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H.R. 257 (103rd): Health Care Crisis Policy Commission Act

The text of the bill below is as of Jan 5, 1993 (Introduced).

HR 257 IH


1st Session

H. R. 257

To establish a Health Care Crisis Policy Commission.


January 5, 1993

Mr. NEAL of North Carolina introduced the following bill; which was referred jointly to the Committees on Energy and Commerce and Ways and Means


To establish a Health Care Crisis Policy Commission.

    Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,


    This Act may be cited as the ‘Health Care Crisis Policy Commission Act’.


    The Congress finds that--

      (1) the people of the United States will find it increasingly difficult to pay for their medical care if the cost of such care continues to increase;

      (2) in 1988, an estimated 37,000,000 individuals in the United States lacked health insurance and another 50,000,000 were underinsured, leading to high levels of uncompensated medical care;

      (3) there exists a tremendous need in the United States for access to basic medical care services;

      (4) as the average age of individuals in the United States increases, there will be a growing demand for health care;

      (5) in 1988, the average cost of a stay of 1 year in a long-term health care facility was $25,000;

      (6) adequate long-term health care insurance is unavailable;

      (7) the medical care system of the Department of Veterans Affairs is not adequate to deal with the health care needs of American veterans;

      (8) 11 percent of the gross national product of the United States is made up of spending for medical care;

      (9) medical malpractice tort reform is necessary because the high cost of malpractice insurance inflates medical costs;

      (10) there is a shortage of prenatal, infant delivery, and well-baby care services in the United States even though it has been proven that such services reduce medical costs over the long term;

      (11) a large percentage of health care expenditures are made for extraordinary medical procedures performed near the end of individuals’ lives rather than for preventative measures early in their lives;

      (12) Federal income tax incentives for employer-paid group health insurance need to be improved;

      (13) businesses that offer only self-insured health care coverage for their employees need to have such coverage regulated to guarantee adequate coverage, as such coverage is the fastest growing segment of health care insurance;

      (14) concern exists regarding the continued solvency of the medicare system with physicians becoming reluctant to participate because Federal payment rates are too low; and

      (15) health care in many rural areas is inadequate and some rural hospitals are closing.


    There is established a commission to be known as the ‘Health Care Crisis Policy Commission’ (in this Act referred to as the ‘Commission’).


    The Commission shall conduct a study of the problems of the cost and delivery of medical care in the United States. In conducting the study, the Commission shall--

      (1) examine the escalating costs of medical care and health care insurance and its effect on the availability of medical care to individuals in the United States;

      (2) investigate alternatives for providing medical care to individuals who do not have health care insurance or who do not have adequate health care insurance;

      (3) evaluate how the private sector could most effectively offer adequate health care insurance to all employed individuals in the United States;

      (4) review the demands that will be placed on the Nation’s health care system in the future as the population of the United States ages;

      (5) examine the costs of long-term institutional and home health care and the affordability and availability of insurance for such care;

      (6) evaluate the health care delivery system of the Department of Veterans Affairs;

      (7) investigate reforms that could be made to the medical malpractice liability system and the effect such system has on medical malpractice insurance and on the cost of health care;

      (8) examine the need for prenatal, delivery, and well-baby health care and how such care impacts on the cost of health care in the long term;

      (9) review the Federal income tax incentives used by businesses for employer-sponsored group health insurance;

      (10) research the trend of businesses to be self-insured in their health insurance coverage and how such coverage is regulated;

      (11) examine the delivery of health care in the rural areas of the United States and the reasons for the closing of many of the hospitals in those areas;

      (12) evaluate the financial stability and effectiveness of, and physician reimbursements from, title XVIII of the Social Security Act (42 U.S.C. 1395-1395ccc; commonly known as medicare);

      (13) investigate financing options and costs for each health care delivery system recommended by the Commission as an alternative to the systems used in the United States as of the date of the enactment of this Act;

      (14) investigate systems of organizing and delivering health care and types of incentives that could be used to improve the efficiency of the provision of health care while improving the quality of care; and

      (15) investigate other areas relating to the efficient and cost-effective delivery of health care that the Commission believes it is necessary to investigate.


    (a) NUMBER AND APPOINTMENT- The Commission shall be composed of 15 members appointed as follows:

      (1) 5 members appointed by the President.

      (2) 5 members appointed by the Speaker of the House of Representatives.

      (3) 5 members appointed by the majority leader of the Senate.

    (b) QUALIFICATIONS FOR AND LIMITATIONS ON APPOINTMENT- Each member shall be knowledgeable about the delivery or the financing of health care, or both, or in the economics, administration, or legal aspects of health care. Each member shall be selected from among consumers of health care, health care providers, employers, health care financial institutions, or organizations that represent such persons. Not more than 1 member appointed under each paragraph of subsection (a) may be--

      (1) an officer or employee of the Federal Government;

      (2) an officer or employee of a State or local government; or

      (3) a Member of the Congress.

    (c) VACANCIES- A vacancy in the Commission shall be filled in the manner in which the original appointment was made.

    (d) POLITICAL AFFILIATION- Not more than 3 members of the Commission appointed under each paragraph of subsection (a) may be of the same political party.

    (e) TERMS- Each member shall be appointed for the life of the Commission.

    (f) BASIC PAY-

      (1) RATES OF PAY- Except as provided in paragraph (2), members of the Commission shall each be paid at a rate equal to the rate of basic pay payable for level IV of the Executive Schedule for each day (including travel time) during which they are engaged in the actual performance of duties vested in the Commission.

      (2) PAY OF FEDERAL EMPLOYEES AND MEMBERS OF CONGRESS- Members of the Commission who are full-time officers or employees of the Federal Government or Members of the Congress shall receive no additional pay, allowances, or benefits, except those provided in paragraph (3), by reason of their service on the Commission.

      (3) TRAVEL EXPENSES- Each member of the Commission shall receive travel expenses, including per diem in lieu of subsistence, in the same manner as is permitted under sections 5702 and 5703 of title 5, United States Code.

    (g) QUORUM- 8 members of the Commission shall constitute a quorum, but a lesser number may hold hearings.

    (h) CHAIRMAN AND VICE CHAIRMAN- The chairman and vice chairman of the Commission shall be elected by the members of the Commission.

    (i) MEETINGS- The Commission shall meet at the call of the chairman of the Commission or a majority of its members.


    (a) IN GENERAL- The chairman of the Commission shall, in accordance with the provisions of title 5, United States Code, governing appointments in the competitive service, and other applicable laws and regulations, hire such staff as is necessary to carry out the duties of the Commission.

    (b) PAY- The staff of the Commission shall be paid in accordance with the provisions of chapter 51 and subchapter III of chapter 53 of title 5, United States Code, relating to classification and General Schedule pay rates.

    (c) EXPERTS AND CONSULTANTS- The chairman may procure temporary and intermittent services of experts and consultants under section 3109(b) of title 5, United States Code.

    (d) STAFF OF FEDERAL AGENCIES- Upon request of the Commission, the head of any Federal agency is authorized to detail, on a reimbursable basis, any of the personnel of such agency to the Commission to assist the Commission in carrying out its duties under this Act.



      (1) IN GENERAL- The Commission may, for the purpose of carrying out this Act, hold hearings, sit and act at times and places, take testimony, and receive evidence, as the Commission considers appropriate.

      (2) OPEN MEETINGS- The Commission shall be considered an agency for the purposes of section 552b of title 5, United States Code (relating to the requirement that meetings of Federal agencies be open to the public).

    (b) POWERS OF MEMBERS AND AGENTS- Any member or agent of the Commission may, if so authorized by the Commission, take any action which the Commission is authorized to take by this section.

    (c) OBTAINING OFFICIAL DATA- All officers and employees of Federal agencies shall cooperate with the Commission in the performance of the duties of the Commission. Subject to sections 552 and 552a of title 5, United States Code (relating to the availability of information of Federal agencies to the public), the Commission may secure directly from any Federal agency information necessary to enable it to carry out this Act. Upon request of the Chairman of the Commission, the head of the Federal agency shall furnish the information to the Commission.

    (d) GIFTS- The Commission may accept, use, and dispose of gifts or donations of services or property.

    (e) MAILS- The Commission may use the United States mails in the same manner and under the same conditions as other Federal agencies.

    (f) ADMINISTRATIVE SUPPORT SERVICES- The Administrator of General Services shall provide to the Commission on a reimbursable basis such administrative support services as the Commission may request.


    The Commission shall transmit to the President and to the Congress a report not later than 2 years after the date of enactment of this Act. The report shall contain a detailed statement of the findings and conclusions of the study conducted pursuant to section 4, together with the recommendations of the Commission for such legislation and administrative actions, at the Federal, State, and local level, and for actions that should be undertaken by the private sector, as the Commission considers appropriate.


    The Commission shall cease to exist 10 days after submitting its final report pursuant to section 8.


    Any spending authority (as defined in subparagraphs (A) and (C) of section 401(c)(2) of the Congressional Budget Act of 1974 (2 U.S.C. 651(c)(2)(A))) authorized by this Act shall be effective only to such extent or in such amounts as are provided in appropriation Acts.