[Congressional Record (Bound Edition), Volume 145 (1999), Part 3]
[House]
[Page 4480]
[From the U.S. Government Publishing Office, www.gpo.gov]




                              {time}  0945

                     WE MUST NOT PRIVATIZE MEDICARE

  The SPEAKER pro tempore (Mrs. Morella). 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, the National Bipartisan Commission 
on the Future of Medicare is poised today to vote on a proposal that 
would end Medicare as we know it.
  The Commission's charge was to come up with a scheme for putting 
Medicare on solid financial footing and improving its value to seniors. 
They definitely came up with a scheme, a scheme to privatize America's 
best government program.
  Under the Commission proposal, known as Premium Support, 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 their private health insurance coverage. Medicare beneficiaries 
could use this voucher to buy into the fee-for-service plan sponsored 
by the Federal Government or to join a private plan.
  To encourage consumer price sensitivity, the voucher would track to 
the lowest cost private plan. Seniors then would shop for the best plan 
that best suits their needs, paying the balance of the premium and 
paying extra if they want higher quality health care. The Commission 
proposal creates a system of health coverage but it abandons Medicare's 
bedrock principle of egalitarianism.
  Today, Medicare is income blind. All seniors have access to the same 
level of health care. The Commission proposal, however, is structured 
to provide comprehensiveness, access and quality only to those who can 
afford them.
  The idea that vouchers will empower seniors to choose a health plan 
that best suits their needs is quite simply a myth. The reality is that 
seniors will be forced to accept whatever plan they can afford.
  The Medicare Commission is charged with ensuring Medicare's long-term 
solvency. This proposal will not do that. Proponents of the voucher 
plan say it would shave off 1 percent of the Medicare budget per year 
over the next few decades. It will only do that by charging senior 
citizens more. In fact, Bruce Vladeck, a Commission member and former 
Medicare administrator, doubts Premium Support will save the government 
even a dime.
  The privatization of Medicare is nothing new. Medicare beneficiaries 
have been able to enroll in private managed Medicare plans for some 
time now, and their experience does not bode well for a full-fledged 
privatization effort. Managed care plans are profit oriented, and the 
theory that they can sustain significantly lower costs than traditional 
Medicare simply has not panned out.
  Profit-driven managed care plans do not tough it out when those 
profits are unrealized. Last year, 96 Medicare HMOs deserted 400,000 
Medicare beneficiaries because the HMOs' customers did not meet the 
HMOs' profit objectives.
  Before the Medicare program was launched in 1965, more than one-half 
of America's senior citizens did not have health insurance. Private 
insurance was the only option then for seniors. Insurers simply did not 
want seniors to join their plans because they knew the elderly would 
use much of their coverage. The private insurance market still avoids 
high-risk enrollees and, whenever possible, dodges the bill for high 
cost medical services.
  What is perhaps most disturbing about the Commission's Premium 
Support plan is what it does not tell us. It does not tell us how we 
can make Medicare more efficient while still preserving its egalitarian 
underpinnings. It does not tell us how much the Nation can or wants to 
spend on health care for seniors. It does not give us options for 
reconciling what the Nation wants with how much we have or are willing 
to spend.
  If we privatize Medicare, like the Commission wants, we are telling 
America that not all seniors deserve the same level of care. The wisest 
course for the Medicare Commission is to disband without delivering a 
final product. We should go back to the drawing board and we should 
construct a plan that builds on Medicare's strengths and ensures its 
long-term solvency. Selling off Medicare to the managed care industry 
is the easy way out and it is wrong.

                          ____________________