<font size="-1" , face="Arial" ,"Helvetica">National Bipartisan Commission on the Future of Medicare

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Opening Remarks by U.S. Rep. Jim McDermott (D-WA)

March 6, 1998

Thank you Mr. Chairman. Let me begin by saying that I am honored to be a part of this very important Bipartisan Commission on the Future of Medicare and I am genuinely excited that we are finally getting underway.

Just looking around the dais, you can see that each person up here is committed to "saving" the Medicare program. But, I think if you asked each of us today what that program should look like in 10 years, or how much it should cost, or whom it should cover, I think you will get 17 different answers.

So it's clear that we've got a lot of work to do over the next 11 months. I am hopeful that under Chairman Breaux's leadership we can establish a schedule and an agenda that will maximize our time together so that we can make the most of the entire mandate which drives the Commission.

Before I get into some of the goals which should be priorities for this Commission, I want to preface my comments with a vigorous endorsement of Medicare's accomplishments and impact on the quality of life of our senior citizens and disabled. Since its creation just over thirty years ago. Medicare has dramatically improved the lives of millions of Americans and their families. By guaranteeing health coverage to the elderly and disabled, the Medicare program has been a key factor in ensuring that a generation of American families have been able to achieve a significant level of economic success.

I feel strongly that in a country as wealthy as ours, health care should be a right. Absent universal coverage, we have little choice but to refine as best we can the patchwork health care system we already have. Medicare is a crucial component of that system for all generations of Americans. As a member of this Commission, I want to work with everyone in this room to make our system stronger and better.

As you know, Americans of all ages share similar anxieties when it comes to health care quality, cost, and availability. The threat to Medicare's security has generated profound concern among baby boomers and the elderly. Parents are caught in the predicament of where to spend scarce resources -- choosing among the education and health care needs of their kids, the health care needs of their parents, and their own needs. It is a sad fact that Americans between ages 62-45 year are losing their health insurance at a rate faster than any other generation.

In preparation for today's meeting, I was asked to fill out a questionnaire. One set of questions dealt with what goals should the Commission set for itself. I thought about this issue for quite some time, and rather than set arbitrary goals or set us on a course that gets us bogged down in the minutia of the Medicare program and possibly losing sight of our mandate, I suggested some core goals which this Commission should, at the minimum, attempt to achieve.

In my view, a major goal of this Commission should be to leave the confines of the Beltway, and learn about Medicare with the rest of the country. The Commission must engage the public in its discussion about Medicare. In the event of a worst case scenario, where we are unable to achieve consensus on the majority of issues, we should at least ensure that we have not wasted our discussions and reasoning behind closed doors or within the confines of DC. Additionally, if the Commission achieves consensus on comprehensive reform, the public needs not only to be included in that process, but prepared for its outcome.

Another top priority is to do no harm: The worst thing the Commission could do is harm the Medicare program by eroding the benefits guaranteed to beneficiaries under the current system.

Beyond these two basic goals, the Commission should not be afraid to modernize Medicare. We need to ensure Medicare has a seamless benefit package which matches current employee health benefit packages. That package could include prescription drugs, control of out-of-pocket costs, rational cost-sharing, hospital care, home health/long-term care, mental health care, and must account for possible Social Security changes.

In modernizing Medicare, we cannot abandon the concept which holds Medicare together: social insurance. Medicare must remain a program which provides everyone with adequate health care that's affordable. Medicare must continue to cross-subsidize between high and low-income beneficiaries and healthy and sick beneficiaries.

Now, while I am optimistic that this Commission can work, I would like to state again that our chances of failure will be significantly increased if we do not get outside the Beltway and bring this discussion to the people.

We need to be accountable and we certainly cannot hide behind this Commission as an excuse to do nothing this Congress.

Also, this Commission will fail if we limit the discussion purely to one about money. We had a big fight in the 104th Congress about whether or not we should turn Medicare into a voucher program. The American people said no. Concentrating our discussion to one about cost will once again turn this into a struggle between those of you who want vouchers and those of us who want Medicare to guarantee people tangible benefits.

And in conclusion, this Commission must take a close look at how well Medicare HMOs are taking care of seniors and the disabled. It's no secret that no matter what this Commission proposes, it most likely will seek to push more seniors into managed care plans. This is not to say that managed care is bad. We in the Pacific Northwest are quite proud of our health care system and managed care has worked quite well there for some time.

But there are a number of other HMOs, which you read about in the papers, that are not doing enough to ensure seniors have access to quality care. We must address those quality issues.

Mr. Chairman, I look forward to working with you and the rest of the Commission to address these and other issues vital to the continued success of the Medicare program. Thank you.


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