Date: 1999-07-15
Speaker: GREG GANSKE9 (republican)
Chamber: S

a Republican Congressman from Iowa. who happens to be a reconstructive surgeon. This is a picture of a child with a very serious medical problem. a cleft lip. Dr. GANSKE contacted his colleagues in reconstructive surgery. and Mr. President. he found that 50 percent of them had cases such as this denied. In cases dealing with reconstructive surgery. 50 percent had cases denied because they were not medically -necessary. Think of that. Think of being the mother or father of this young child and being told reconstructive surgery is not medically necessary. Ask yourself whether you think that is reasonable. Yet it happens in this country and will happen again under the Republican bill because they do not allow a patients doctor to determine what is medically necessary. Let me show you another picture of a child with the same cleft lip problem. Now let me show Members what happens when reconstructive surgery gives this young child a chance. an opportunity. Here is the same child. Take a look at what someone decides is "medically necessary" and what it will mean to this young childs life. This picture demonstrates what reconstructive surgery can do for this wonderful child. As these real cases illustrate. this debate is not about theory. It is not about arguing the terminology in some halfbaked plan that doesnt do much. It is about providing assurance and guarantees to people in this country. Help this young child. Provide protection for Jacqueline Lee who fell off a cliff 40 feet. fractured her body in three places. and unconscious. is helicoptered to an emergency room. She is unconscious. out cold on a gurney. She survives and then is told by her HMO that she did not get prior approval for her emergency room visit and therefore they will not pay it. Or Ray. the father who. with tears in his eyes. told about Matthew. his 12yearold son. who lost his battle with cancer because they were forced to fight both the cancer and the insurance company to provide for the treatment necessary to try to save him. Ray says. "We could not fight cancer and the insurance company at tle same time. and it is not fair to ask us to do it." I say this to you. those who say you are providing wonderful protection -you are not. This editorial says you are not and we know you are not and you know you are not. Mr. President. 100 million people are left out of your plan and you say: Yes. they are left out of our plan but the States cover them. They do not and you know they do not. Medical necessity? Emergency room? OB/GYN? Go down the list and then tell the American people. tell these children. tell the women. tell the families why you do not think they ought to be covered. This last amendment says to patients. we do not think you ought to be protected. but we certainly think we ought to provide protection to the insurance companies. We certainly think insurance companies ought to be given protection and patients should be denied the right to hold them accountable. My colleague talks about lawsuits. It is interesting. Texas passed a statute allowing consumers to hold HMOs accountable a couple of years ago. There has been one lawsuit. I understandperhaps by now two or three. Where is the blizzard of lawsuits our opponents predict when you make health care providers accountable? Every Medicare patient in this country has the basic protections we are proposing in our Patients Bill of Rights. Every Medicaid patient in this country has the same protections. and every Federal employee and every Senator sitting on. this floor has these protections. But we have folks in this Chamber who decide it might be good enough for Senators. they voted for it for Medicare. but it is not good enough for the rest of the American people. And the result is too many cases. too many children. too many Jimmy Adamses whose parents decide they have to comply with the rules because they do not have the money. I remember the first time I saw an entertainer use the moon walk. It made him look as if he was moving forward when instead he was moving backwards. I see that on the floor of the Senate in this debate. People offer proposals when they want people to believe they are making progress. but in reality. they are not doing anything or maybe even moving backwards. That is not going to work in this debate. This debate is not about theory. It is about peoples lives. about their medical treatment. It is about providing protection for hardworking Americans who have insurance and think they are protected with decent health coverageonly to discover at 2 a.m. that they do not have access to an emergency room.