[Congressional Record Volume 145, Number 46 (Tuesday, March 23, 1999)]
[House]
[Pages H1576-H1577]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 WE CANNOT AFFORD TO PRIVATIZE MEDICARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Ohio (Mr. Brown) is recognized for 5 minutes.
  Mr. BROWN of Ohio. Mr. Speaker, the Medicare Commission fortunately 
has voted down a Medicare reform proposal that would have privatized 
one of the best government programs in American history.
  The Commission's charge was to come up with a scheme for putting 
Medicare on a solid financial footing and improving its value to 
seniors. Instead, they came up with a scheme to end Medicare as we know 
it. While the Commission's time may have run out, it is not, 
unfortunately, the end of the story. Plans are being made to introduce 
legislation based on the plan, they call it premium support, that the 
Commission just rejected.
  Under this proposal, Medicare would no longer pay directly for health 
care services. Instead, it would provide each senior with a voucher 
good for part of the premium for private coverage. Medicare 
beneficiaries could use this voucher to buy into the fee-for-service 
plan sponsored by the Federal Government or to join a private plan.
  To encourage consumer price sensitivity, the voucher would track to 
the lowest cost private plan; ostensibly, seniors would shop for the 
plan that best suits their needs, paying extra for higher quality care. 
But the proposal would abandon the principle of egalitarianism that has 
made Medicare one of our Nation's best government programs.
  Today the Medicare program is income-blind. All seniors have access 
to the same level of care. The premium support proposal, however, would 
be structured to provide comprehensiveness, access, and quality only to 
those who could afford them.
  The idea that vouchers would empower seniors to choose a health plan 
that best suits their needs is simply a myth. The reality is that 
seniors will be forced to accept whatever plan they can afford.
  The Medicare Commission was charged with ensuring Medicare's long-
term solvency. This proposal will simply not do that.
  Bruise Vladeck, a former administrator of the Medicare program and a 
commission member, doubted the commission plan would save the Federal 
Government even one dime. The same proposal under another name will not 
do it either.
  The privatization of Medicare is, of course, nothing new. Medicare 
beneficiaries have been able to enroll in private managed care plans 
for some time now, and their experience does not bode well for a full-
fledged privatization effort. They are already calling for higher 
government payments, they are dropping out of unprofitable markets, and 
they are cutting back on patient benefits.
  Managed care plans are profit-driven, and they do not tough it out 
when those profits are unrealized. We learned this the hard way last 
year when 96 Medicare HMOs deserted more than 400,000 Medicare 
beneficiaries because their customers simply did not meet the HMO 
profit objectives.
  Before Medicare was launched in 1965, more than half this Nation's 
seniors were uninsured. Private insurance was then the only option for 
senior citizens. Insurers did not want seniors to join their plans 
because they knew the elderly would use their coverage. The private 
insurance market has changed considerably since then, but it still 
avoids high-risk enrollees and, whenever possible, dodges the bill for 
high-cost medical services.
  The purpose of public medical systems is to provide the best health 
care possible to help people, especially children and the elderly, so 
that they can live longer, healthier lives.

                              {time}  2115

  The purpose of privatized medical systems is to maximize profit 
through private insurance companies, denying benefits and instituting 
physician and other provider incentives to withhold care.
  The problem is the expectation that private insurers can serve two 
masters: the bottom line and the common good. There are 43 million 
uninsured Americans. If the private health insurance industry cannot 
figure out how to cover these people, most of whom are middle-income 
workers and children, how will they treat high-cost seniors?
  If we privatize Medicare, we are telling Americans that not all 
senior citizens deserve the same level of care. We are betting on a 
private insurance system that puts its own interest ahead of health 
care quality and a balanced Federal budget. As the focus of Medicare 
reform shifts to Congress, we must question our priorities.
  The answer is clear: Medicare is a national priority and must be kept 
the excellent public program that it has been for 3 decades. Thirty-six 
million Americans depend on Medicare every day, and it has helped our 
Nation lead the world in life expectancy for people 80 years and older.
  The Medicare Commission wisely disbanded without delivering a final 
product. It is time now that we go back to the drawing board and 
construct a plan

[[Page H1577]]

that builds on Medicare's strengths and ensures its solvency for 
decades ahead.

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