HEARING - U.S. Senate Special Committee on Aging

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Chairman MELCHER. Well, I have concluded one thing, and I
want to be sure I am right. What you are really recommending is
that we go beyond the Bowen proposal to take care of some of the
gaps that were evidenced today.
Mr. SHAPLAND. That is right. What I want you to realize is that
the gaps that he is trying to close have already been closed, plus
they are very minor gaps in any event, even if they had not been
closed, compared to-look at the chart over there; that is all you
have got to do-and you see that Mr. Bowen's proposal is a scratch
in the bucket or a drop in the bucket or whatever you want to call
it, compared to what the catastrophic needs today are.
I mean, for people who are spending money who are not covered
by insurance programs, it is nursing home care, and Bowen does
not make any change in the nursing home coverage.
Chairman MELCHER. And home health care, too.
Mr. SHAPLAND. Home health care, respite care. All of those
things need to be wrestled with. We have to decide what are the
true catastrophic needs of the people, but also how do you finance
them, and then how do you change health care to minimize those
costs besides. And home health care and respite care and those
things were suggested here today, and those are good suggestions
or ways of trying to minimize the health care costs that are out
there, and let people take care of their own, but have some relief
and so on, to keep people at home.
Chairman MELCIHER. Mr. Shapland, I am sure you have paid attention
to and gone through very carefully the booklet, the paper
published by the Harvard Medicare Project in March of last year
that said-I think they titled it, "Medicare Coming of Age.' In
that, they say that one-quarter of all Medigap plans are worthless
because they simply duplicate existing Medicare coverage.
First of all, does the Health Insurance Association of America
take care of everybody? Does everybody that sells Medigap insurance
belong to this association?
Mr. SHAPLAND. No. The Health Insurance Association of America
represents the majority of the health insurance business, but not
all of it.
Chairman MELCHER. Is that statement of theirs in this study correct,
that one-fourth of all Medigap policies merely duplicate what
is already there, and coverage that is already there in Medicare?
Mr. SHAPLAND. I have not read the report, but that statementmaybe
it is being taken out of context-I would say it is a blatant
lie. Chairman MELCHER. It is what?
Mr. SHAPLAND. A blatant lie, unless it is being taken out of context.
Chairman MELCHER. Oh, I just assumed that probably you knew
a lot more about this report than I do.
Mr. SHAPLAND. No, I have not read the report.
Chairman MELCHER. Would you mind digesting it for us?
Mr. SHAPLAND. Let me explain why I say that it cannot be true.
The Health Insurance Association of America, the National Association
of Insurance Commissioners, people from HCFA, people
from AARP-just a broad spectrum of people-sat down many
years ago and said if companies are going to sell a Medicare sup-