Washington, D.C. – Downsizing the federal government appears to be an oxymoron when one looks at the Department of Health and Human Services. That was the testimony delivered to a House Appropriations subcommittee today by Dr. Merrill Matthews, Vice President – Domestic Policy for the National Center for Policy Analysis.
"If Congress is serious about downsizing the federal government, Health and Human Services has to be on the table," Matthews said. "Unfortunately, trends created by both Congress and that department actually expand government." He pointed out two examples involving the department's Health Care Financing Administration (HCFA).
- Provisions in the Kassenbaum-Kennedy health insurance reform bill of 1996 delegate more oversight responsibilities to HCFA.
- The HCFA is now printing millions of brochures and has created a toll-free call center where seniors can call and ask questions about their new Medicare options.
Matthews believes there are a number of steps Congress can take to make Health and Human Services more efficient and more economical. "Why not have health insurers and health plans make the decisions about how to market their health insurance systems? Letting people who know the business of insurance provide that information is the only logical efficient solution," he said.
Even more vital to the downsizing of HHS is fundamental reform of Medicare, Medicaid and welfare, Matthews said. Otherwise, he said, expect to see HHS continue to grow and spend more taxpayer money.
For reforming welfare, Matthews suggests Taxpayer Choice – a system in which people would designate where their welfare tax dollars go. He proposed block grants for Medicaid and the gradual implementation of a Medical IRA to pay for health care upon retirement as a way to reform Medicare.
"There are a number of ways Congress can downsize the federal government," Matthews said, "but unless Congress is willing to look at the major programs, most downsizing attempts will just be nibbling around the edges."