[Congressional Record (Bound Edition), Volume 145 (1999), Part 3]
[House]
[Pages 3243-3244]
[From the U.S. Government Publishing Office, www.gpo.gov]




             MEDICARE REFORM: DO NOT TAKE THE EASY WAY OUT

  The SPEAKER pro tempore (Mr. Stearns). 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. Mr. Speaker, the National Commission on the Future 
of Medicare will wrap up its work sometime this month. The Commission 
members were given the task of putting Medicare on solid financial 
footing. Unfortunately, they want to save Medicare by privatizing it.
  Under the Commission proposal, Medicare would no longer pay directly 
for health care services. Instead, it would provide each senior with a 
voucher good for part of the premium for private coverage. Medicare 
beneficiaries could use this voucher to buy into the fee-for-service 
plan sponsored by the Federal Government, so-called traditional 
Medicare, or join a private plan.
  The Commission proposal creates a system of health coverage, but it 
abandons the principles of comprehensiveness and egalitarianism that 
make Medicare such a valuable national program, an essential national 
service for America's elderly.
  Today the Medicare program is income-blind. All seniors have access 
to this same level of care. The Commission proposal markets a class-
based health care system of two-tiered health care: excellent care for 
the affluent, only barely adequate or worse health care for the less 
well off.
  The idea that vouchers would empower seniors to choose a health plan 
that best suits their needs is a myth. The reality is that they will be 
forced to accept whatever health care plan that they can afford. 
Medicare beneficiaries have been able to enroll in private managed care 
plans for sometime now, and their experience, unfortunately, does not 
bode well for a full-fledged privatization effort.
  Most managed care plans are for profit. The theory that they can 
sustain significantly lower costs than traditional Medicare simply is 
not panning out. Because managed care plans are profit-driven, they do 
not tough it out when those profits are not so forthcoming. We learned 
that the hard way last year, when 96 HMOs deserted more than 400,000 
seniors because the business did not meet their profit objectives.
  Before the Medicare program was launched in 1965, private insurance 
was

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the only option for seniors, and more than half of them were uninsured. 
Insurers did not want to sign seniors up because they tend to actually 
use their health care coverage.
  The private insurance market has changed a good deal since then, but 
it still avoids high-risk enrollees, and tries not to pay for high-cost 
services. The fact that 43 million Americans under age 65 are uninsured 
and the broad-based support for managed care reform in this Congress 
and all over the country should at the very least give us pause when we 
consider turning over the Medicare program to the private sector.
  Medicare Commission leaders would also save Medicare money by raising 
the Medicare eligibility age from 65 to 67. It is interesting timing 
for such a proposal, given the growing number of uninsured in the 55 to 
64 age range. These individuals cannot find an insurer now who will 
take them, and they were certainly a better risk as 55- to 64-year-olds 
for insurers than 65- and 66-year-olds.
  Shell games simply do not work in health care. Someone still has to 
pay the bill when a person not yet eligible for Medicare becomes sick. 
Delayed care received in emergency rooms does not serve the individual 
or the public.
  What is perhaps the most disturbing aspect of the Medicare Commission 
likely proposal is what it does not tell us. It does not tell us how we 
could make the current program more efficient while still maintaining 
its egalitarian underpinnings and its orientation in providing the 
right care to everyone, rather than simply the least expensive care.
  The bottom line is this, Mr. Speaker. If we privatize Medicare, we 
are telling America that not all seniors deserve the same care. We are 
betting on a private insurance system that may not save us any money in 
the long run, and certainly minimizes care by avoiding individuals who 
are health care risks.
  All this is to avoid the difficult questions. Selling off the 
Medicare program, privatizing Medicare, turning over America's best 
government program to insurance companies may be easy, but it is simply 
wrong.

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