Health Care Reform

Floor Speech

Mr. INGLIS. Madam Speaker, the gentleman just before me was speaking about the public option. And I, like him, am happy that the Senate Finance Committee has turned down the public option. But I don't think the snake is dead yet here on the House floor because it seems that the Speaker is working over the CBO numbers in trying to persuade some folks there is some $85 billion worth of savings if we just set the reimbursement rate at 5 percent above Medicare.

Well, let's think that through. Here is what we've got. We've already got two public programs that under-reimburse providers. In fact, for hospitalizations, Medicaid, which is a Federal and State program, reimburses typically at 87 percent of actual cost for hospitalizations. Medicare reimburses at 92 percent of actual cost. So if you go 5 percent higher than Medicare, if I'm doing the math right, it means that maybe the new public option would reimburse maybe 93, 94 percent of actual cost, which means that you have got a 13 percent cost shift in Medicaid, a 7 percent cost shift in Medicare; and now if a public option comes to be, a 6 percent or so cost shift there. The result is that private payers have to pay 129 percent of actual cost, on average, when they go into the hospital. Now that's a problem because if it's 129 percent of actual cost, it means that premiums go up.

So the public option, far from solving the problem of cost shift, actually is going to add to the problem of cost shift by giving us a third Federal program that adds to the problem. So it's clear that this is not a solution, and the $85 billion worth of savings is not a real savings. It's a savings only if you can go pull money out of the pocket of anybody that walks into the hospital with an insurance card in their pocket, because again, they pay 129 percent of actual costs.

So somehow what we have to do here in this health care reform business is figure out how to stop that cost shift, how to be accountable here at the Federal Government so that we're not paying just 87 percent of actual cost for Medicaid patients, not just paying 92 percent of actual costs for Medicare patients, and certainly not creating a third program that will under-reimburse hospitals.

So our challenge, the challenge before us, is to figure out how to stop the cost shift and how to be accountable from here in Washington, from our State capitals, and surely not to create a public option that just adds to the problem

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