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Capitol Comment

    Capitol Comment 202 - A Health Care Checklist for Congress and President Clinton: Time to Clean Up Your Mistakes

    09/24/1998

    Members of Congress have only a few weeks before they go home and learn whether voters want them to return to Washington or stay put. Though they have much to do between now and Election Day, Congress and the president need to correct three dangerous errors they made that are threatening America’s health care.

    Mistake #1: Crippling Patient Access to Medical Savings Accounts.

    In 1997, Congress and President Bill Clinton introduced Americans to tax-free medical savings accounts (MSAs) through a small pilot program. MSAs combine high-deductible health insurance with a tax-free personal savings account. Patients pay their medical bills up to their deductible tax-free from the MSA; above the deductible, insurance takes over. Whatever patients do not spend grows tax-free in the account. They can also use deposits to pay health premiums when between jobs.

    MSAs promote health care quality and affordability. Because most medical decisions involve only a patient and a doctor, there are no treatment denials and no wrangling with bureaucrats. An IRS study of the pilot program found that every sixth MSA is opened by someone who was previously uninsured. One observer estimates 100,000 MSAs have been sold so far. If so, the program has already reduced the number of uninsured Americans by about 17,000.

    However, limitations on the program keep that number from climbing higher. No one can sign up after the year 2000, and only people who work for small businesses can participate. Regulations also hamper consumers’ choice of deductibles, copayments and their ability to make MSA deposits and withdrawals.

    Congress and the president must open this program to all Americans; make it permanent; let consumers choose their deductibles and copayments; and let consumers decide how to make deposits and how to spend extra MSA funds once they have saved one year’s deductible.

    Mistake #2: Taking Away Medicare Patients’ Choice of Doctors

    Also in 1997, Congress and President Clinton took away the right of many seniors to see the doctor of their choice. Under a new law, doctors who accept Medicare payment (or 96 percent of all doctors) cannot accept direct payment from seniors for services covered by Medicare. This effectively forbids Grandma to pay her doctor for such services even with her own money. Seniors who turn 65 to find their doctor is not taking any more Medicare patients must switch doctors because it is illegal to pay out of their own pocket. One Arizona doctor refused to treat a diabetic woman because he feared fines and imprisonment by the government. The president and Congress must end this affront to seniors’ rights.

    Mistake #3: Putting Your Sensitive Medical Information in a Government Database

    Finally, in 1996, Congress and President Clinton agreed to put every American’s medical records in a government database. They would assign each American a "unique health identifier" (like a Social Security number) that would track your entire medical history. Anyone who gets hold of your "unique health identifier" could post your most sensitive medical records on the internet. Worse, patients might not be completely forthcoming with their doctors if they fear someone else might gain access to the information. President Clinton and Congress should repeal this law and stop collecting information on Americans that is none of their business.

    Conclusion: clean up your mess.

    In just a few years, President Clinton and Congress have done serious damage to our health care rights, and Americans are suffering as a result. Whatever distractions lay ahead, they must correct these errors before Congress faces the voters.