Administration's 1994 health budget : hearing before the Committee on Finance, United States Senate, One Hundred Third Congress, first session, April 1, 1993

United States. Congress. Senate. Committee On Finance

Description

S. Hrg. 103-168 ADMINISTRATION'S 1994 HEALTH BUDGET Y4.F 49: S. HRG. 103-168 A*ni»islr*tio»'s 1*94 Ilealtfc Budget. HEARING BEFORE THE COMMITTEE ON FINANCE UNITED STATES SENATE ONE HUNDRED THIRD CONGRESS FIRST SESSION APRIL 19931, ocr efore are admitted.ofefficacy admitting person hospital nursing they actually -Costs 50 The federal share of medicaid administration covers 50All Other Administrative percent. medicaid administrative costs. These costs include those for: aof all other establishing drugpercent and a non-MMIS automated data nurses aiderebate processing system,system, installing operating outstationed workers.andtraining, eligibility AdministrationAFDC ofUnder current the AFDC enhanced rates for threelaw, provides matching categoriesprogram costs. The full cost of a alien verification of entitlement (SAVE)administrative installing systematic which determines status, is covered federal funds. Federal fundsimmigration bysystem, applicant ofused to cover 90 of the costs of andalso be planning, design, development, operationmay percent automated data The rate for the establishment andstatewide matchingprocessing systems. of fraud is 75 Table 2 shows the distribution otpercent.implementation prevention programs costs these functions.administrative among in Administrative RatesReductionProposed Matching would lower the federal rate for all AFDC. andThe Administration's medicaid,proposal matching 50 on 1994.

Sujets

• Health care
• Medicare
• United States
• Medicaid

Informations

• Publié par: les_archives_du_savoir
• Nombre de lectures: 10
• Langue: English
• Poids de l'ouvrage: 10 Mo

Extrait

S. Hrg. 103-168
ADMINISTRATION'S 1994 HEALTH BUDGET
Y4.F 49: S. HRG. 103-168
A*ni»islr*tio»'s 1*94 Ilealtfc Budget.
HEARING
BEFORE THE
COMMITTEE ON FINANCE
UNITED STATES SENATE
ONE HUNDRED THIRD CONGRESS
FIRST SESSION
APRIL 19931,
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Printed for the use of the FinanceCommittee on
U.S. GOVERNMENT PRINTING OFFICE
70-096-CC WASHINGTON : 1993
For sale the U.S. Government Officeby Printing
ofDocuments, Sales DC 20402Superintendent Congressional Office, Washington,
ISBN 0-16-041401-6S. HRG. 103-168
ADMINISTRATION'S 1994 HEALTH BUDGET
I.F 49: S.HRG. 103-168
»istr*tiot's m<t Itealtk Burfjet...
HEARING
THEBEFORE
FINANCECOMMITTEE ON
SENATEUNITED STATES
ONE HUNDRED THIRD CONGRESS
FIRST SESSION
APRIL 19931,
OCT
?5
for the use of the Committee on FinancePrinted
PRINTING OFFICEU.S. GOVERNMENT
: 199370-096—CC WASHINGTON
For sale the U.S. Government Officeby Printing
DC 20402of Documents. Sales Office,Superintendent Congressional Washington.
ISBN 0-16-041401-6COMMITTEE ON FINANCE
ChairmanDANIEL PATRICK NewMOYNIHAN, York,
MAX Montana BOB PACKWOOD,BAUCUS, Oregon
KansasDAVID L. Oklahoma BOBBOREN, DOLE,
V. DelawareBILL New WILLIAM ROTH, Jr.,BRADLEY, Jersey
C. MissouriGEORGE J. Maine JOHN DANFORTH,MITCHELL,
H. Rhode IslandDAVID Arkansas CHAFEE,PRYOR,
DAVE MinnesotaDONALD W. DURENBERGER,RIEGLE, Jr., Michigan
E. IowaJOHN D. ROCKEFELLER West CHARLES GRASSLEY,IV, Virginia
UtahTOM South Dakota ORRIN G. HATCH,DASCHLE,
JOHN B. Louisiana MALCOLM WALLOP,BREAUX, Wyoming
KENT North DakotaCONRAD,
DirectorLawrence OT)onnell, Jr., Staff
Edmund J. Mihalski, Chief of StaffMinority
(II)CONTENTS
OPENING STATEMENTS
Page
Hon. Daniel a U.S. Senator from New York, chairman,Moynihan, Patrick,
Committee on Finance 1
Hon. a U.S. Senator from 3Packwood, Bob, Oregon
Hon. a U.S. from North Dakota 4Conrad, Kent,
Hon. Charles a U.S. Senator from Iowa 4E.,Grassley,
Hon. a U.S. Senator from Arkansas 5David,Pryor,
Hon. Donald a U.S. Senator from 18W., Jr.,Riegle, Michigan
Hon. a U.S. Senator from Louisiana 20Breaux, John, Thomas a U.S. Senator from South Dakota 22Daschle, A,
Hon. a U.S. from Minnesota 24Dave,Durenberger,
COMMITTEE PRESS RELEASE
Finance Committee Schedules on Administration's 1994 HealthHearing
1Budget
ADMINISTRATION WITNESS
Hon. Donna Health and HumanShalala, E., Ph.D., Services,Secretary,
DC 6Washington,
PUBLIC WITNESSES
Jerald board of American MedicalSchenken, R., M.D., member, trustees,
NE 29Association, Omaha,
executive National Governors'director, Association,Scheppach, Raymond,
DC 31Washington,
Association ofAmerican MedicalForeman, M.D.,Spencer, president, Colleges,
and Montefiore Medical NY 32Center, Bronx,president,
executive vice for Federal American Hos-Pollack, Rick, relations,president
Jim seniorAssociation, DC,pital Washington, accompanied by Bentley,
vice for 35president policy
ALPHABETICAL AND APPENDLX MATERIAL SUBMITTEDLISTING
Max:Baucus,
statement 41Prepared
Hon. John:Breaux, 20Opening
Hon. Kent:Conrad,
statement 4Opening
Hon. Thomas A:Daschle, 22Opening
Hon. Dave:Durenberger,
statement 24Opening 41Prepared
Foreman, Spencer:
32Testimony
42statement with attachmentsPrepared
Hon. Charles E.:Grassley,
4Opening
statement 53Prepared
(III)IV
Page
Hon. Orrin G.:Hatch,
statementPrepared 53
Hon. J.:Mitchell, George 54
Hon. Daniel Patrick:Moynihan,
statement 1Opening
Hon. Bob:Packwood, 3Opening
Rick:Pollack,
34Testimony
statement 55Prepared
Hon. David:Pryor, 5Opening
statement 59Prepared
Hon. Donald Jr.:Riegle, W., 18Opening
Hon. John IV:Rockefeller, D.,
statement 60Prepared
JeraldSchenken, R.:
29Testimony
statement 61Prepared
Scheppach, Raymond:
31Testimony
statement 67Prepared
Hon. Donna E.:Shalala,
6Testimony
statement with attachments 78Prepared
to from Senators:Responses questions
Rockefeller 92
Chafee 98
101Durenberger
Hatch 106
108Wallop
Communications
American Association ofNurse Anesthetists 110 Clinical Association 118Laboratory of 122RadiationCollege Oncology
American of 126 Radiology Association 130Hospital Orthotic and Prosthetic Association 135
American Association 138Physical Therapy
American Association 141Psychiatric
American of 147Society Anesthesiologists of Internal 157Medicine
Association of Radiation 163CentersFreestanding Oncology
ofAmerican 165College Pathologists
Trade Association Healthcare Coalition 169
United Mine 171Workers ofAmerica Health and Retirement FundsADMINISTRATION'S 1994 HEALTH BUDGET
APRIL 1993THURSDAY, 1,
U.S. Senate,
Committee on Finance,
DC.Washington,
The was to at 10:10 inconvened, notice, a.m.,hearing pursuant
room Dirksen Senate Office Hon. Daniel PatrickSD-215, Building,
of the(chairman committee)Moynihan presiding.
Also Senatorspresent: Pryor, Riegle, Daschle, Breaux, Conrad,
andPackwood, Danforth, Durenberger, Grassley.
release the[The press announcing hearing follows:]
[Press Release No. H-10, March 24, 1993]
Finance Committee Schedules Hearing on Administration's 1994 Health
Budget
Senator Daniel Patrick Chairman of the Senate Committee(D.-N.Y.),Moynihan
on announced that the Committee will hold a to examineFinance, today hearing
the administration's health for fiscal 1994.budget year
will Shalala andWitnesses include Health and Human Services DonnaSecretary
of the American Medical the American Asso-representatives Association, Hospital
ciation and the American Association ofMedical Colleges.
The will at 10.-00 a.m. on 1 in room Dirk-Thursday, SD-215,hearing begin April
sen Senate Office Building.
OPENING STATEMENT OF HON. DANIEL PATRICK MOYMHAN,
A U.S. SENATOR FROM NEW COMMITTEEYORK, CHAIRMAN,
ON FINANCE
The Chairman. A to our wit-very distinguishedgood morning
the of Health and Human and to ourness, Services,Secretary
guests.
This is a that will Shalala thehearing give Secretary opportunity
to on for theand the President'sexpound explicate proposals
reductions and cost in the Medicare and Medicaidspending cutting
ofthe President'saspect budget.
I would take the if I can askliberty, my colleagues' indulgence,
to out that in both these are of the Socialpoint respects provisions
Act. And the of Social to our socialSecurity centrality Security pol-
in the United States is overlooked.icy easily
wethis last of the at oneDuring resolution,phase budget point,
had a to cut Medicare costs a amount. Theproposal by very large
statement we were on the Senate floor was that these cutsgiven
exclude Social You had to make the that we wereSecurity. point
about title XVIII of the Social Act. The connectiontalking Security
is not made.just
(1)This is not our most faceted but ifjust program, my colleagues
on this side will me to it is the Democraticpermit say so, perhaps
achievement in socialParty's greatest policy.
Franklin Roosevelt the bill 58 this Andsigned years ago August.
Frances who was much around in the of the Ken-Perkins, very age
she wrote in 1946 that Roosevelt re-nedy administration, always
the Social Act as the cornerstone of his administra-garded Security
tion. I think he derived satisfaction from it than fromgreater any-
else he achieved on the domestic front.thing
And the has all but eliminated fromproperly so, program poverty
the We have 41 million of which 26 millionamong aged. recipients,
are retired 7 million 3 million disabledworkers, survivors, workers,
and 5 million and children of retired or workers.spouses
There are about 135 million workers into the Thesystem.paying
itself is in a excellent financial state. It will run a bil-system $65
lion thissurplus year.
Medicare is in time are toldsurplus. Every you say that, you
that one it will not be. one we will not be either.day Well, day,
[Laughter.]
There used to be a wonderful in on ofover the wallssign, fact,
the House Committee on and Means in the 1960's. It said,Ways
to the of the end of the"Owing shortage experienced carpenters,
world has been indefinitely postponed."
But in the meantime in this veil of there is a withtears, problem
the of Social The of non-retiredpublic perception Security. majority
adults do not think will their Socialthey get Security.
And in one of the most memorable events that I have seen in my
former administrators of the Social Ad-here,experience Security
once a of have inministration, position great trust, begun, my
to abuse that trust terrorist lettersview, by making money sending
to the American public.
Two of the last three administrators of Social have nowSecurity
a that sends lettersjoined really rapacious organization terrifying
to senior them that fund isthe Socialpeople, telling Security
it has been it has it has beenbroke, looted, off, abandoned,gone
and will be and now all is lost unless sendthey abandoned, you
$15 immediately.
I refer to Ms. ThereMartha McSteen and to Ms. Dorcas Hardy.
was a time when this would never have whohappened. Nobody
had been the honor and of thatgiven high responsibility position
would dream of it in this manner. now do.Theyabusing
We held a on this. It has n