[Congressional Record Volume 146, Number 125 (Tuesday, October 10, 2000)]
[House]
[Page H9514]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
RIGHT TO GO HOME ACT
The SPEAKER pro tempore. Under the Speaker's announced policy of
January 19, 1999, the gentleman from Ohio (Mr. Brown) is recognized
during morning hour debates for 5 minutes.
Mr. BROWN of Ohio. Madam Speaker, last year I introduced modest
legislation that would allow seniors in managed care plans to return
after a hospitalization to the retirement community they know, instead
of a network HMO nursing home somewhere else. I offered the Right to Go
Home Act on behalf of seniors who had been needlessly separated because
of HMO rules from their loved ones and from their usual source of care.
It is difficult to believe a health plan would treat a hospitalized
senior this way, until you speak to Medicare+Choice enrollees,
privatized Medicare, if you will, who experienced it firsthand.
Take, for example, a couple in New Hampshire, separated after the
husband's hospitalization because the HMO required him to be discharged
to a nursing home in Maine, a 40 minute drive from the community where
he and his wife had lived. Or a couple in Florida separated when their
HMO required the wife to recuperate from a hospital stay in a nursing
home 20 miles away from the retirement community. The husband had
difficulty visiting her, and she died later at the HMO member facility.
A retirement community, a nursing facility, is more than just a
health care provider; it is a home. Forced relocation means moving
vulnerable patients, taking them away from providers experienced in
these individual's chronic care needs. It places them in new, strange
surroundings during that fragile period of recovery. It separates them
from emotionally supportive family and friends.
Under our legislation, HMOs would not be required to pay a dime more
for care provided at the beneficiary's retirement facility than in a
network facility. What my bill would do is what HMOs should not need
our prompting to do; that is, it allows hospitalized nursing home
patients to recuperate near their loved ones.
Yet the HMO industry opposes this legislation. They lobbied for
changes in the bill that effectively would exclude all but a small
subset of seniors. Fortunately, the Committee on Ways and Means did not
buckle under the pressure of the HMO industry. They included their
legislation in their Balanced Budget Act Restoration proposal.
If the HMO lobby does not kill it, this legislation may make it into
law. But the fact that Congress has to take action to ensure the well-
being of hospitalized seniors in Plus Choice plans and the fact that
the HMO industry would lobby against this bill should tell us
something.
Those are facts Congress and the public should keep in mind as George
W. Bush promotes commercial health insurance, as he promotes commercial
health maintenance organizations, as a replacement, as a replacement,
for Medicare.
George W. Bush believes Medicare should be turned over to private
insurers. That is not conjecture, that is fact. Visit his web site. His
plan is to establish a 4 year commission to restructure Medicare so
that it is no longer a ``one-size-fits-all big government plan.''
Translate that into English. It means simply turning Medicare over to
the private insurance industry. HMO's do some things well, but putting
Medicare beneficiaries first is not one of them. How many times do we
have to intervene with a managed care plan or other insurer on behalf
of our constituents before the industry's loyalties become clear to us?
Their loyalty is to their stockholders. No surprise there. It is
verified every time managed care plans make decisions that fly in the
face of good medicine.
Unshakeable loyalty to the bottom line results in decisions often not
in the best interests of Medicare enrollees. Unconditional loyalty to
the bottom line is what creates the need for a Patients' Bill of
Rights. Unwavering loyalty to the bottom line explains why health
insurers market to the healthiest individuals, the most profitable, and
do everything in their power to avoid the rest; let government do that.
It explains how private managed care plans contracting with Medicare
can enroll seniors one year, make money from them, and then cavalierly
drop them the next when they are not quite as profitable. They promise
supplemental benefits they cannot deliver; they blame the government
then for problems that they, the insurance company-HMOs, create.
It explains how the managed care industry has the nerve, the outright
arrogance, to lobby against legislation that costs them nothing and
means the world to seniors in nursing homes. It is a disgrace.
The traditional Medicare program is different. It is universal, it is
reliable, it is accountable to the public. Medicare's loyalty is to
beneficiaries and to taxpayers. It is an undiluted commitment. Medicare
offers choices in ways that actually make a difference in terms of
health care quality in patient satisfaction.
Medicare does not tell beneficiaries which providers they can see;
HMOs do. Medicare does not dictate which hospitals and nursing homes
are permissible; HMOs do. Medicare does not discriminate between
beneficiaries based on their health status; HMOs do. Medicare offers
reliable coverage that does not come and go with the stock market.
So before voting for George W. Bush, I urge every American to think
carefully about the wholesale changes he has in mind for Medicare.
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