E82 CONGRESSIONAL RECORD — Extensions of Remarks January 9, 1997 obsolete institution known as the electoral col- pendents could be forced to seek illegal and one of those goods which by their nature are lege. unsafe procedures or could be forced to delay not and cannot be mere commodities. Given It is no accident that this bill is being intro- the procedure until they can return to the Unit- this special status, the primary end or essen- duced today, the day that the electoral ballots tial purpose of medical care delivery should ed States. be a cured patient, a comforted patient, and are opened and counted in the presence of This is an issue of fundamental fairness. a healthier community, not to earn a profit the House and Senate. I hope that the timing Servicewomen and military dependents sta- or a return on capital for shareholders. of this bill's introduction will only underscore tioned abroad do not expect special treatment, The goal isn't health care anymoreÐthe the fact that the time has come to put an end only the right to receive the same constitu- goal has become the care of the stockholder to this archaic practice that we must endure tionally protected medical services that women interest. every 4 years. in the United States receive. Only the President and the Vice President That's why today, as the senior Democratic THE PROBLEM of the United States are currently elected indi- woman on the House National Security Com- Historically, the nonprofit hospital has, in rectly by the electoral collegeÐand not by the mittee, I am introducing the ``Freedom of general, assured that necessary services are voting citizens of this country. All other elected Choice for Women in the Uniformed Services available, that all populations are cared for, officials, from the local officeholder up to U.S. Act.'' This bill simply repeals the statutory pro- and that there is always a place to go for care. Senator, are elected directly by the people. hibition on abortions in overseas military hos- The goal of a for-profit hospital is just thatÐ Our bill will replace the complicated elec- pitals and restores the law to what it was dur- profit. The for-profits allegiance is to their toral college system with the simple method of ing most of the Reagan administration. If en- shareholder, not the communityÐand certainly using the popular vote to decide the winner of acted, women would be permitted to use their not the uninsured or poor. The for-profit hos- a Presidential election. By switching to a direct own funds to obtain abortion services. No pital chains have the minds of piranha fish and voting system, we can avoid the result of Federal funds would be used and health care the hearts of Doberman pinschers. Whereas for-profit hospitals are accountable electing a President who failed to win the pop- professionals who are opposed to performing to their shareholders, nonprofit hospitals have ular vote. This out come has, in fact, occurred abortions as a matter of conscience or moral another kind of accountabilityÐto patients, to three times in our history and resulted in the principle would not be required to do so. providers of care, to payers and to the com- elections of John Quincy Adams, 1824, Ruth- I would like to thank my colleagues CONNIE munities in which they operate. Instead of pro- erford B. Hayes, 1876, and Benjamin Har- MORELLA, ROSA DELAURO, SUE KELLY, RON ducing a return on investments to sharehold- rison, 1888. DELLUMS, JOHN BALDACCI, EVA CLAYTON, JOHN ers, nonprofit hospitals have the inherent moti- In addition to the problem of electing a CONYERS, SAM FARR, BARNEY FRANK, MARTIN vation and deep obligation to produce a dif- President who failed to receive the popular FROST, LYNN RIVERS, LUCILLE ROYBAL-ALLARD, ferent kind of returnÐthat of quality care to vote, the electoral college system also allows and LOUISE SLAUGHTER for joining me as origi- for the peculiar possibility of having Congress nal cosponsors. their patients and overall good for the commu- decide the outcome should a Presidential tick- I urge the House to take up and pass this nity. The need to show a profit focuses the for- et fail to receive a majority of the electoral col- important legislation restoring the right of free- profit hospital on cost structure rather than on lege votes. Should this happen, the 12th dom of choice to women serving overseas in the structure of care. Their decisionmaking amendment requires the House of Represent- our Nation's Armed Forces. cannot help but he skewed toward sharehold- atives to elect a President and the Senate to f elect a Vice President. Such an occurrence ers rather than patients. Whereas nonprofit would clearly not be in the best interest of the THE PURSUIT OF PROFIT: NON- hospitals manage care because doing so im- people, for they would be denied the ability to PROFIT HOSPITALS BECOME THE proves health outcomes, for-profit hospitals directly elect those who serve in our highest BIG PUBLIC GIVEAWAY OF THE manage the cost of care because it is the offices. NINETIES cheapest, most profitable thing to do. Their This bill will put to rest the electoral college primary legal and fiduciary dutyÐto return a and its potential for creating contrary and sin- HON. FORTNEY PETE STARK profit to the shareholdersÐputs patients and gular election results. And, it is introduced not public welfare in second place. OF CALIFORNIA In 1993, there were 18 conversions of non- without historical precedent. In 1969, the IN THE HOUSE OF REPRESENTATIVES House of Representatives overwhelmingly profit hospitals and health care plans. In 1995, Thursday, January 9, 1997 passed a bill calling for the abolition of the there were 347. In the past 18 months, for ex- electoral college and putting a system of direct Mr. STARK. Mr. Speaker, today along with ample, Columbia HCA, the largest of the for- election in its place. Despite passing the Mr. LEWIS of Georgia, Mr. MCDERMOTT, Mr. profit hospital chains, has completed, has House by a vote of 338 to 70, the bill got WAXMAN, Mr. FILNER, Mr. KENNEDY of Rhode pending, or is in the process of negotiating bogged down in the Senate where a filibuster Island, and Mr. BROWN of Ohio, I am pleased more that 100 acquisitions or joint ventures blocked its progress. to introduce the Medicare Non-profit Hospital with nonprofit hospitals. I have many concerns about the sale of So, it is in the spirit of this previous action Protection Act of 1997 in response to the fast- nonprofit hospitals to for-profit corporations: that we introduce legislation to end the elec- growing number of hospital conversions. Con- too often the terms of the sale are secret; toral college. I am hopeful that our fellow version refers to the process by which a non- there are often conflicts of interest among the members on both sides of the aisle will stand profit entity opts to change its nonprofit status parties; the mission of the nonprofit foundation with us by cosponsoring this important piece and forgo its tax exemption. In a conversion, that results from the conversion may not be of legislation. investor-owned, for-profit companies buy com- consistent with the original mission of the hos- f munity, nonprofit hospitals in deals that usually are secret, with costs and details not dis- pitalÐthe funds in the resulting foundation are THE FREEDOM OF CHOICE FOR closed. Proceeds of the sales are suppose to sometimes used for things like sports training WOMEN IN THE UNIFORMED establish charitable foundations. facilities, flying lessons, or foreign language programs in schools; and the valuation price is SERVICES ACT HEALTH CARE IS A SERVICE, IT IS NOT A COMMODITY TO BE BOUGHT AND SOLD often much less than it should be. Perhaps HON. JANE HARMAN Some how we've reached the point where most important, quality and access to health care in the community is often significantly di- OF CALIFORNIA our society thinks of the medical system not in minished. IN THE HOUSE OF REPRESENTATIVES terms of keeping patients well or helping them COLUMBIA HCAÐTHE PAC-MAN OF THE INDUSTRY Thursday, January 9, 1997 get better but instead as a fiercely competitive business in which survivors concentrate on Columbia HCA, the largest of the for-profit Ms. HARMAN. Mr. Speaker, among the making tremendous amounts of money. hospital chains, is characterized as the PAC- more extreme laws put in place by the last The late Cardinal Bernadin, Archbishop of MAN of the industryÐgobbling up nonprofit Congress is the policy banning privately fund- Chicago, had it right in his speech to The Har- hospitals as it expands its market share in ed abortions performed at overseas military vard Business School Club of Chicago, He communities across the United States. Nation- hospitals. This policy means that women serv- said: wide, Columbia HCA is riding high from doz- ing overseas in our Nation's Armed Forces Health care . . . is special. It is fundamen- ens of acquisitions of hospitals that have cannot exercise the same constitutional rights tally different from most other goods be- made it not only the biggestÐwith 355 hos- afforded women living in the continental Unit- cause it is essential to human dignity and pitalsÐbut also one of the wealthiest for-profit ed States. These servicewomen and their de- the character of our communities. It is . . . chains with $18 billion in annual revenue.