HEARING - U.S. Senate Special Committee on Aging

I think we stand at a crossroads. Our choice is to strengthen and
expand our commitment to provide essential health care services
for all Americans or, in the alternative-which I hope we do not
do-to cave in to compulsive budgeteers and program polemics who
say we have done enough already.
I think the choice is clear, and I think Secretary Bowen, whom
we will hear from later this week, deserves credit for steering the
public debate down the right road with his proposal for catastrophic
coverage.
But I offer one caveat as Congress and all of us take up the issue
of catastrophic coverage, and that is this-that we should avoid
stopping short of a solution that is truly comprehensive. We have
to provide for a full range of services, from community-based to institutional,
from catastrophic acute to long-term care. We need a
solution, in other words, that protects against the impoverishment
of individuals and their families, that assures access to care without
regard to ability to pay, and for Americans of all ages. Most of
all, we need a solution which includes incentives for cost containment
which do not threaten quality.
The people, Mr. Chairman, that you have invited to this hearing
today are themselves or represent people who, for in excess of six
decades, have been proud, self-sufficient people, taking care of
themselves and their own.
It is a national tragedy that, beset by an illness, a sickness, that
a huge excess of hospital or nursing home bills should plunge such
an individual, such a family, from a plateau of self-respect into an
abyss of dependency and desperation. And it is my hope that out of
these hearings that you have called, Mr. Chairman, we will be able
to assure that people are protected from falling into the chasm,
and that instead of having a crash landing, there will be a much
happier ending.
Thank you, Mr. Chairman.
Chairman MELCHER. Thank you very much, Senator Heinz.
Senator David Pryor and Senator Chuck Grassley cannot be with
us today due to prior commitments. They have, however, submitted
statements for the record, and without objection, they will be inserted
at this point.
[The prepared statements of Senators Pryor and Grassley follow:]
OPENING STATEMENT OF HON. DAVID PRYOR
Mr. Chairman, I'd like to congratulate you on the scheduling of this hearing. Catastrophic
coverage seems to be the issue of the hour-the newspapers are filled with
articles of it, and this week alone several Congressional committees have scheduled
hearings on the topic. This is a significant change since last August when I held an
Aging <strong>Committee</strong> hearing on this topic in Arkansas, and found limited hearing reference
to the issue during recent Congresses. I hope that this increased attention
will translate into some positive legislative action this year.
It is no secret that HHS Secretary Otis Bowen is to be credited for a great deal of
the attention being focused in the area of catastrophic health care costs. Although
through the years there have been a number of legislative proposals submitted to
deal with one or more aspect of the catastrophic problem, the Secretary's endorsement
of a catastrophic plan and subsequent Advisory <strong>Committee</strong> meetings started
many of the interested parties talking. Equal in importance, however, is the definition
for "catastrophic" that the Secretary's Advisory <strong>Committee</strong> came up with-a
disease or condition was defined as catastrophic based on its financial impact upon
an individual or a family. This is much broader approach than had been previously
taken, one which includes three distinct problem areas- acute catastrophic care for