HEARING - U.S. Senate Special Committee on Aging

43
will be tough, and I am glad I am not sitting in your seat, because
we are talking about spending a lot of money at a time when the
Government does not have a lot of money to support programs like
that.
But I can say from my own personal perspective that I would
like you to spend some of my money and tax me to help these
people out. I am not speaking for anybody but my personal self
now, but I see these needs, and I think you have got to bring yourselves
to get some tax dollars out there to take care of some of
these needs. It is not going to be an easy thing to do, but I think
you are going to have to do it.
I think I might give you a little bit of insight regarding the
Bowen proposal as it fills the catastrophic gaps that we need to
cover. I guess I would generalize first and say that Bowen's proposal-and
here, I think I had better define Bowen's proposal as his
proposal for people with Medicare to expand the Medicare program-because
he has made lots of different proposals that covers
a whole gamut of options and so on, but--
Senator WILSON. Mr. Chairman, excuse me. I hate to interrupt,
but I am having difficulty hearing Mr. Shapland. If you could
speak a little louder, please.
Mr. SHAPLAND. All right. In the context of that portion of
Bowen's proposal, I think you are going to find in your studiesand
we have charts and things that might be helpful on this-that
his proposal adds very little to the solution of the catastrophic
problem, and that is for several reasons.
One, it addresses, as you have already talked about here today,
only those types of expenses covered by Medicare. And as we have
also talked about here today, Medicare has a limited laundry list of
things it covers, and then a lot of things it does not cover.
Senator HEINZ. Excuse me, Mr. Chairman. Could I interrupt just
to clarify something? A few minutes ago, you said that there were
some problems, that you could not disagree with any of the kinds
of problems that have been laid out here. And yet on the first page
of your testimony, you say,
If I could summarize for you the prevailing conclusion from our industry's assessments
of Medicare and its present condition, I would have to say that we see no
compelling need to begin a major overhaul of this program. In our opinion, the current
combination of private and public coverage is serving the public well. So, since
the system obviously is not "broken", a major "fix" hardly seems warranted.
My question is I do not understand why you were here a minute
ago saying that you could not disagree with anything the witnesses
were saying, and your statement says the opposite.
Mr. SHAPLAND, I am glad you asked that question because that is
a confusing point. What we are saying is within the context of
what Medicare is paying for, its laundry list of covered items, and
only in that context, we agree that the Medicare and private insurance
industries are providing catastrophic coverage, but--
Senator HEINZ. For those things that are being paid for.
Mr. SHAPIAND. Yes, right.
Senator HEINZ. For those things that are not being paid for,
which include for a lot of people catastrophic coverage, things are
still working well?
Mr. SHAPLAND. No, no.