[Congressional Record Volume 144, Number 145 (Tuesday, October 13, 1998)]
[Extensions of Remarks]
[Page E2145]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


[[Page E2145]]
 MEDICARE HOME HEALTH AND VETERANS HEALTH CARE IMPROVEMENT ACT OF 1998

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                               speech of

                             HON. RON PAUL

                                of texas

                    in the house of representatives

                        Friday, October 9, 1998

  Mr. PAUL. Mr. Speaker, I appreciate the opportunity to explain why I 
must oppose H.R. 4567 even though I support reforming the Interim 
Payment System (IPS) and I certainly support expanding the health care 
options available to American veterans. However, I cannot support this 
bill because this solution to home care is inadequate and it raises 
taxes on Americans instead of cutting wasteful, unconstitutional 
spending to offset the bill's increases in expenditures.
  I am pleased that Congress is at last taking action to address the 
problems created by the IPS. Unless the IPS is reformed, efficient home 
care agencies across the country may be forced to close. This would 
raise Medicare costs, as more seniors would be forced to enter nursing 
homes or forced to seek care from a limited number of home health care 
agencies. In fact, those agencies that survive the IPS will have been 
granted a virtual monopoly over the home care market. Only in 
Washington could punishing efficient businesses and creating a monopoly 
be sold as a cost-cutting measure!
  Congress does need to act to ensure that affordable home care remains 
available to the millions of senior citizens who rely on home care. 
However, the proposal before us today does not address the concerns of 
small providers in states such as Texas. Instead, it increases the 
reimbursement rate of home care agencies in other states. I am also 
concerned that the reimbursement formula in this bill continues to 
saddle younger home health agencies with lower rates of reimbursement 
than similarly situated agencies who have been in operation longer. Any 
IPS reform worthy of support should place all health care agencies on a 
level playing field for reimbursements.
  A member of my staff has been informed by a small home health care 
operator in my district that passage of this bill would allow them only 
to provide an additional eight visits per year. This will not keep home 
health patients with complex medical conditions out of nursing homes 
and hospitals. Congress should implement a real, budget-neutral home 
health care reform rather than waste our time and the taxpayers' money 
with the phony reform before us today.
  Mr. Speaker, I also support the language of the bill expanding the 
health care options available to veterans' benefits. Ensuring the 
nation's veterans have a quality health care system should be one of 
the governments' top priorities. In fact, I am currently working on a 
plan to improve veterans' health care by allowing them greater access 
to Medical Savings Accounts (MSAs). However, I cannot, in good 
conscience, support the proposals before us today because, for all 
their good intentions, it is fatally flawed in implementation for it 
attempts to offset its new spending with a tax increase.
  Now I know many of the bill's supporters will claim that this is not 
a tax increase just an adjustment in the qualifications for a tax 
benefit or tightening a tax loophole. However, the fact is that by 
raising the threshold before a taxpayer can rollover their traditional 
IRA into a Roth IRA the federal government is forcing some people to 
pay higher taxes than they otherwise would, thus they are raising 
taxes. It is morally wrong for Congress to raise taxes on one group of 
Americans in order to provide benefits for another group of Americans.
  Instead of raising taxes Congress should ``offset'' these programs by 
cutting spending in other areas. In particular, Congress should finance 
veterans health care by reducing expenditures wasted on global 
adventurism, such as the Bosnia mission. Congress should stop spending 
Americans blood and treasure to intervene in quarrels that do not 
concern the American people.
  Similarly, Congress should seek funds for an increased expenditure on 
home care by ending federal support for institutions such as the 
International Monetary Fund (IMF), which benefit wealthy bankers and 
powerful interests but not the American people. At a time when the 
federal government continues to grow to historic heights and meddles in 
every facet of American life I cannot believe that Congress cannot find 
expenditure cuts to finance the programs in this bill!
  Mr. Speaker, I must also note that the only time this Congress seems 
concerned with offsets is when we are either cutting taxes or 
increasing benefits to groups like veterans or senior citizens. The 
problem is not a lack of funds but a refusal of this Congress to set 
proper priorities and put the needs of the American people first.
  In conclusion, Mr. Speaker, I call upon this Congress to reject this 
bill and instead support an IPS reform that is fair to all home care 
providers and does not finance worthwhile changes in Medicare by 
raising taxes. Instead, Congress should offset the cost to these worthy 
programs by cutting programs that do not benefit the American people.

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