PREPARED STATEMENT OF REPRESENTATIVE JAMES H. BILBRAY

MR. CHAIRMAN, JUST LIKE EVERYBODY
ELSE HERE TODAY, I SPENT SOME TIME
THIS WEEKEND GOING OVER THE PEPPER
COMMISSION'S RECOMMENDATIONS. I
WANT TO THANK THE MEMBERS OF THE
COMMISSION FOR ALL THE TIME THAT
THEY SPENT STUDYING THESE TWO COM-
PLEX ISSUES THAT, TO THIS DATE, STILL
HAVE NOT BEEN ADDRESSED BY CON-
GRESS ADEQUATELY. WHILE I, LIKE MANY
OTHERS, AM DISAPPOINTED THAT THE
COMMISSION'S PLAN DID NOT CONTAIN A
FINANCING PACKAGE TO PAY FOR THE REC-
OMMENDED BENEFITS, I STILL FEEL THAT
IT CONTAINS MANY WORTHWHILE FEA-
TURES, ESPECIALLY IN THE AREA OF LONG
TERM CARE.

THERE CAN BE NO DOUBT TODAY, ESPECIALLY IN LIGHT OF LAST YEAR'S REPEAL

OF THE CATASTROPHIC ACT, THAT LONG TERM CARE IS NUMBER ONE ON THE PRIORITY LIST OF OLDER AMERICANS. ACCORDING TO THE ESTIMATES I HAVE SEEN, ONLY SOMEWHERE AROUND 10 TO 15 PERCENT OF THE SENIOR POPULATION OF THE UNITED STATES HAS LONG TERM CARE INSURANCE. AS IT NOW STANDS, EVEN A SHORT NURSING HOME STAY CAN BREAK ALL BUT THE WEALTHIEST OF AMERICANS

ON THE WHOLE, THE LONG TERM CARE BENEFITS PACKAGE PROPOSED BY THE PEPPER COMMISSION IS SOUND. I WAS ESPECIALLY PLEASED TO SEE THAT THE COMMISSION INCLUDED A THREE MONTH FRONT END COVERAGE THAT WILL COST THE BENEFICIARY NOTHING MORE THAN A MODEST CO-PAYMENT. DUE TO A NUMBER OF FACTORS, INCLUDING THE SEVERITY OF

THE ILLNESS AND THE INABILITY OF THE HUMAN BODY TO HEAL AS QUICKLY AS IT ONCE DID, MANY SENIORS REQUIRE SOME RECUPERATION TIME IN A NURSING HOME AFTER THEY HAVE BEEN HOSPITALIZED. WITH NURSING HOME COSTS FREQUENTLY IN EXCESS OF $2,000 PER MONTH, JUST ONE OR TWO SHORT NURSING HOME STAYS LIKE THIS COULD RAPIDLY DEPLETE THE ASSETS OF MANY SENIORS.

ADDITIONALLY, I WAS ENCOURAGED BY
THE COMMISSION'S INCLUSION OF HOME
AND COMMUNITY BASED CARE IN ITS
PLAN. CURRENTLY, WE HAVE FAR TOO
MANY ELDERLY WHO ARE NEEDLESSLY
CONFINED IN NURSING HOMES SIMPLY BE-
CAUSE THEY NEED HELP WITH SOMETHING
LIKE EATING OR DRESSING. MEDICARE
JUST DOESN'T PROVIDE THIS TYPE OF COV-

ERAGE, AND IT IS SOMETHING THAT WE SHOULD GIVE VERY SERIOUS CONSIDERATION TO, SINCE IT ALLOWS THE ELDERLY TO REMAIN AS INDEPENDENT AS POSSIBLE WHILE COSTING LESS PER BENEFICIARY THAN FULL NURSING HOME CARE.

THE COMMISSION ESTIMATED THE COST OF
THE LONG TERM CARE PROGRAM AT
ABOUT $43 BILLION, AN AMOUNT THAT
WHILE PERHAPS BEING A LITTLE LOW, IS
BASICALLY IN LINE WITH OTHER PROJEC-
TIONS THAT I HAVE SEEN FOR WHAT A
COMPREHENSIVE LONG TERM CARE PRO-
GRAM WILL COST. OBVIOUSLY, A FINANC-
ING MECHANISM MUST BE DEVELOPED
FOR THIS PROGRAM. THIS WON'T BE EASY,
GIVEN THE HEAT THAT WE ALL TOOK FOR
THE CATASTROPHIC ACT SURTAX LAST
YEAR, AND I LOOK FORWARD TO HEARING

YOUR THOUGHTS, MR. SECRETARY, ON
WHAT TYPE OF PACKAGE WOULD BE
AGREEABLE TO THE ADMINISTRATION.

FINALLY, I WOULD ALSO LIKE TO SPEND SOME TIME ON OUR EXISTING MEDICARE PROGRAM. ONCE AGAIN, THE ADMINISTRATION IS PROPOSING HEFTY MEDICARE CUTS, COUPLED WITH RAPID INCREASES IN THE PART B PREMIUM. CONSIDERING THE STUDY THAT CHAIRMAN ROYBAL WILL RELEASE TODAY, IT APPEARS TO ME THAT MANY OF OUR ELDERLY ARE SIMPLY REACHING THE OUTER LIMITS OF WHAT THEY CAN AFFORD TO SPEND ON OUT OF POCKET HEALTH CARE COSTS. THE PROPOSALS IN THE ADMINISTRATION'S

BUDGET WOULD NO DOUBT EVEN FUR

THER INCREASE THE OUT OF POCKET BUR

DEN ON OUR NATION'S ELDERLY, AND I