[Congressional Record Volume 146, Number 37 (Wednesday, March 29, 2000)]
[Senate]
[Pages S1893-S1894]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. LUGAR:
  S. 2312. A bill to amend title XVIII of the Social Security Act to 
provide for a moratorium on the mandatory delay of payment of claims 
submitted under part B of the Medicare Program and to establish an 
advanced informational infrastructure for the administration of Federal 
health benefits programs; to the Committee on Finance.


           HEALTH CARE INFRASTRUCTURE INVESTMENT ACT OF 2000

  Mr. LUGAR. Mr. President, I rise to introduce the Health Care 
Infrastructure Investment Act.
  Formerly arcane statistics of interest only to economists, 
productivity and innovation are now veritable buzz-words in today's 
much-heralded new economy. Recently released productivity figures drew 
front page coverage from both the Washington Post and New York Times. 
Most economists, including Federal Reserve Chairman Alan Greenspan, 
attribute the surge in productivity to technological improvements. A 
host of new and improved technologies, including faster computers and 
rapid expansion of the Internet, have led to improved efficiencies. The 
result: workers are more productive, companies continue to grow and 
wealth is created.
  Today nearly every industrial sector is involved in a race to apply 
new technology and management techniques to gain greater efficiencies. 
Yet one sector that accounts for 13 percent of America's gross domestic 
product--health care--still uses a patchwork-quilt of outdated 
technology for the most basic of its transactions.
  While individual components within the health industry are adopting 
advanced communication, manufacturing and other technologies but the 
inner core of health care--a series of transactions between doctor, 
patient and insurance provider--remains largely untouched by 
technological advances that would decrease the administrative load 
accompanying every transaction.
  At a time when America's growing population is seeking a higher 
quality of care; when the greying of America means that Medicare 
enrollment will double by 2040; when new medical procedures are being 
developed that hold great promise for the treatment and cure of 
diseases like cancer and AIDS; when prescription drugs are becoming 
available that extend and improve the quality of life--we have every 
motivation for adopting into health care some

[[Page S1894]]

of the same technologies and ideas responsible for transforming other 
sectors of the American economy.
  A robust and modern infrastructure for American health care will 
enable resources to be shifted to where they are most needed and allow 
for the dramatic increases in productivity necessary to treat 
increasing numbers of people at a higher level of care. In this sense, 
efficiency is not double-speak for additional restrictions placed on 
the doctor-patient relationship or further regulations on insurance 
coverage. Instead, greater efficiency means that doctors are free to 
spend more time treating patients, insurance companies reduce the cost 
of claims processing and consumers are empowered with a better 
understanding of treatment and costs.
  America's interstate highway system is a prime example of a wise 
infrastructure investment. As a result of a sustained Federal 
commitment, Americans enjoy an unprecedented degree of mobility while 
the economy benefits from the low cost and ease of transportation. A 
similar approach should be applied to health care whose roads for 
processing information resemble the rutted cobblestone paths of 
medieval times.
  The Health Care Infrastructure Investment Act is designed to spur 
Federal and private sector investment so that a nationwide network of 
systems is built for health care. A network of systems is a descriptive 
term that refers to the conglomeration of hardware, software and secure 
information networks designed to speed the flow of information and 
capital between doctors, patients and insurance providers.
  The primary goal of the Health Care Infrastructure Investment Act is 
to build an advanced infrastructure to efficiently process and handle 
the vast number of straightforward transactions that now clog the 
pipeline and drain scarce health care resources. Among the targeted 
transactions are immediate, point-of-service verification of insurance 
coverage, point-of-service checking for incomplete or erroneous claim 
submission and point-of-service resolution of clean claims for doctor 
office visits including the delivery of an explanation of benefits and 
payment.
  When designing a complex system, a first step is to define 
performance standards that the system must meet. As configured, the 
legislation mandates broadly defined performance standards for the 
federally administered Medicare program that will be phased-in over a 
ten year period. To ensure that improvements in the infrastructure 
supporting federally-financed health care are matched in the managed 
care sector, insurers participating in the Federal Employees Health 
Benefits program will also be required to meet these same performance 
standards.

  Also critical will be harnessing the expertise of selection of the 
Federal agency responsible for the design and implementation of an 
advanced health care infrastructure. Some of my colleagues have 
suggested that the Department of Defense or even NASA, two agencies 
with decades of experience with complex, distributed networks, be 
assigned a leadership role. Accordingly, the legislation forms a Health 
Care Infrastructure Commission, chaired by the Secretary of Health and 
Human Services, and composed of senior officials from NASA, the Defense 
Advanced Research Projects Agency, the National Science Foundation, the 
Office of Science and Technology Policy and the Department of Veterans 
Affairs. Officials named to the Health Care Infrastructure Commission 
are required to be expert in advanced information technology.
  The legislation also strives to create a strong partnership with the 
private sector, as many of the advances in communication technology are 
driven by companies, both large and small.
  Many pieces of a truly advanced health care infrastructure already 
exist. But like a modern-day Tower of Babel, communication is hindered 
by differences in language and function. Sorely needed is a combination 
of vision and commitment: vision to design a system that is secure, 
efficient and flexible and the commitment to dedicate necessary 
intellectual and financial resources for its design and implementation.
  America has put a man on the moon, designed advanced stealth fighters 
and is now enjoying a sustained period of economic expansion stimulated 
by electronic devices, telephone and Internet. We must now develop and 
build a health care infrastructure that checks insurance status with 
the swipe of a card, provides speedy payment to doctors for their 
expertise in healing and allows a patient to leave the doctor's office 
with a single statement of treatment and cost. I am confident that we 
will succeed.
  I urge my colleagues to support the Health Care Infrastructure 
Investment Act.
                                 ______