[Congressional Record (Bound Edition), Volume 146 (2000), Part 17]
[Extensions of Remarks]
[Pages 25613-25614]
[From the U.S. Government Publishing Office, www.gpo.gov]



                   MEDICARE AND MEDICAID IMPROVEMENTS

                                 ______
                                 

                        HON. FORTNEY PETE STARK

                             of california

                    in the house of representatives

                        Monday, October 30, 2000

  Mr. STARK. Mr. Speaker, for the Record, I submit a letter signed by 
133 Members sent to Speaker Hastert in support of improvements to the 
Medicare/Medicaid amendments of 2000 and the need for an open, fair, 
democratic process.
  If the requests in this letter had been followed, the quality of the 
bill passed by the House on October 26, 2000 would undoubtedly have 
been better and the veto threat may have been avoided.

                                    Congress of the United States,


                                     House of Representatives,

                                 Washington, DC, October 11, 2000.
     Hon. Dennis Hastert,
     Speaker of the House of Representatives, Speaker's Office, 
         The Capitol.
       Dear Mr. Speaker: As Democratic Members of the House of 
     Representatives, we are deeply concerned about reports that 
     the full House may not be given the opportunity to offer 
     amendments to the Medicare legislation which has been 
     reported by the full Commerce Committee and by the Ways and 
     Means Health Subcommittee.
       We further understand that these two bills are being melded 
     together without any involvement of Democratic Members or 
     staff, and we are very concerned that the House will be asked 
     to vote quickly on a final bill which we have not seen or 
     been involved with.
       Therefore, we ask that you schedule this legislation (which 
     spends roughly $25 billion dollars over the next five years) 
     for at least several hours of debate and with a rule that 
     allows a number of amendments.
       We note that the two Committees' bills have many excellent 
     features, particularly those sections that directly help 
     beneficiaries. In particular, the various bills speed relief 
     from the high co-payment burdens of hospital outpatient 
     department services, help legal immigrants and their children 
     under Medicaid, cover glaucoma screening, permanently cover 
     immuno-suppressive drugs for organ transplant patients, help 
     the low-income receive Medicare premium and co-payment 
     relief, and make many other important program improvements. 
     We hope that these important improvements will not be 
     squeezed out, and that the final bill will retain these 
     excellent features. We are certain that the final bill will 
     receive the strong support of a majority of our Caucus.
       Still, adequate and open floor debate is essential, because 
     this is the last chance for this Congress to consider adding 
     a real prescription drug program to Medicare. An open debate 
     would allow Members to include the type of Medicare 
     prescription medicine program the American people want. It is 
     unconscionable for this Congress to adjourn without 
     addressing the prescription medicine crisis facing so many of 
     our senior and disabled citizens. If the House can meet many 
     of the legitimate needs of health care providers, it can 
     certainly also address the needs of Medicare beneficiaries. 
     To adjourn giving billions to managed care plans, but failing 
     to help all seniors with prescription drugs costs would be 
     shameful.
       We would like to provide a completely voluntary 
     prescription medicine benefit within

[[Page 25614]]

     the traditional Medicare program. Our plan has no deductible, 
     covers half the cost of medicines up to $2000 in the first 
     year, gradually rising to $5000 by 2009. Any beneficiary who 
     has out-of-pocket costs greater than $4000 would be fully 
     protected against further catastrophic pharmaceutical 
     expenses. Premiums for this voluntary program are $25 a month 
     in the first year, and will gradually increase as the benefit 
     increases. All seniors would be assisted with price discounts 
     on all of their medicine purchases and low-income seniors 
     would be fully protected. According to the Congressional 
     Budget Office, this proposal would cover almost all seniors, 
     whereas the bill which passed the House this summer leaves 
     7.8 million Medicare beneficiaries (one-in-five) unprotected.
       It is particularly ironic that the Ways and Means Health 
     Subcommittee bill does not include a prescription drug bill 
     for seniors, but provides hundreds of millions of dollars in 
     extra payments to pharmaceutical companies, by delaying the 
     implementation of more accurate non-chemotherapy drug prices 
     which have become available as a result of an extensive 
     investigation by the Justice Department.
       In addition to the prescription drug amendment, various 
     Members in the Democratic Caucus would like to offer 
     amendments to provide more balance to the bill: by ensuring 
     that it includes additional beneficiary protections and 
     improvements; by ensuring that it includes additional 
     beneficiary protections and improvements; by requiring HMOs 
     to be more accountable to enrollees in exchange for the 
     higher payments in the bill, and by doing more for hospitals, 
     nursing homes and other traditional providers and less for 
     HMOs. We believe the reported bills give a disproportionate 
     amount of relief to HMOs. The Majority's decision to give 
     HMOs so much should not prevent us from giving adequate 
     relief to other deserving providers. We believe that more of 
     the surpluses which allow such changes should go to 
     traditional providers and the seniors and the disabled whom 
     Medicare is designed to serve.
       Thank you for your consideration of these requests. This 
     Congress must not adjourn without addressing the need to help 
     health care providers with the unintended impacts of the 
     Balanced Budget Act of 1997; the need for seniors and the 
     disabled to afford necessary pharmaceuticals; and 
     improvements in the Medicare and Medicaid program to fill gap 
     in care for the disabled and homebound, in the cost of 
     treatments, and in covering modern, preventive care services.
           Sincerely,
         John D. Dingell, Ranking Democrat Committee on Commerce, 
           Richard A. Gephardt, Democratic Leader; Charles B. 
           Rangel, Ranking Democrat Committee on Ways and Means; 
           David E. Bonior, Democratic Whip; Ed Markey, and 124 
           others.