[Congressional Record (Bound Edition), Volume 146 (2000), Part 12]
[House]
[Pages 17837-17838]
[From the U.S. Government Publishing Office, www.gpo.gov]



                    PRESCRIPTION DRUGS AND MEDICARE

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Ohio (Mr. Brown) is recognized for 5 minutes.
  Mr. BROWN of Ohio. Mr. Speaker, the public learned something about 
presidential candidate George Bush last week. Actually, the word 
``important'' is an understatement. We learned something crucial. We 
learned his plans for Medicare.
  Every senior citizen, every person with a family member covered by 
Medicare, every taxpayer in this country needs to understand this. 
George W. Bush believes Medicare as we know it should be replaced by 
private insurance plans. That is not conjecture. It is fact. It is what 
he tells us.
  It is clear as day if one looks at his prescription drug plan. The 
first part of his proposal features a transitional program designed to 
give a special commission time to come up with a private sector 
alternative to the Medicare program. Mr. Bush goes so far as to avoid 
the obvious. That is adding prescription drugs to the list of health 
care services and supplies that Medicare covers. He actually advocates 
a transitional prescription drug program feature with mini-
bureaucracies in each State to administer temporary prescription drug 
welfare programs. If one is opposed to big government, this part of his 
proposal is their worst nightmare: 50 State bureaucracies.
  His welfare-type program approach, which would cover the lowest-
income seniors only, is also sorely inadequate. Nearly half of all 
seniors who lack prescription drug coverage would be left out in the 
cold. The first part of his proposal may simply be ill conceived. The 
second part is simply irresponsible.
  Under that section, the Federal Government would begin to subsidize 
part of the cost of private prescription drug coverage, but only after 
the Medicare program as a whole undergoes a transformation. That 
transformation, not surprisingly, features private insurance-type HMO 
health plans. Privatization of Medicare is not a transformation. It is 
an oxymoron. Private insurance plans cannot replace Medicare. Private 
insurance plan HMOs, their loyalty is to the bottom line. How many 
times do we have to intervene when a managed care or other insurer plan 
messes? Up how many times do we have to intervene on behalf of our 
constituents before the industry's loyalties become clear to us?
  The loyalty results in decisions that are not in the best interest of 
enrollees. That loyalty is what creates the need for a Patients' Bill 
of Rights, which this House of Representatives and the other body 
should pass and send to the President. That loyalty, the bottom line, 
explains why health insurers market to the healthiest individuals and 
do everything in their power to avoid the sick. That loyalty explains 
how private, managed care plans, how private insurance company HMOs, 
contracting with Medicare, could enroll seniors one year, promising 
them all kinds of benefits, and unceremoniously drop them the next 
year; promise supplemental benefits they cannot deliver and then blame 
the government for problems that they created.
  The traditional Medicare program is different. It is universal. It is 
reliable. It is accountable to the public. It has 1 to 2 percent 
administrative costs. Medicare's loyalty is to beneficiaries and to 
taxpayers. It is an undiluted commitment. Medicare offers choice in 
ways that actually make a difference in terms of health care quality 
and patient satisfaction. It does not tell beneficiaries which 
providers they can see and which providers they cannot see, like 
Medicare HMOs do, or provide financial incentives to discourage proper

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care, again as Medicare HMOs do, or interfere with the doctor/patient 
relationship, as Medicare HMOs do.
  Medicare does not tell beneficiaries any of those things.
  Having your choice of private health plans under the Bush plan, under 
private managed care, does not mean much if those plans all restrict 
access to providers and erect barriers to medically-necessary care. 
Medicare offers reliable coverage that does not come and go with the 
stock market, that does not discriminate against beneficiaries based on 
health status or any other criteria.
  So George W. Bush has decided to join his Republican colleagues to 
promote the privatization of Medicare, to end Medicare as we know it, 
and to provide a new market for private insurance plans. And when it 
comes down to it and prescription drugs, whom do you trust? Do you 
trust Medicare, traditional Medicare, that served the public well for 
35 years? Do you trust Medicare to provide these benefits to the public 
with prescription drugs, or do you trust private insurance HMOs who 
have pulled out of county after county, made promises they have not 
kept? It is a question of trusting traditional Medicare or, again, do 
you trust private insurance HMOs?

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