[Congressional Record Volume 147, Number 48 (Wednesday, April 4, 2001)]
[Extensions of Remarks]
[Page E537]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                         ACCESS TO HEALTH CARE

                                 ______
                                 

                          HON. JOHN P. MURTHA

                            of pennsylvania

                    in the house of representatives

                        Wednesday, April 4, 2001

  Mr. MURTHA. Mr. Speaker, I want to express concern about the 
increasing challenges facing health care providers, both hospitals and 
long-term care providers. Pressed by continued government underfunding, 
inadequate managed care payments, exploding professional liability 
costs, growing numbers of uninsured, and workforce shortages, these 
providers are struggling to meet community needs. Access to care is 
being threatened.
  At the federal level, we have been trying to right the wrongs created 
when the Balanced Budget Act of 1997 cut millions of dollars in 
Medicare payments to hospitals. We have made progress to return some of 
this money, but more must been done.
  And to succeed, we need the continued support of all elements. I've 
spoken with Pennsylvania hospital administrators about efficiency, and 
Pennsylvania now has the second most cost-efficient system in the 
Nation. Costs in Pennsylvania acute care hospitals are 6 to 7 percent 
below their expected costs. Also I've spoken with Governor Ridge and 
Pennsylvania legislators about growing problems with nurse shortages, 
long-term care, and care for children and pregnant women and encouraged 
more support from the Commonwealth to help meet costs and address these 
problems.
  In addition, a special independent Pennsylvania Legislative Budget 
and Finance Committee study released recently shows that hospitals' 
financial condition continues to deteriorate, and that Pennsylvania is 
paying only 74 cents for each dollar of Medical Assistance care 
provided.
  The study reveals Pennsylvania hospital margins have deteriorated 
markedly since 1997, with total margins dropping to 2.4% in 1999 and 
operating margins averaging only .03%. Nationwide, total hospital 
margins in 1999 were 4.65% and operating margins were 1.07%.
  The low margins in Pennsylvania's hospitals are not due to cost 
inefficiency since costs in Pennsylvania acute care hospitals are 6 to 
7 percent below their expected costs. Pennsylvania hospitals are the 
second most cost efficient in the nation.
  And add to the overall cost problem the fact that professional 
liability costs will go up this year a minimum of 35 to 50 percent and 
that we have a decreasing payment-to-cost ratio of commercial insurers, 
and a growing uninsured rate, the writing is on the wall. No 
organization can continue to survive and provide all the services our 
citizens need.
  On the long-term care side, two reports delivered last week to the 
Pennsylvania Intra-Governmental Council on Long-Term Care revealed that 
Pennsylvania and long-term care providers must find new ways to raise 
the pay and status of long-term care workers or face an extended 
workforce crisis. There is a worker shortage across the ``spectrum of 
elder services'' that affects access to care and quality of care for 
our elderly. Turnover rates are skyrocketing. If we do not get a handle 
on this problem today, we will have a vulnerable population of seniors 
counting on a broken system that can't deliver.
  Over one-third of long-term care providers reported serious problems 
finding and keeping direct-care workers. More than 40 percent of 
private nursing homes and home-care and home-health agencies report a 
serious problem with either recruitment or retention of workers.
  We have Area Agencies on Aging with growing waiting lists because 
people can't arrange home services for needy clients. Nursing homes are 
looking to temp agencies to fill vacancies among staff aides, and 
between one-third and one-fourth of the long-term care workforce in the 
state have less than one year's experience with their employer.
  Currently about 94,000 Pennsylvanians are employed by more than 3,400 
providers to help dress, feed, bathe and transport frail elderly 
persons. Low pay and low respect are to blame. Combine these issues 
with a growing demand for services and we find long-term care providers 
in a major dilemma.
  We have the second largest senior population in Pennsylvania and an 
ever-growing number of seniors over the age of 80. Access to healthcare 
and all forms of long-term care are critical. Pennsylvania leaders, 
Congress and health care professionals must all work together to 
resolve these problems.

                          ____________________