[Congressional Record (Bound Edition), Volume 145 (1999), Part 5]
[House]
[Pages 6270-6271]
[From the U.S. Government Publishing Office, www.gpo.gov]




            LET US KEEP MEDICARE A SUCCESSFUL PUBLIC PROGRAM

  The SPEAKER pro tempore. 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, we received good news 2 weeks ago 
when the Medicare and Social Security trustees reported that both 
programs will be solvent significantly longer than projected. For 
Medicare, the trustees reported that the Medicare trust fund will 
remain solvent through at least 2015.
  Those in Congress, the think tanks and the Washington pundits who 
want to privatize Medicare are wringing their hands over the trustees' 
latest report. They believe these new projections will lead Congress to 
do nothing towards reforming Social Security and Medicare.
  Once again, Medicare privatizers are wrong. The real threat to 
Medicare is not its alleged pending bankruptcy. The real threat to 
Medicare is a legislative proposal just rejected by the National 
Bipartisan Commission on the Future of Medicare which would have 
privatized Medicare and delivered it to the private insurance market.
  Under a proposal soon to be introduced called ``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 private 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; Medicare privatizers tell us that seniors 
could then shop for the plan that best suits their needs, paying the 
balance of the premium and extra if they want higher quality care. The 
proposal would create a new, private system of health coverage but it 
would abandon Medicare's fundamental principle of egalitarianism.
  Today, the Medicare program is income-blind. All seniors have access 
to the same level of care. The idea that vouchers would empower seniors 
to choose a health plan that best suits their needs is simply, Mr. 
Speaker, a myth. The reality is that seniors will be forced to accept 
whatever plan they can afford.
  The goal of the Medicare Commission was to ensure the program's long-
term solvency. This proposal will not do

[[Page 6271]]

that. Supporters of the voucher plan say it would shave 1 percent per 
year from the Medicare budget over the next few decades. That is still 
not enough to prevent insolvency, and it is based frankly on overly 
optimistic projections of private sector performance. Bruce Vladeck, a 
former administrator of the Medicare program and a commission member, 
doubted the commission plan would save the government even a dime.
  Efforts to privatize Medicare are, of course, nothing new. Medicare 
beneficiaries have long been able to enroll in private managed care 
plans. Their experience, however, does not bode well for a full-fledged 
privatization effort. These managed care plans are already calling for 
higher government payments. They are dropping out of unprofitable 
markets and they are cutting back on benefits to America's elderly.
  Managed care plans are profit driven and they do not tough it out 
when those profits are unrealized. We learned this lesson the hard way 
last year when 96 Medicare HMOs deserted more than 400,000 Medicare 
beneficiaries, including in Lorain and Trumbull Counties, Ohio, because 
the HMOs did not meet their profit objectives.
  Before the Medicare program was launched in 1965, more than half the 
Nation's seniors were uninsured. Private insurance was the only option 
for the elderly, but insurers did not want seniors to join their plans 
because they knew that seniors would actually use most of their 
coverage. The private insurance market has changed considerably since 
then, but it still avoids high risk enrollees and, whenever possible, 
dodges the bill for high-cost medical services.
  The problem is not necessarily malice or greed. It is the expectation 
that private insurers can serve two masters, the bottom line and the 
common good. Logically, always looking to the bottom line, our system 
of private insurance has left 43 million uninsured individuals in the 
United States. If the private insurance industry cannot figure out how 
to cover these people, most of whom are middle-income workers and 
children, how will they treat high-risk, high-cost seniors?
  If we privatize Medicare, we are telling America that not all seniors 
deserve the same level of quality health care. We are betting on a 
private insurance system that puts its own interests ahead of health 
care quality and a balanced Federal budget.
  The Medicare Commission wisely disbanded without delivering a final 
product. Premium support proponents must realize that they cannot make 
Medicare privatization look like an equitable, fair alternative to the 
public program upon which 36 million seniors in this country depend. 
Premium support backers also have repeatedly tried to scare America's 
seniors by predicting that Medicare will go bankrupt.
  Congress would not let Medicare go bankrupt any more than it would 
let the Department of Defense run out of money.
  The goal is simple. Let us keep Medicare the successful public 
program it has always been.

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