by permitting private
contracts. Unfortunately, the President insisted he would veto the
entire 1997 Balanced Budget Act unless this fundamental right of all
Americans was eliminated or severely limited for senior citizens.
Medicare beneficiaries should have the same freedom to obtain the
health care they choose from the physician or provider of their
choice--as do Members of Congress and virtually all other Americans.
It's ridiculous that this right was taken away and unfortunate that
it's taken so long to correct.
Mr. President, I thank the majority leader, Senator Lott, and Senate
Finance Committee Chairman Roth for acknowledging the importance of
this issue and for pledging to look into it further next year in the
106th Congress.
Mr. SHELBY. Mr. President, I thank my distinguished friend, Senator
Kyl, for introducing S. 1194--the Medicare Beneficiary Freedom to
Contract Act and for his leadership on this issue.
I firmly believe it is my obligation, as an elected member of the
United States Senate, to defend the liberty of the constituents that
put me in office. Freedom manifests itself in various ways, but one
fundamental concept of importance in America is the protection of one's
discretion over one's financial resources. I often raise this issue in
the context of taxes, but in addition to allowing one to reap what one
sows, it is equally important that people have the ability to spend
their earnings as they see fit.
I want to be perfectly clear what I think the essence is of what we
are discussing when the issue of Medicare private contracting arises.
We are talking about allowing people to spend their money as they see
fit. This is a very simple, yet important, freedom that people enjoy.
We are not talking about letting people buy illegal products, but
rather about the right of people to spend their money on health care.
Only in Washington DC could such a notion be considered controversial.
But to those who have little regard for individual freedom, and who
have a vested interest in seeing the scope and power of government
grow, this is a controversial matter.
H.L. Menken once said that ``the most dangerous man, to any
government, is the man who is able to think things out for himself.''
That is the threat, Mr. President. Those that favor the Medicare
monopoly, often even to the detriment of Medicare beneficiaries, resist
the freedom of people to make these private decisions, because it
threatens the government's control of health care delivery.
Unfortunately the era of big government is not over. In fact, it is
alive and well and is embodied in Section 4507 of last year's Balanced
Budget Act. Therefore, I want to request that Majority Leader Lott and
Finance Committee Chairman Roth help us attach S. 1194 to the first
appropriate legislative vehicle, so that we can repeal Section 4507.
Mr. President, we must restore the right of our elderly to buy the
health care they feel they need, without any ``big government''
constraints on their decisions. This effort is important not only to
our ensuring quality health care to our elderly, but also to the larger
battle of defending freedom in America.
Mr. KYL. Mr. President, I thank the majority leader, Senator Lott,
and Finance Committee chairman, Senator Roth, for recognizing the
problem of many seniors who are not afforded choice in determining
where they get their health care and on agreeing to address this
problem in the 106th Congress.
I also thank Senators Hollings, Roth, Gorton, Craig, Nickles, Allard,
Mack, Grassley, Bennett, Inhofe and Shelby for participating with
statements for the Record. We do intend to address this problem in the
next session of the Congress because we could not get it done this
session. I appreciate my colleagues' commitment to doing that and,
again, thank the Senator from Virginia.
The PRESIDING OFFICER. The Senator from Virginia.
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