[Congressional Record Volume 146, Number 45 (Tuesday, April 11, 2000)]
[Extensions of Remarks]
[Page E531]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




            HELP FOR THE NATION'S PREMIER TEACHING HOSPITALS

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                         HON. CHARLES B. RANGEL

                              of new york

                    in the house of representatives

                        Tuesday, April 11, 2000

  Mr. RANGEL. Mr. Speaker, I am pleased to join today with Senator 
Patrick Moynihan,and a number of my House and Senate colleagues in 
introducing legislation to stop further Medicare cuts in the indirect 
medical education (IME) program.
  IME payments are extra payments made to teaching hospitals for the 
fact that they are training the next generation of doctors, and that 
the cost of training a young doctor--like any apprenticeship or new 
person on the job--is more expensive than just dealing with 
experienced, older workers. The young person requires mentoring, orders 
more tests, and makes mistakes unless closely supervised. It is natural 
that a group of young residents in a hospital will reduce a hospital's 
efficiency and increase its costs. Medicare should help pay for these 
extra ``indirect'' costs, if we want--as we surely do--future 
generations of competent, highly skilled doctors.
  The Balanced Budget Act took the position that the extra adjustment 
we pay a hospital per resident should be reduced from 7.7% in FY 1997 
to 5.5% in FY 2001. This provision was estimated to save about $6 
billion over 5 years and $16 billion over ten--in addition to about 
another $50 billion in hospital cuts in other portions of the BBA. In 
the Balanced Budget Refinement Act which was enacted last November, we 
recognized that these cuts were too much, and froze the fiscal year 
2000 rate at 6.5%, reduced it to 6.25% in 2001 and then dropped it to 
5.5% thereafter.
  Mr. Speaker, last fall's delay and spread out of the cuts is 
helpful--but these cuts are still too much. The nation's teaching 
hospitals, which do so much to serve the uninsured and poor, and which 
are the cradle of new clinical research and technical innovation, are 
hemorrhaging red ink.
  Our bill stops further scheduled cuts in the IME, freezing the 
adjustment factor at 6.5% rather than letting it fall to 5.5%, and 
saving teaching hospitals about billions of dollars that would 
otherwise be taken from them.
  I hope this legislation will receive consideration this year, before 
the cuts resume, and these premier medical institutions are faced with 
cuts, layoffs, and reduced service that will literally cost us lives in 
the years to come.

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