[Congressional Record (Bound Edition), Volume 148 (2002), Part 9]
[House]
[Pages 12236-12237]
[From the U.S. Government Publishing Office, www.gpo.gov]




                                MEDICARE

  The SPEAKER pro tempore. Pursuant to the order of the House of 
January 23, 2002, the gentleman from Florida (Mr. Foley) is recognized 
during morning hour debates for 5 minutes.
  Mr. FOLEY. Mr. Speaker, several weeks ago a constituent of mine 
approached me to complain about her Medicare bill. I assumed this would 
be a typical complaint about either how much she was paying for 
premiums or how much she paid for services. Boy, was I wrong. Her 
complaint was worse. She was concerned not about her cost but about how 
much Medicare was paying for a particular product she uses. As a 
diabetic, she is required to wear special shoes that need shoe inserts. 
At one time, the only type of insert available was custom made. 
However, with the wide use of these products, coupled with advancements 
in technology, many of these inserts are now available off the shelf 
which are the ones that she gets for herself.
  Looking at her bill, I found that Medicare was paying, on average, 
$50 a pair for these inserts. This is the insert, a simple Styrofoam 
insert. The shoes she is required to wear are $134. The inserts for the 
shoe, over $50 apiece. She is required to pay a portion of that and 
Medicare reimburses, for three sets of diabetic shoe density inserts, 
$190. $190 for these inserts. In total, the provider was getting over 
$50 per pair for simple inserts. If you go to the local pharmacy or 
grocery store, you will discover that these off-the-shelf orthodontics 
cost only about $10. Even these inserts, which I purchased at CVS, a 
local pharmacy, not to do a plug for the pharmacy, but you can get them 
anywhere you want, they are Dr. Scholl's, these were $16. They look 
state of the art. They have all kinds of descriptions on them, a strong 
heel pad.
  I am not an orthopedic surgeon; I am not a podiatrist. I am a simple 
average person who had my own business in Florida, and I know how to 
comparative shop. I think we all do. But this is outrageous. If 
Medicare paid that amount for the $16, we would have saved 
substantially. She would have been thrilled and delighted. That is why 
she brought it to my attention, because she felt as a senior citizen, 
talking about Medicare and the need for prescription drugs, that we 
will never be able to solve the problems inherent in Medicare if we do 
not get our acts together and start finding ways to prevent these kinds 
of horrific overexpenditures of the Federal Government.
  But why do they do it? Let us ask the basic question. Why did people 
charge such an outrageous sum of money for these, what I will call, 
rather inadequate inserts? Because Congress told them to. We wrote into 
the statute what price should be paid for these products, assuming at 
the time that the only available insert was custom made. Now that off-
the-shelves are available, Medicare is stuck.
  In today's Washington Post, there is an article talking about the 
rising cost of health care and the choices many employers, including 
the government, will have to make if these skyrocketing costs are not 
placed under some control. Two weeks ago, Congress began to address 
this problem when we passed H.R. 4954, the Medicare Modernization and 
Prescription Drug Act of 2002. However, we need to do more. We need to 
look at the entire Medicare program from top to bottom and allow the 
marketplace, not Congress, to determine prices. The only way we can 
save both the Medicare program and our health care system in general is 
to stay out of the business of setting prices and establishing 
controls.
  I look forward to working with Chairman Thomas and others as we 
continue to debate this very important issue. The Republicans, when we 
proposed prescription drug coverage, we recognized that within 
Medicare, for its solvency, we needed to do more and should be able to 
do more to provide for these benefits for our constituents, our 
seniors, and do so without robbing and causing taxes to have to be 
increased on existing working Americans. If we continue down this path 
and allow this kind of ripoff to take place, if we allow an insert to 
be over $60 a pair paid for by the Federal Government, then we will be 
walking away from our responsibilities to our seniors, we will bankrupt 
Medicare, and we will cause significant disparity for seniors.
  We believe we have an answer, but we believe we have to act now. 
There is no way anyone can explain to me and give me comfort about 
these charges and make me believe this is a legitimate expense of the 
Federal Government. Yes, she needs insoles; but at $16 versus about 
$50-plus, I think we can find a way to not only make her walk 
comfortably but save the Federal Government a ton of money. Therein 
lies the opportunity to provide a prescription drug coverage for our 
seniors who need it.

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