January 1999
by Senator James Jeffords
As Chairman of the Committee on Health, Education,
Labor, and Pensions with its jurisdiction over private health
insurance and public health programs, I anticipate that the
Committee will have an active health care agenda during the 106th
Congress.
Many of the healthrelated issues that this Congress
will address will build on the work of the last Congress. This is
part of the natural evolution of how legislation is developed;
rather than being rushed into law, most issues evolve into law, a
process which I believe we will see in the area of health
legislation.
Although we were not able to get a time agreement
that would have permitted consideration of the "Patents' Bill of
Rights" during the last Congress, I am hopeful that managed care
legislation could be debated early in the 106th Congress.
As the Health and Education Committee works on this
legislation, I will keep in mind three goals. First, to give
families the protections they want and need. Second, to ensure
that medical decisions are made by physicians in consultation with
their patients. And, finally, to keep the cost of this
legislation low so that it displaces no one from getting healthcare
coverage.
Information about products and services is the
keystone to any wellfunctioning market. A Patients' Bill of
Rights should require full information disclosure by an employer
about the health plans he or she offers to employees. Also,
consumers should be guaranteed a timely decision about what a plan
will cover.
If an individual disagrees with the plan's
decision, that individual should be allowed to ultimately appeal the
decision to an independent external reviewer. The reviewer's
decision should be binding on the health plan.
However, a patient should maintain his or her
current rights to go to court. And central to all managed care
bills will be a restatement of the right of patients to basic
medical services, such as emergency room care. The legislation
should also prevent discrimination based on predictive genetic
information. In addition, it should provide a stronger
emphasis on quality improvement in our health care system, with a
refocused role for the Agency for Health Care Policy and Research
(AHCPR).
While the normal course of legislation is to move
slowly, there is nothing like a deadline to accelerate the
process. An important health issue which comes to us with a
deadline this year is that of medical records confidentiality.
The Health Insurance Portability and Accountability Act of 1996
(HIPAA) directed Congress to enact legislation on electronic medical
record privacy by August, 1999. If Congress fails to act, this
law directs the Secretary of Health and Human Services to promulgate
regulations establishing privacy protections.
This is too important a matter of public policy to
be done outside of the legislative process, and it is my intent to
work with others to establish national standards to protect medical
information.
Still another issue inherited from the last
Congress is the need to combat the rise in tobacco use among our
children. The settlement between the states and the major
tobacco companies has changed the type of tobacco legislation likely
to come from Congress. While the new agreement takes off the
table the need for broad, Federal tobacco legislation, interest
continues in creating legislation which would define the role of
Federal health agencies in antismoking efforts, and, particularly,
the Federal role in efforts to reduce youth smoking.
Another issue which this Congress should tackle
will be longterm care. As our population continues to age and
the need for such care touches more and more families, the pressure
for government action will grow. Over the years numerous
members of Congress have worked on this issue, and President's
recent proposal will serve to give added visibility to the issue,
but the idea of a $1,000 tax credit will do little to address the
needs of families with longterm care obligations.
In my view, a longterm care solution must include a
long-range perspective, encouraging Americans to plan throughout
their working lives for the possibility of expensive nursing home or
home care in later years. Our solutions should also include a
variety of options so families can design a solution that conforms
to individual needs.
A recent study indicates that the nation's health spending will
more than double, from $1 trillion in 1996 to $2.1 trillion in
2007. Health spending as a share of gross domestic product
(GDP) is expected to increase from 13.6 percent to 16.6
percent. I intend to closely monitor the growth in national
health spending. The future of technology in medicine and
prescription drug costs will be a particular focus of the
Committee's examination of rapidly increasing health care
expenditures.
People want solutions to problems like health care;
they don't want fingerpointing about who is most responsible for
failure. I have always actively sought solutions, which is how
I will continue to approach issues in the 106th
Congress.
