[Congressional Record (Bound Edition), Volume 145 (1999), Part 5]
[House]
[Pages 7539-7540]
[From the U.S. Government Publishing Office, www.gpo.gov]



                    MEDICARE MUST NOT BE PRIVATIZED

  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, many in Congress have been on a 
campaign to scare America's seniors into believing that Medicare is 
going bankrupt. They say Medicare must be privatized in order to save 
it. Once again, Medicare privatizers and their Mediscare campaign are 
wrong. The trustees of the Medicare Trust Fund have just reported that 
Medicare will remain solvent through 2015, up from its earlier 
projection of 2008.
  Those in Congress, the think tanks, and the Beltway 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. With the 
programs projected to last longer, we cannot rest on the our laurels, 
they say.
  The real threat to Medicare, however, is not its alleged pending 
bankruptcy. That is not true. The real threat is a proposal just 
rejected by the National Medicare Commission to privatize Medicare and 
deliver 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 
their voucher to buy into the fee-for-service plan already in effect, 
sponsored by the Federal Government, or join a private HMO plan.
  To encourage consumer price sensitivity, the voucher would track to 
the lowest cost private plan. Ostensibly, seniors would shop for the 
plan that best suits their needs, paying the balance of the premium and 
paying extra if they want higher quality health care. The proposal 
would create a system of health coverage but, most importantly, 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 quality care. The idea that vouchers would empower 
seniors to choose a health plan that best suits their needs is 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. The premium support proposal simply will not do that. 
Supporters of this voucher plan say it could shave 1 percent per year 
from the Medicare budget over the next few decades. But Bruce Vladeck, 
a former Medicare administrator, doubted it would save the Federal 
Government even one dime.
  Efforts to privatize Medicare are, of course, nothing new. Medicare 
beneficiaries have long been able to enroll in private Medicare plans. 
Their experience, however, does not bode well in a full-fledged 
privatization effort.

                              {time}  1245

  These managed care plans are already calling for higher government 
payments, they are dropping out of unprofitable markets, they are 
cutting back on benefits to America's elderly.
  Managed care plans obviously are profit-driven and they simply do not 
tough it out when their profits are not realized. We learned this the 
hard way last year when 96 Medicare HMOs deserted more than 400,000 
Medicare beneficiaries because the HMOs were not meeting their profit 
objectives.
  Before Medicare was launched in 1965, more than one-half of the 
Nation's seniors had no health insurance. Private insurance was then 
the only option for the elderly. But insurers did not want seniors to 
join their plans because they knew that seniors would use 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 malice or greed, it is the expectation that 
private insurers can serve two masters: the bottom line and the common 
good. Logically looking at the bottom line, our system leaves 43 
million people without health

[[Page 7540]]

insurance, 11 million of whom are children. Only Medicare can insure 
the elderly and disabled population because the private market has 
failed to do so.
  If we privatize Medicare, we are telling America that not all seniors 
deserve the same level of health care. We are betting on a private 
insurance system that puts its own private interests ahead of health 
care quality and ahead of a balanced Federal budget.
  The goal is simple, Mr. Speaker. Let us keep Medicare the successful 
public program it has always been.

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