SPEECH OF
HON. RON PAUL
OF TEXAS
IN THE HOUSE OF REPRESENTATIVES
Friday, July 24, 1998
1998 Ron Paul 84:1 Mr. PAUL.
Mr. Speaker, I appreciate the opportunity
to explain why I cannot vote for the
Patient Protection Act (H.R. 4250). However, I
would first like to express my support for two
of the bill’s provisions, relating to Medical Savings
Accounts and relating to the proposed
national health ID.
1998 Ron Paul 84:2 Earlier this week I introduced legislation, the
Patient Privacy Act (H.R. 4281), to repeal
those sections of the Health Insurance Portability
and Accountability Act of 1996 that authorized
the creation of a national medical ID.
I believe that the increasing trend toward allowing
the federal government to track Americans
through national ID cards and numbers
represents one of the most serious threats to
liberty we are facing. The scheme to create a
national medical ID to enter each person’s
medical history into a national data base not
only threatens civil liberties but it undermines
the physician-patient relationship, the cornerstone
of good medical practice. Oftentimes, effective
treatment depends on a patient’s ability
to place absolute trust in his or her doctor, a
trust that would be severely eroded if the patient
knew that any and all information given
their doctor could be placed in a data base accessible
by anyone who knows the patient’s
“unique personal identifier.”
1998 Ron Paul 84:3 While I was not here in 1996 when the medical
ID was authorized, it is my understanding
that this provision was part of a large bill
rushed through Congress without much debate.
I am glad that Congress has decided to
at least take a second look at this proposal
and its ramifications. I am quite confident that,
after Congress hears from the millions of
Americans who object to a national ID, my colleagues
will do the right thing and pass legislation
forbidding the federal government from
instituting a “uniform standard health identifier.”
1998 Ron Paul 84:4 Mr. Speaker, I am also pleased that Congress
is addressing the subject of health care
in America, for the American health care system
does need reform. Too many Americans
lack access to quality health care while millions
more find their access to medical care
blocked by a “gatekeeper,” an employee of an
insurance company or a Health Maintenance
Organization (HMO) who has the authority to
overrule the treatment decisions of physicians!
1998 Ron Paul 84:5 An an OB/GYN with more than 30 years experience,
I find it outrageous that any insurance
company bureaucrat could presume to
stand between a doctor and a patient. However,
in order to properly fix the problem, we
must understand its roots. The problems with
American health care coverage are rooted in
the American tax system, which provides incentives
for employers to offer first-dollar insurance
benefits to their employees, while providing
no incentives for individuals to attempt
to control their own health care costs. Because
“he who pays the piper calls the tune,”
it is inevitable that those paying the bill would
eventually seize control over personal health
care choices as a means of controlling costs.
1998 Ron Paul 84:6 Because this problem was created by distortions
in the health care market that took control
of the health care dollar away from the
consumer, the best solution to this problem is
to put control of the health care dollar back
into the hands of the consumer. We also need
to rethink the whole idea of first-dollar insurance
coverage for every medical expense, no
matter how inexpensive. Americans would be
more satisfied with the health care system if
they could pay for their routine expenses with
their own funds, relying on insurance for catastrophic
events, such as cancer.
1998 Ron Paul 84:7 An excellent way of moving toward a health
care system where the consumer is in charge
is through Medical Savings Accounts (MSA’s).
I enthusiastically endorse those provisions of
this bill that expand access to MSA’s. It may
be no exaggeration to say that MSA’s are vital
to preserving the private practice of medicine.
1998 Ron Paul 84:8 MSA’s provide consumers the freedom to
find high-quality health care at a reasonable
cost. MSA’s allow consumers to benefit when
they economize in choosing health care so
they will be more likely to make informed
health care decisions such as seeking preventive
care and, when possible, negotiate with
their providers for the lowest possible costs.
Most importantly, MSA’s are the best means
available to preserve the patient’s right to
choose their doctor and the treatment that
best meets their needs, free from interference
by an insurance company or an HMO.
1998 Ron Paul 84:9 Mr. Speaker, all those concerned with empowering
patients should endorse H.R. 4250’s
provisions lifting all caps on how many Americans
may purchase an MSA and repealing
federal regulations that discourage Americans
from using MSA’s. For example, a provision in
the tax code limits the monthly contribution to
the MSA to one-twentieth of the MSA’s yearly
amount. Thus, MSA holders have a small portion
of their yearly contribution accessible to
them in the early months of the year. The Patient
Protection Act allows individuals to make
the full contribution to their MSA at any time
of the year, so someone who establishes an
MSA in January does not have to worry if they
get sick in February.
1998 Ron Paul 84:10 This legislation also allows both employers
and employees to contribute to an employee’s
MSA. It lifts the arbitrary caps on how one can
obtain MSA’s and expands the limits on the
MSA deductible. Also it provides that possession
of an MSA satisfies all mandated benefits
laws as long as individuals have the freedom
to purchase those benefits with their MSA.
1998 Ron Paul 84:11 However, as much as I support H.R. 4250’s
expansion of MSA’s, I equally object to those
portions of the bill placing new federal standards
on employer offered health care plans.
Proponents of these standards claim that they
will not raise cost by more than a small percentage
point. However, even an increase of
a small percentage point could force many
marginal small businesses to stop offering
health care for their employees, thus causing
millions of Americans to lose their health insurance.
This will then lead to a new round of
government intervention. Unlike Medical Savings
Accounts which remove the HMO bureaucracy
currently standing between physicians
and patients, the so-called patient protections
portions of this bill add a new layer of
government-imposed bureaucracy. For example,
H.R. 4250 guarantees each patient the
right to external and internal review of insurance
company’s decisions. However, this does
not empower patients to make their own decisions.
If both external and internal review turn
down a patient’s request for treatment, the average
patient will have no choice but to accept
the insurance companies decision. Furthermore,
anyone who has ever tried to navigate
through a government-controlled “appeals
process” has reason to be skeptical of the
claims that the review process will be completed
in less than three days. Imposing new
levels of bureaucracy on HMO’s is a poor substitute
for returning to the American people the
ability to decide for themselves, in consultation
with their care giver, what treatments are best
for them. Medical Savings Accounts are the
best patient protection.
1998 Ron Paul 84:12 Perhaps the biggest danger these regulations
pose is ratification of the principle that
guaranteeing a patients’ access to physicians
is the proper role for the government, thus
opening the door for further federal control of
the patient-physician relationship. I ask my
physician-colleagues who support this regulation,
once we have accepted the notion that
federal government can ensure patients have
access to our services, what defense can we
offer when the government places new regulations
and conditions on that access?
1998 Ron Paul 84:13 I am also concerned that this bill further
tramples upon state automony by further preempting
their ability to regulate HMO’s and
health care plans. Under the 10th amendment,
states should be able to set standards for organizations
such as HMO’s without interference
from the federal government. I am disappointed
that we did not get an opportunity to
debate Mr. BRADY’s amendment that would
have preserved the authority of states in this
area.
1998 Ron Paul 84:14 In conclusion, Mr. Speaker, while the Patient
Protection Act takes some good steps toward
placing patients back in control of the
health care system, it also furthers the federal
role in overseeing the health system. It is my
belief that the unintended, but inevitable, consequence
of this bill, will require Congress to
return to the issue of health care reform in a
few years. I hope Congress gets it right next
time.
Notes:
1998 Ron Paul 84:11
employer offered health care plans probably should be hyphenated:
employer-offered health care plans.
1998 Ron Paul 84:11
review of insurance company’s decisions probably should be
plural: review of insurance companies’ decisions.
1998 Ron Paul 84:11
the insurance companies decision probably should be singular and possessive:
the insurance company’s decision.
1998 Ron Paul 84:12
a patients’ access to physicians probably should be singular:
a patient’s access to physicians.
1998 Ron Paul 84:13
I am disappointed that we did not get an opportunity to debate Mr. BRADYs amendment that would have preserved the authority of states in this area.
Here, Ron Paul does not specify whether he means The Honorable Robert A. Brady of Pennsylvania or The Honorable Kevin Brady of Texas.
