[Congressional Record (Bound Edition), Volume 146 (2000), Part 15]
[House]
[Page 21894]
[From the U.S. Government Publishing Office, www.gpo.gov]



                          RIGHT TO GO HOME ACT

  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. Madam Speaker, last year I introduced modest 
legislation that would allow seniors in managed care plans to return 
after a hospitalization to the retirement community they know, instead 
of a network HMO nursing home somewhere else. I offered the Right to Go 
Home Act on behalf of seniors who had been needlessly separated because 
of HMO rules from their loved ones and from their usual source of care.
  It is difficult to believe a health plan would treat a hospitalized 
senior this way, until you speak to Medicare+Choice enrollees, 
privatized Medicare, if you will, who experienced it firsthand.
  Take, for example, a couple in New Hampshire, separated after the 
husband's hospitalization because the HMO required him to be discharged 
to a nursing home in Maine, a 40 minute drive from the community where 
he and his wife had lived. Or a couple in Florida separated when their 
HMO required the wife to recuperate from a hospital stay in a nursing 
home 20 miles away from the retirement community. The husband had 
difficulty visiting her, and she died later at the HMO member facility.
  A retirement community, a nursing facility, is more than just a 
health care provider; it is a home. Forced relocation means moving 
vulnerable patients, taking them away from providers experienced in 
these individual's chronic care needs. It places them in new, strange 
surroundings during that fragile period of recovery. It separates them 
from emotionally supportive family and friends.
  Under our legislation, HMOs would not be required to pay a dime more 
for care provided at the beneficiary's retirement facility than in a 
network facility. What my bill would do is what HMOs should not need 
our prompting to do; that is, it allows hospitalized nursing home 
patients to recuperate near their loved ones.
  Yet the HMO industry opposes this legislation. They lobbied for 
changes in the bill that effectively would exclude all but a small 
subset of seniors. Fortunately, the Committee on Ways and Means did not 
buckle under the pressure of the HMO industry. They included their 
legislation in their Balanced Budget Act Restoration proposal.
  If the HMO lobby does not kill it, this legislation may make it into 
law. But the fact that Congress has to take action to ensure the well-
being of hospitalized seniors in Plus Choice plans and the fact that 
the HMO industry would lobby against this bill should tell us 
something.
  Those are facts Congress and the public should keep in mind as George 
W. Bush promotes commercial health insurance, as he promotes commercial 
health maintenance organizations, as a replacement, as a replacement, 
for Medicare.
  George W. Bush believes Medicare should be turned over to private 
insurers. That is not conjecture, that is fact. Visit his web site. His 
plan is to establish a 4 year commission to restructure Medicare so 
that it is no longer a ``one-size-fits-all big government plan.''
  Translate that into English. It means simply turning Medicare over to 
the private insurance industry. HMO's do some things well, but putting 
Medicare beneficiaries first is not one of them. How many times do we 
have to intervene with a managed care plan or other insurer on behalf 
of our constituents before the industry's loyalties become clear to us? 
Their loyalty is to their stockholders. No surprise there. It is 
verified every time managed care plans make decisions that fly in the 
face of good medicine.
  Unshakeable loyalty to the bottom line results in decisions often not 
in the best interests of Medicare enrollees. Unconditional loyalty to 
the bottom line is what creates the need for a Patients' Bill of 
Rights. Unwavering loyalty to the bottom line explains why health 
insurers market to the healthiest individuals, the most profitable, and 
do everything in their power to avoid the rest; let government do that.
  It explains how private managed care plans contracting with Medicare 
can enroll seniors one year, make money from them, and then cavalierly 
drop them the next when they are not quite as profitable. They promise 
supplemental benefits they cannot deliver; they blame the government 
then for problems that they, the insurance company-HMOs, create.
  It explains how the managed care industry has the nerve, the outright 
arrogance, to lobby against legislation that costs them nothing and 
means the world to seniors in nursing homes. It is a disgrace.
  The traditional Medicare program is different. It is universal, it is 
reliable, it is accountable to the public. Medicare's loyalty is to 
beneficiaries and to taxpayers. It is an undiluted commitment. Medicare 
offers choices in ways that actually make a difference in terms of 
health care quality in patient satisfaction.
  Medicare does not tell beneficiaries which providers they can see; 
HMOs do. Medicare does not dictate which hospitals and nursing homes 
are permissible; HMOs do. Medicare does not discriminate between 
beneficiaries based on their health status; HMOs do. Medicare offers 
reliable coverage that does not come and go with the stock market.
  So before voting for George W. Bush, I urge every American to think 
carefully about the wholesale changes he has in mind for Medicare.

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