Death with Dignity, the Balance Budget Act and Medicare Funding

Mr. Speaker the Balanced Budget Act of 1997 (BBA) substantially cut payments to health care providers in order to reduce total Medicare spending. I voted against the Balanced Budget Act because the cuts were too severe and have threatened health care delivery to the Medicare population. It is no surprise to me that the bill before us today, H.R. 2614, seeks to undo portions of the BBA. However, I am extremely disappointed with the unfair provision of this bill; it doesn't provide adequate help to the neediest parts of our health care system.

     

  • Hospitals absorbed the largest funding reductions under the BBA, Oregon hospitals alone are expecting a $33.6 million loss in fiscal year 2002. However, hospitals only receive a fraction of the `give back' provided by H.R. 2614. Over 41 percent of the spending in this bill goes to Medicare HMOs, affecting only the 16 percent of the Medicare population covered by managed care plans. I will not support a bill that does not provide sufficient relief to our hospitals, home health care agencies, nursing homes, and hospices.
  • Hospital payments aside, the increased funding to Medicare HMOs does not ensure improved healthcare for Medicare HMO customers, nor does it address the flawed Medicare managed care reimbursement rate structure that unfairly punishes cost effective states like Oregon. Managed care plans in my district have recently doubled the monthly co-payment from $35 to $69.50 with no corresponding increase in benefits. At the same time, seniors in states with higher than average reimbursement rates like California, New York, and Arizona have no out-of-pocket costs for health care and often receive dental and vision coverage and a prescription drug benefit. It is unfair to increase payments to Medicare HMOs without focusing relief on those customers that are forced to pay the highest rates and receive the fewest benefits.
  • A major concern is a provision that would criminalize decisions doctors make on pain management for the most seriously ill and overturn Oregon's Death with Dignity Act. Oregonians have twice voted to support the assisted suicide law. H.R. 2614 not only is an attack on the Democratic process, but also threatens to pain management. There is evidence that doctors are increasingly hesitant to prescribe pain medications to terminally ill patients for fear of being accused of unlawfully assisting a suicide. The on-going attempts by Congress to criminalize the doctor-patient relationship are a threat to pain management in all fifty states.

     

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