Extensions of Remarks

23132 EXTENSIONS OF REMARKS August 11, 1992 EXTENSIONS OF REMARKS PROPOSAL FOR REFORM OF THE in which patients choose their doctors and tives for controlling costs in the high-tech AMERICAN HEALTH CARE SYSTEM pay for each visit-cost $3,400 in 1991 per em nology, disease-oriented health care system ployee in Cleveland and nationwide $3,600. which we have today. 2. ACCESS IS DECLINING The competitive model developed in the HON. DENNIS E. ECKART The roster of uninsured and undersured in early 1980's in the expectation that it would OF OHIO dividuals grows longer day by day. In Great control costs, has been a major disappoint IN THE HOUSE OF REPRESENTATIVES er Cleveland 13-15 percent are uninsured-in ment to many of us. Instead of resulting in operating efficiencies or the development of Tuesday, August 11, 1992 cluding a disproportionate number of chil dren. Many of these people live in poverty, market "niches" resulting in regionalized Mr. ECKART. Mr. Speaker, Thomas C. have little knowledge of basic health care services, many hospitals continue to believe Westropp, the chairman emeritus of Women's and often lack the know how to access what they have to be all things to all people in Federal Savings Bank and current chairman of ever services may be available to them. order to compete effectively for contracts Moreover, the poor are often forced to live in at times unnecessarily duplicating services. the Health Systems Agency of North Central Mergers, while offering some hope in the fu Ohio, recently presented a unique proposal for conditions which work against establishing a healthy longevity, but rather foster chronic ture for reduced administrative costs, have reform of the American health care system. and debilitating disease. not to this time reaped any measurable cost His proposal would provide opportunities for As if to add insult to injury, the State has savings. cost savings, protect the physician-patient re imposed additional barriers to care for the Reimbursement policies focus on treat lationship, and ensure access to quality health poor by denying the small assistance avail ment of diseases rather than prevention, a care for all Americans. In light of the Con able through the General Medical Assistance far less costly proposition. This in turn has gress' current concern with h9alth care reform, Program. In Cuyahoga County alone, this encouraged doctors to pursue expensive spe means that 36,000 people are denied basic cialties instead of primary care. As a result, I am happy to submit the following presen many areas of the country have no access to tation by Mr. Westropp to the Congress. health care services. The new Disability As sistance Program will be able to assist some primary care while other areas-witness HEALTH SYSTEMS AGENCY OF NORTH CENTRAL of these people-at most 6,000. It is clear, northeast Ohio-have what appears to be an OHIO however, that in spite of all the political abundance of specialists. (Presentation of Thomas Westropp) rhetoric to the contrary, the government's Fearing malpractice litigation, doctors As this will probably be my last presen ability and willingness to pay for health care order many unnecessary or inappropriate tation to HSANCO's Board, I want to use has been diminished. tests and procedures adding significantly to this opportunity to discuss some of the Some of the actions taken by businesses health care costs. things that have impressed me and some of and insurance companies have included prac And, finally the last contributors to the the thoughts I have had during my six-year tices that selectively insure only healthy problems of cost, access and quality are we tenure. young people and screen out the sick. consumers. I would like to share my concerns about Because of the costs, businesses have had Americans have greatly increased their our health care system-a system compris to reduce health care coverage or increase awareness of health and many rank good ing consumers, providers, and payors who co-pays. In some cases businesses are afraid health as their most important source of sat should work together but instead function in to begin to provide a health benefit that isfaction in life. In addition, an increasing ways that have resulted in increased costs, they might have to rescind later because of number of people have come to regard "free" reduced access, and concerns about quality. costs. health care as every bit as much a birthright And, finally, there is overwhelming anxi as public education. The system has become so complex that it ety among all income classes. An increasing seems unable to move in any productive di Everyone knows we're spending more and number of people are afraid to change jobs or more on health care. Total national expendi rection toward solving these problems. to take entrepreneurial risks because they I. First, I will discuss the crisis in health tures in 1970 were $75 billion; today we spend fear losing health coverage for themselves or more than $500 billion. But while awareness care that the nation is facing today; then their families. consider some of the factors that brought us and expectations have been heightened, to this point over time; and finally propose 3. OUR QUALITY OF LIFE IS UNDER SIEGE many people fear exclusion from treatment what I believe needs to happen to change The field of medicine lacks the reserves to because of its cost or loss of insurance cov this situation for the benefit of the health deal with the fact that it is a dynamic, rap erage. Anger and disillusionment often are care system-the consumers, the payors and idly changing discipline and one that is full the result of this exclusion from care even the providers. of unpleasant surprises. Consider, for exam though the fact remains that the need for ex We are all painfully aware that the nation ple, the emergence of two horrendous con pensive health care could be avoided by the is grappling with a monumental crisis in temporary problems-AIDS and cocaine ad American public simply choosing healthier health care and one for which the best and dicted babies. These problems alone are life styles. the brightest among us have been hard draining the resources of institutions across Meanwhile, vendors capitalizing on peoples pressed to offer viable solutions. Many pro the country at the very time we're strug heightened awareness of health are providing posals have been proffered during this elec gling to provide all people with simple basic a variety of health products ranging from ex tion year, but no workable consensus has health coverage. ercise machines to fitness spas, from emerged. We find ourselves caught in a quag The population is aging and the elderly "healthy" frozen entrees to vitamin pills, mire of self-interest, political expediency, need and use more health services than any from diagnostic kits to diet plans. They con and refusal to face the prospect of inevitable other age group. Our current health care sys vey the impression that anyone with the difficult decisions. tem is not yet geared up to provide the kinds money can buy good health. A few facts can demonstrate the depth and of services needed by people who are living The paradox is that while people generally scope of today's crisis: into their eighties and nineties, the so-called are more aware of what it takes to stay frail elderly. Medicine has made great gains healthy, they continue to eat, drink, smoke, 1. COSTS CONTINUE TO INCREASE with acute care and most infectious diseases drive and use drugs recklessly. They end up From 1980 to 1991 the average health pay but can claim little progress in dealing with going to doctors and hospitals for problems ments by families nationwide rose from the chronic debilitating problems resulting they might have avoided by changing their nearly $2,000 to over $4,000, a 145 percent in from longevity. Most of these problems can behavior, and this in turn adds to the overall crease. The estimate for the year 2000 is be managed best and at least cost outside of cost of health care. $9,000, an increase of nearly 440 percent since acute care settings. III. I've talked about the genesis of the 1980. II. At this point, I'd like to take a look at current health care system and how costs The expense of providing health care for some of the factors that have brought us to have compounded over the years and about workers jumped 10 percent in 1991 for Cleve this crisis point over time: people's heightened awareness of health and land employers and 13 percent nationwide. The payors-usually government or insur the belief of many that health care is a basic The cost of indemnity medical plans-those ance companies-have provided few incen- and the belief of many that health care is a • This "bullet" symbol identifies statements or insertions which are not spoken by a Member of the Senate on the floor. Matter set in this typeface indicates words inserted or appended, rather than spoken, by a Member of the House on the floor. August 11, 1992 EXTENSIONS OF REMARKS 23133 basic human right. At this point, at the risk and loans stay in business. By controlling tern. At present our system clearly does not of belaboring the obvious I'd like to suggest the cost of funds the Federal Reserve has a work. Although we have the best health care some ideas that can make the health care positive impact on the banking industry in the world it is not necessarily applied to system work better.

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