that really bothers me about that bill is the portion that precludes a visiting or consulting physician from reviewing an electrocardiogram. If a consulting doctor is called in, the consulting doctor gets no reimbursement for reviewing that EKG. I do not have the whole bill with me, but I have a sheet from it. I also understand that in February, the early part of February, there will be or has been a hearing on the components of the Omnibus Act. Has that been held? And if it has not been held, who can we write to to express our concerns?

Senator PRYOR. The Finance Committee is expected to hold such a hearing. Senator Lloyd Bentsen is Chairman. I'm on that Committee. I'll be participating in that hearing. And that's a 1990 act, by the way, rather than 1991. I was a bit confused about those years myself, Kathleen. But thank you.

Ms. RUSK. Thank you. I do appreciate being able to

Senator PRYOR. You've been a great advocate for the people that you represent and your organization. Yes, sir. We'll go to this mike now. We'll try to make our comments, if we could, a little bit short

er.

WARREN GARDENHEIMER

Mr. GARDENHEIMER. My name is Warren Gardenheimer. We have been addressing the aging people, older people, which I see the need of. We have avoided the issue of the younger kids who have been diagnosed terminally ill at the ages 4, 5 years old, that my son was, who has now reached 24, unable to work because the Government made him quit to keep his Medicaid, hospital bills and doctor bills exceeding $75,000 a year. Medicaid is cutting back his 20 days a year in the hospital. He has been in the hospital this year since the 8th of January. Senator Pryor, who is going to pay for this? I don't have it.

Senator PRYOR. Thank you, sir. And he's expressing the sentiment of hundreds of thousands of Americans and parents who are feeling this agony now. And I'm hoping this year we will have those answers, and we don't today. Yes, sir.

WOODY ARMOR, HOT SPRINGS, AR

Mr. ARMOR. Senator Pryor, I am Woody Armor, Hot Springs, Arkansas. I did a seminar in this town 12 days ago, and I just wanted to tell you and this witness today that the predominant phone call that I have had since the seminar and the predominant letter were senior citizens that told me they could not afford to pay for the drugs. Now, when I get this from all over northwest Arkansas, Fayetteville to Mena, Salisaw to Conway, there's a problem. They could not buy drugs.

Senator PRYOR. Y'all, I want to tell you something interesting about this man right here. He's from Hot Springs, Woody is. This gentleman operates a wonderful little restaurant in Hot Springs and it's called the Heart Rock Cafe, and it is for people like me, heart victims. And when I go to Hot Springs, I go in his place and he has all healthy food. I'm not advertising his place. I just want you to know that there are a few places you can get a healthy meal around in our State, Woody.

Mr. ARMOR. I appreciate that. But it is a problem. We know it. This gentleman is working for it. Writing letters, write all the Senators, write the House. We've got to do something for the senior citizens now.

Senator PRYOR. Thank you, Woody. Thank you. Yes, sir.

SCOTT HOLIDAY, LITTLE ROCK, AR

Mr. HOLIDAY. Senator, Scott Holiday from Little Rock. Many of us support the work that the Pepper Commission did and particularly the recommendations on long-term care, which I think would go a long way to alleviating a lot of the hardships and problems that people are having and that we've heard about today. And I wondered, it's been 2 years since the recommendations came out. What are we going to be able to do to get these recommendations implemented?

Senator PRYOR. I was on the Pepper Commission, as you may or may not know, Scott. And when the recommendations came out, I said, "This is a start. It is a beginning." and I will always feel that way about the Pepper Commission. We worked a year and a half, Jay Rockefeller chaired that Commission, Democrats and Republicans, members appointed by the White House. When we finished our work, I said that all the recommendations of the Pepper Commission are not going to be adopted, but at least it's the skeleton. It's the blueprint for us to build on. I think that's going to occur. I think we're going to see that.

I think ultimately what we use as the marking point this year for health care reform is not going to be the President's proposal, but it's going to be the Pepper Commission proposals, especially as it relates to long-term care.

Mr. HOLIDAY. Well, that would be good because we do need longterm care along with health care reform, and I hope everybody here will write to Senator Bumpers and other Congressmen and, you know, let them know how you feel about it. Thank you.

Senator PRYOR. Okay. Speaking of that, y'all don't know how much it helps, every now and then, to have some letters of support and also some letters of personal experience because when Dale Bumpers and myself and others are trying to get on the floor of the Senate and in our respective committees and try to do some of these things, many times if we can hold up a letter from a constituent not only of support, also we can cite a personal experience just like we've heard today. And that gives us a great deal of ammunition to go from. It's better than statistics, I tell you that, because we'll put a human face with a statistic and that will really mean a lot. Yes, sir.

BILL ENGLES, FORT SMITH, AR

Mr. ENGLES. Senator Pryor, I'm Bill Engles of Fort Smith here. I do financial planning in health. I might ask you this, I've written you several times and I'm real proud of you. How's your heart doing?

Senator PRYOR. I think-let me check it. I want to hear it. I had to do a lot of lifestyle changing, I might say, and I believe I feel better because of it.

Mr. ENGLES. I work with health, businesses, elderly people, and it's so sad when you go out. But it's sad also protecting a little bit of the insurance people. I've got a list of 225 insurance companies. I am going to send them to you. The first largest company sold $5 billion worth of health insurance last year, or year before. They lost over $100 million. I'll show you where 20 to 50 percent in every year lose money, from $20 to $100 million. Now, the second one also starts with a P. They sold $22 billion, but they made 156 million. You say, "Well, what does that mean?" It means they're either doing something right or they're overcharging, which it can be either one.

But what I wanted to say is this, there's a disease going around. And the doctors have it, the attorneys have it, the hospitals, the customer, everyone has it, seems like. In fact, even Senators are getting it, and it's called greed.

Senator PRYOR. That's right.

Mr. ENGLES. That's one of the biggest problems I see. We go out, and they'll write us a policy 1 year that's costing-I've got a friend that's been in business a long time, used to make money. He was paying $28,000 a year for 13 employees, $28,000 a year. They just got through raising it to $50 something thousand a year. He can't afford it, but he can't afford to drop it because he's got two people, one had a heart bypass and another had another problem. But he can't buy it anywhere else, so he's going to have to pay $50 something thousand for it, and he's not making that kind of money. I asked him, I said, "Bobby, are you making that kind of money?" He says, "No, I'm not." But he said, "I'm afraid of losing my good employees." But the greed, if you can get rid of that, you'll help out a lot.

Senator PRYOR. You know, you've brought up a good point. It's kind of in the area of—maybe indirectly to the point of preventive medicine. Talking about my own situation just a little bit, we don't talk about preventative, but let me tell you what a doctor in Washington told me. One day I was talking to him last spring and he was doing a workup of cholesterol and triglycerides, all the HDLL, all that stuff. And he was a worldwide expert in nutrition. He's also a surgeon, heart surgeon.

And he said, "You want me to tell you, Senator Pryor, one thing that is wrong with our system?" I said, "No, but I'll listen to it anyway." No. I said, "Sure." He says, "I'm going to counsel with you, and your Blue Cross/Blue Shield is going, for this hour, is going to send me a check for about $250 an hour." I said, "Okay." He said, "I can take you downstairs. In the same amount of time, I can put you on that operating room table and I can operate on your heart and give you a bypass and they'll send me a check for $30,000." He said, "What do you think most doctors are going to do?"

You've got to think about that. It's sobering. Because there are physicians here who are very, very eager-I'm not saying it's for financial purposes, but many don't look and see if there are alternatives to surgery. And I think that we're now relooking and see if preventative medicine and diet and others might be better options sometimes. Sometimes we have to have the surgery. I certainly realize that.

Mr. ENGLES. There are several companies now starting policies that you can buy that is preventative. They let you go to a doctor, and anything that they can do in a doctor's office, it's only $10. Where they'll go for $10, but they won't go until they get $250 or $1,000, so they let their kid get pneumonia instead of going for a $10 bill and find out what's wrong with the child. Same thing with the old people.

Senator PRYOR. By the way, I'd like that list of companies. I've not seen that. It would be helpful to us.

Mr. ENGLES. Yes, sir.

Senator PRYOR. Yes, sir.

JIMMY JOHNSON, UNIONTOWN, AR

Mr. JOHNSON. I'm Jimmy Johnson. I'm from the city of Uniontown, Arkansas, and I'm an engineer by trade. And I have here with me a check stub which says that I pay $17.26 every other month for Medicare. And I assume that this new bill, which I haven't heard addressed today, who is going to be paying these new insurances? But assuming that I'm the one that's going to be paying for it, let's assume that I pay $10 a week. And instead of paying it to the Government, I'm allowed to put it into a savings account, and each year, I increase my contribution by 5 percent. And let's say I'm also, at the same time, I'm drawing 10 percent interest to pay on my account. I can work for the next 38 years. At the end of that 38 years, I will have accumulated $312,000. And at 10 percent interest, I can withdraw the $30,000 in interest. I can take that $30,000 and pay my medical bills, that $30,000 that you mentioned earlier, and I can take the other $1,233 in interest that I will be drawing and give it to someone else that cannot pay for their insurance. I will be more than willing to do that if the Government would only allow me to have the bank account instead of having the Government have the bank account.

Senator PRYOR. Right. What we're talking about is there is, you're seeing a young man's frustration with the Social Security system. And if every young person in America was like that and would work and put that amount aside and whatever, it might be all right. But the problem is, everyone is not like him. And before long, we're going to see our fund diminish because people are not going to be putting into it. So he's expressing a frustration that is very, very real. Yes, ma'am.

IMOGENE COLEMAN

Ms. COLEMAN. My name is Imogene Coleman, and I'd like to request services. And I think Arkansas might qualify for the ombudsman, that there be a task force on Healthy Communities 2000. Every State is going to be required to do that. And instead of waiting, I think that, you know, we should go ahead and do that now. Senator PRYOR. Rather than waiting till the year 2000?

Ms. COLEMAN. Yes. And then there's a different kind of programs where you can do studies and have demonstrations and things like that with community support, and you won't be behind in services. And Arkansas is kind of bad on health care right now, especially

long-term care because services are not coordinated so well as they could be.

Senator PRYOR. Okay. Thank you very much for that suggestion. I think I know what your suggestion is and I appreciate that.

KAREN KIDD

Ms. KIDD. My name is Karen Kidd, and I would like to address two issues, and one of those is people who are uninsurable but yet they work and they're able to afford the insurance, but they're not able to get it because of past medical history, and then whenever something does happen, you overqualify for Medicaid. And I see that that's a real problem. I know with me even it's a real problem. I'm uninsurable. I'm a healthy person. And because I'm uninsurable, my family is uninsurable. And just recently, my husband was in the hospital for a newly diagnosis of diabetes, and we're going to have to pay for that out of our pocket.

And another thing I want to address is long-term health care, nursing homes. One of the problems that I see with nursing homes is I've done a lot of studying in nursing homes, is there's not enough staffing. And in order to get these people fed, there needs to be more staffing because realistically, it takes 30 minutes to feed somebody. And whenever you only have 4 nursing assists trying to feed 80 patients, it's unrealistic. And I think that what Mr. David Banks suggested about a Federal insurance policy for a blanket insurance throughout the United States, this Medicare/Medicaid being taken care of federally, I think that that was a real good suggestion. And I also think that the staffing on nursing homes needs to be up. The nursing homes here in Arkansas follow the minimum requirement of staffing and I think that that needs to be up.

SENATOR PRYOR. Thank you. You're a very good expert in that. Thank you. The young lady's first observations and comments, that area is going to be covered tomorrow in our hearing in Jonesboro, by the way, that specific area. Yes, sir.

ROBERT DEETS, HARTFORD, AR

Mr. DEETS. Senator David Pryor, my name is Robert Deets. I'm from Hartford, Arkansas. I have been looking over this international drug price comparison when it comes to other States and including our own. Now, you've listed one, which I think was Great Britain, that a drug company could make only so much profit. Senator PRYOR. That is correct.

Mr. DEETS. Then why can't we do the same?

Senator PRYOR. Well, that's why I'm trying to look at that.

Mr. DEETS. You've listed out many things that you would like to do, but who is going to pay for it?

Senator PRYOR. Who is going to pay for what?

Mr. DEETS. Well, if we was to set a limit on what a drug company could make or set up a commission such as our utilities commission, every so often they want a raise, of course. But we could work the same thing, same system.

Senator PRYOR. See, I believe that we could. In my legislation on prescription drug prices control, I establish a commission. Now, the drug industry says I'm establishing a new bureaucracy. But it's a