[Congressional Record Volume 150, Number 65 (Tuesday, May 11, 2004)]
[House]
[Pages H2779-H2780]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                   NATIONAL COVER THE UNINSURED WEEK

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Texas (Mr. Green) is recognized for 5 minutes.
  Mr. GREEN of Texas. Mr. Speaker, this week marks National Cover the 
Uninsured Week where we focus our attention on the many health care 
problems confronting Americans without health insurance. This evening I 
returned to Washington from Houston after participating in a symposium, 
at St. Joseph's Christus Hospital, on the uninsured. St. Joseph's and 
Sisters of Charity have for decades served both the uninsured and the 
insured in the Houston area. Some of the most innovative and lifesaving 
research and treatment developments are being discovered in our 
backyard. The problem is that too many of our neighbors cannot access 
these lifesaving treatments because they lack health insurance.
  Currently 31.2 percent of adult Texans are living without health 
insurance, more than any other State in this country. The growing 
number of uninsured in this country is truly a problem for all 
Americans. The uninsured often use the emergency room as their primary 
source of health care, which increases health care costs for all 
Americans. Americans without health insurance are less likely to seek 
preventive health care and only get care once their health problems 
reach emergency proportions. In fact, nearly 40 percent of the 
uninsured adults skip a recommended medical test and half of those 
people have not received care for a serious health problem in the last 
year.
  I hope that Cover the Uninsured Week will result in a renewed debate 
about the serious health care problems that we face in our country and 
the actions we must take to ensure Americans access to quality health 
care. But we are increasingly going in the wrong direction. Uninsured, 
particularly children, have taken such a huge cut in the children's 
health care initiative program, the CHIPs program. I know in my State 
of Texas alone we have lost at least 107,000 children from CHIPs 
because of State budget problems. I am sure that problem is around the 
country with all our States.
  As we have learned in the past, a rush to enact flawed policy is 
arguably just as bad as enacting no policy at all. A prime example is 
the new Medicare discount drug cards that are giving our seniors too 
little benefits and too many frustrations. This card was created from a 
flawed Medicare prescription drug bill that does not provide 
prescription drug coverage until 2006 and creates a huge gap in 
coverage forcing seniors to pay all their drug costs between $2,250 to 
$3,600.
  Therefore, it is no surprise that I had doubts about our seniors' 
ability to utilize this first step, the discount drug card. I worried 
about seniors' access to information about the various cards and their 
ability to get reliable data from which to make an informed decision. 
Yet with great fanfare, Medicare released a Web site to provide just 
this information and allow seniors to compare the drug prices offered 
by the cards. That is precisely where the confusion began. The Houston 
Chronicle recently published an article detailing just how confusing 
this drug card is for seniors. In fact, the author found that the drug 
card was more confusing than preparing your income taxes or dealing 
with an insurance company regarding a hospital bill. I think this 
article sheds important light on the frustrations seniors are facing 
right now. I submit this article for printing in the Record.

               [From the Houston Chronicle, May 4, 2004]

            Medicare Drug Discount Cards Explained, Sort of

                             (By Jim Shea)

       The first thing seniors need to find out about the new 
     Medicare prescription drug discount cards is if they are 
     eligible.
       This will not be easy.
       Doing your taxes is easy.
       Trying to straighten out a hospital bill with the insurance 
     company is easy.
       Explaining the infield-fly rule is easy.
       Figuring out if you qualify for a discount card is, well, 
     let me try to put it in context.
       Beginning this week, seniors who are thinking of applying 
     for the card can call for information. To handle the 
     anticipated volume, the government has hired 1,000 ``benefit 
     advisers.''
       This sounds pretty good until you do the math:
       Problem: How many times does 1,000 (government bureaucrats) 
     go into 12.5 million (confused Medicare recipients who may 
     call)?
       Answer: Enough times to boost ``death by on-hold music'' to 
     the top of the mortality charts.
       Next, let's explore the matter of choosing which of the 28 
     government-approved private companies you should get your 
     discount card from.
       To make this choice, the government suggests you compare 
     such things as drug availability and price before signing 
     with a provider.
       Seems like reasonable advice, except for one little hitch.
       The discount card company you join is under no restriction 
     to maintain the price that enticed you to join in the first 
     place. In fact, it doesn't even have to guarantee it will 
     continue to carry the drugs you need.
       In private business this practice is known as bait and 
     switch. In Republican-controlled Washington these days, it is 
     known as a benefit.
       If this provision seems a little one-sided, a little too 
     big-business friendly, consider this: Even if you are baited 
     and switched and generally hosed all over, you are prohibited 
     from moving to another discount card company until your 
     mandatory one-year commitment is up.
       I mean, you get better terms from the Gambinos.
       In fairness, seniors at the low-income end of the spectrum 
     who manage to escape the registration process without 
     contracting a terminal case of phone ear will benefit from 
     the program. They qualify for an annual subsidy of $600, 
     which if they are smart, they will use to purchase round-trip 
     bus tickets to drug-stores in Canada.
       Seniors at the high-income end of the spectrum, who own the 
     right stocks, will also make out well.
       To everyone else, let me just say that if you can't get 
     your questions answered, give me a call and I will explain 
     the following:
       The first thing to know about the infield-fly rule is that 
     it only applies if there are less than two outs and . . .

  The first problem with the Medicare Web site is that a large number 
of senior citizens do not enjoy or are not proficient with the 
Internet. Frankly, I do not blame them for being skeptical about 
providing sensitive financial information such as their monthly income 
or other indicators of their financial situation. Yet even if our 
seniors are willing to go through all the steps on the Medicare Web 
site, the information generated is too confusing to help our seniors 
make a truly informed choice regarding their discount drug card. My 
staff and I attempted to put together a simple document to help seniors 
in our district easily understand the choices before them, yet it did 
not take long for us to realize there is nothing simple about this 
card.

                              {time}  1945

  One zip code in my district had 12 participating cards; yet a 
neighboring zip code under the Web site had zero participating cards. 
It is hard enough for a senior to determine what cards serviced their 
zip code. For example, a senior would also have to figure out if

[[Page H2780]]

her pharmacy accepted that card and if her drugs were considered 
preferred under that card. If that is not difficult enough, then that 
senior would have to compare that card to all the other cards in her 
area, for example, the one that had 12 with the neighboring zip code 
that had zero.
  Unfortunately, the story gets worse for our seniors. After spending 
the time, energy, and brain power to choose the best card, seniors are 
not even guaranteed that the companies will continue to maintain the 
cost that is on that Web site or access to those particular drugs that 
the seniors have looked for and they need. The company is under no 
obligation to maintain its advertised prices or even carry the drugs 
that they need. If they start losing too much money on a particular 
drug, they can just cease to offer that coverage during the year. And 
while all these private companies get escape clauses, Medicare 
beneficiaries are forced to stay with each card for at least a year.
  In the end I am afraid we will learn the hard way that this discount 
drug card is just as bad a deal as the Medicare drug bill that created 
it.

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