HEALTH CARE REFORM HEARINGS BEFORE THE SUBCOMMITTEE ON HEALTH OF THE COMMITTEE ON WAYS AND MEANS HOUSE OF REPRESENTATIVES ONE HUNDRED THIRD CONGRESS VOLUME XI President's Health Care Reform Proposals: OCTOBER 7, 21, 22, 26; NOVEMBER 15, 1993; FEBRUARY 1 AND 4, 1994 PART 2 OF 3 OCTOBER 26, AND NOVEMBER 15, 1993 82-464 CC Serial 103-90 Printed for the use of the Committee on Ways and Means U.S. GOVERNMENT PRINTING OFFICE WASHINGTON: 1994 For sale by the U.S. Government Printing Office Superintendent of Documents, Congressional Sales Office, Washington, DC 20402 ISBN 0-16-046197-9 KF2M ·W 344 1993 vol.11 COMMITTEE ON WAYS AND MEANS DAN ROSTENKOWSKI, Illinois, Chairman SAM M. GIBBONS, Florida CHARLES B. RANGEL, New York BARBARA B. KENNELLY, Connecticut RICHARD E. NEAL, Massachusetts WILLIAM J. JEFFERSON, Louisiana BILL ARCHER, Texas AMO HOUGHTON, New York CONTENTS Adamson, John, Council of Community Blood Centers American Academy of Child and Adolescent Psychiatry, Peter R. Cohen American Academy of Ophthalmology, Allan D. Jensen, M.D American Academy of Physical Medicine and Rehabilitation, Leon Reinstein, American Association of Clinical Endocrinologists, Eugene T. Davidson, M.D American Association of Occupational Health Nurses, Geraldine C. American College of Foot and Ankle Surgeons, Eric Lauf American College of Gastroenterology, William D. Carey, M.D American College of Rheumatology, Robert J. Lloyd, M.D American College of Sports Medicine, Steven Van Camp, M.D American Geriatrics Society, John Burton, M.D American Occupational Therapy Association, Inc., Jeanette Bair American Osteopathic Healthcare Association, David Kushner 42 American Society of Anesthesiologists, Wilson C. Wilhite, Jr., M.D American Society of Internal Medicine, Alan R. Nelson, M.D American State of the Art Prosthetic Association, John N. Billock American Urological Association, Inc., Alan H. Bennett, M.D Arthur G. James Cancer Hospital and Research Center, Columbus, Ohio Bair, Jeanette, American Occupational Therapy Association, Inc Balch, Charles M., M.D., Memorial Sloan-Kettering_Cancer Center, New York, N.Y.; M.D. Anderson Cancer Center, Houston, Tex.; Fred Hutchinson Cancer Research Center, Seattle, Wash.; City of Hope National Medical Center, Duarte, Calif.; Dana-Farber Cancer Institute, Boston, Mass.; Fox Chase Cancer Center, Philadelphia, Pa.; Arthur G. James Cancer Hospital and Research Center, Columbus, Ohio; Kenneth Norris, Jr., Cancer Hos- pital, Los Angeles, Calif.; and Roswell Park Cancer Institute, Buffalo, N.Y Bennett, Alan H., M.D., American Urological Association, Inc Billock, John N., American State of the Art Prosthetic Association 301 Burt, Mary Jane, American Association of Bioanalysts, and Burt Medical 245 Carey, William D., M.D., Gastroenterology Leadership Council, and American |