[Congressional Record (Bound Edition), Volume 146 (2000), Part 14]
[House]
[Pages 19961-19962]
[From the U.S. Government Publishing Office, www.gpo.gov]



  CONGRESS MUST PROVIDE A TRANSFUSION TO AMERICA'S HEALTH CARE SYSTEM

  The SPEAKER pro tempore. Under a previous order of the House, the 
gentleman from Washington (Mr. Nethercutt) is recognized for 5 minutes.
  Mr. NETHERCUTT. Mr. Speaker, I am delighted today to pay tribute to a 
gentleman who is not only a friend but a great part of the Fifth 
Congressional District of Washington. His name is Gordon McLean. He is 
the Administrator of the Whitman County Community Hospital in Colfax, 
Washington. He has been working in my office the last couple of weeks 
on the issue of health care and helped me prepare these remarks today 
for delivery to the House. He is not only a valued friend but a 
valuable part of the medical community in eastern Washington and really 
across the Nation.
  Mr. Speaker, the Nation's health care system needs a transfusion that 
only Congress can provide. I am delighted to recognize the 
extraordinary health care system we have in my Fifth Congressional 
District of Washington, a model of cooperation, collaboration, and 
creative solutions to the challenges facing an industry continually 
pressed to do more with less and never make a mistake.
  Without a transfusion in the form of further Medicare and Medicaid 
relief, this system is in jeopardy, and it is not alone. The lack of 
reasonable and necessary reimbursement for quality health care services 
is affecting health care systems across our country. Right here, in 
what people in my State call ``the other Washington,'' one major 
hospital totters on the brink of closure, while another copes with a 
strike by nurses.
  Ever more often we see headlines about patients dying or being 
injured because of medication errors, short staffing, too much 
overtime, misuse of restraints, unsafe bed rails and overworked 
interns. Many of these reports are exaggerated, based on flawed or 
insufficient study and embellished by tabloid sensationalism. But we 
must admit that there is often an element of truth in every report.
  In a hospital, a reportable accident or a situation prompts a root-
cause analysis that is conducted to get to the root of the problem, 
change policies and procedures, and take steps to ensure the risk is 
reduced or removed. The truth is that more and more of these reportable 
incidents can be traced back to insufficient funding. The truth is that 
there will be more safety, service and staffing incidents until 
Congress provides a funding transfusion not only for hospitals but for 
community clinics, home health, and hospice services, graduate medical 
education, and all the vital components of our health care system.
  The Balanced Budget Act was a timely and appropriate effort by 
Congress, and I also believe that the reduction in projected payments 
for Medicare and Medicaid was intended to be reasonable and necessary. 
One intended consequence was what we eastern Washingtonians describe as 
separating the wheat from the chaff. There needed to be some pruning of 
excess duplication and abuse, shaking out those who saw Medicare as a 
gravy train. While painful and maybe a little too aggressive at first, 
the Medicare crackdown on Medicare fraud was timely and appropriate as 
well. Yes, it has been difficult for the last 3 years, but I believe 
our health care system is now and will continue to be healthier for the 
experience.
  At the same time, even Mother Joseph, who pioneered health care 
ministries in our great Pacific Northwest, the Mother Joseph we honor 
in our Congressional Hall of Statutes, understood the meaning of no 
margin, no mission. And it is this deteriorating margin in the health 
care industry that prompts my comments today.
  The new reality is that our extraordinary system of health care in 
this country, designed to care for the ill, injured and infirm is 
itself infirm, unstable and tottering. Yes, this system sacrificed for 
the cause of a balanced budget. Yes, there have been the pains of 
change as the system has become more efficient and productive. Needless 
to say, Medicare compliance is a priority for providers who have 
received the message from Congress.
  Yet, Mr. Speaker, I believe we have gone beyond intended consequences 
and are in the realm of serious systems failures if there is no boost 
to margins

[[Page 19962]]

for health care providers. One of the first rules in medicine is, 
``First do no harm.'' I believe we have reached the point of harm in 
many programs, from graduate medical eduction to home health.
  We recall the urgency to balance the Federal budget. We achieved that 
goal. And we recall how reductions in projected Medicare and Medicaid 
patients' payments made a significant contribution. I believe too 
significant. For example, 3 years into our 5-year program, we find the 
hospital inflation rate running at three to four times their Federal 
payment updates. The hospital inflation rate is driven by wage and 
benefit demands in a labor shortage environment, the rising cost of 
supplies, replacing and adding new technology, responding to greater 
numbers of uninsured, and adding staff to cope with the increasing 
complexities of administration.
  While I use the hospital example, I am speaking for the entire health 
care system. Each component faces similar as well as unique challenges. 
The one common denominator they share is deteriorating margins. 
Congress has been besieged by countless messages from health care 
providers telling us of the unintended consequences of the Balance 
Budget Act; that our reconciliation efforts last year were appreciated 
but were not enough; and that a 2-year transfusion is needed now.
  There is another saying in medicine. ``Bleeding always stops.'' The 
challenge is to determine the cause of the bleeding and take action 
before it is too late. Today, I ask my colleagues to join together in a 
bipartisan effort to recognize the extraordinary health care system we 
have in America, acknowledging enough is enough, and providing prompt 
and appropriate Balanced Budget Act relief to stem the bleeding, and to 
do no more harm to one of our Nation's most valued assets; the American 
health care system.

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