[Congressional Record Volume 147, Number 62 (Tuesday, May 8, 2001)]
[Senate]
[Page S4503]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


                  MEDICARE INPATIENT HOSPITAL SERVICES

  Mrs. CLINTON. Mr. President, today, I am so pleased to join my good 
friends, Senator Hutchison from Texas and Senator Bayh from Indiana, in 
supporting this legislation to help Medicare payments keep pace with 
the rising costs of hospital care, and to halt further Medicare 
reductions to teaching hospitals.
  Our hospitals are under tremendous strain. They face soaring costs 
from nearly every direction: The growing number of uninsured 
individuals coupled with the devastating shortages of skilled health 
care workers. The struggle to afford skyrocketing pharmaceuticals 
prices, while simultaneously investing in emerging needs, such as 
information technology. At the same time, reductions in Medicare 
payments have hindered hospitals' ability to respond to these increased 
demands. How can we expect patients to receive quality health care when 
we're asking our hospitals to do more with so much less?
  As you know, this week we are focusing on the crisis around the 
shortage of nurses. Ninety-one percent of hospitals in New York State 
report shortages of registered nurses, RNs. But this is really just the 
tip of the iceberg. The shortages in the health care workforce permeate 
the entire health care system, especially our hospitals. There are 
shortages in pharmacists, technicians, nurse aides, billing staff, and 
housekeepers that have all negatively impacted the quality of care New 
Yorkers are able to receive.
  As a representative of the State of New York, I am especially 
troubled by the growing strains that our hospitals have been forced to 
contend with on top of the devastating cuts that have resulted from the 
balanced budget agreement of 1997, BBA. I have heard numerous firsthand 
accounts of the adverse impact on New York hospitals and the facts 
speak for themselves: In the 2 years following the BBA, New York 
hospitals' financial health ranked worst in the Nation. In fact, almost 
two-thirds of New York hospitals had negative operating margins last 
year. And in addition to the workforce shortage affecting health 
providers nationwide, New York providers are also confronting labor 
costs increases of 5-7 percent a year, while the Medicare rates for 
inpatient hospital rates, even with the full market basket update we 
are seeking in today's legislation, expected to rise only around 3.1 
percent.
  In recent years, Congress has successfully provided some short-term 
relief to address areas where the cuts enacted in the BBA of 1997 went 
much further than intended. However, much of the relief merely 
postponed scheduled cuts in Medicare payments and that is why the 
legislation that we are introducing today is so important.
  This legislation today would eliminate some of those previously 
delayed cuts. First, it would restore the market basket update for 
inpatient hospital rates to the full level, rather than market-basket 
minus 0.55 percent, as scheduled for fiscal year 2002 and 2003. This 
important step will help hospitals nationwide keep up with the rising 
costs of inpatient care for Medicare beneficiaries. This provision 
helps all hospitals in New York State by increasing inpatient hospital 
payments across the board.
  I am especially pleased that this legislation would also address the 
cuts faced by teaching hospitals to their Medicare indirect medical 
education payments. Teaching hospitals are the crown jewels of our 
Nation's health care system and play a vital role in making our system 
one of the finest in the world.
  We rely on them to train physicians and nurses, care for the sickest 
of the sick and the poorest of the poor, and engage in research and 
clinical trials. Thanks to the research, for example, at Memorial 
Sloan-Kettering, cancer patients will suffer less while receiving 
chemotherapy because of a drug that was developed there.
  As my predecessor and friend, Senator Daniel Patrick Moynihan, in 
whose footsteps I am so honored to be following, put it so well a few 
years ago, ``We are in the midst of a great era of discovery in the 
medical science. It is certainly not a time to close medical schools. 
This great era of medical discovery is occurring right here in the 
United States . . . And it is centered in New York City.''
  This legislation that we are introducing today would address the cuts 
faced by teaching hospitals to their Medicare indirect medical 
education payments. Last year's Medicare, Medicaid, and SCHIP Benefits 
Improvement Act of 2000, BIPA, provided some relief by delaying the 
cuts to help teaching hospitals cover the costs of caring for sicker, 
more complicated patients. Today's provision would make that relief 
permanent by freezing the indirect medical education adjustments 
percentage at 6.5 percent.
  In addition, teaching hospitals throughout the State would benefit, 
including rural hospitals such as Kingston Hospital, Benedictine 
Hospital, Champlain Valley Physicians Hospital Medical Center, Olean 
General Hospital, and Hepburn Medical Center in Ogdensburgh, NY.
  Today's legislation is essential to ensuring that our Nation's older 
and disabled patients can continue to receive the high quality of care 
that they deserve. I look forward to working with my colleagues and the 
administration to address this and other important health care 
priorities.

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