January 1994 55 Reports to Congress 2 Testimonies STUDENT LOANS: MILLIONS LOANED The Department of Education is required to ensure that foreign medical schools are comparable to U.S. schools before allowing them to participate in the student loan program. However, the Department does not have adequate standards to ensure that the schools are comparable or enforce the few standards that exist nor do its procedures preclude students attending unapproved schools from receiving loans. As a result, the Department made $118 million in questionable loans between 1986 and 1991 to students attending foreign medical schools. (HEHS-94-28) PRESCRIPTION DRUGS: COMPANIES TYPICALLY On the basis of May 1992 price information, drug manufacturers charged 60 percent more for 77 commonly prescribed brand-name drugs in the United States than in the United Kingdom. The price differences were due mainly to the lack of regulatory constraints in the United States, not differences in manufacturers' costs. In the United Kingdom, the government health system, which is virtually the sole payer for prescription drugs, has an agreement with manufacturers that limits profits that they may earn on sales. (HEHS-94-29) NAVY AVIATION: V-22 DEVELOPMENT SCHEDULE EXTENDED, PERFORMANCE REDUCED, AND COSTS INCREASED In October 1992, the V-22 Osprey tilt-rotor aircraft program was still experiencing major design uncertainties and operational problems and the cost of each aircraft was estimated to be as much as $64 million. At that time, the Navy began considering a V-22 variant and other helicopter alternatives. As part of its cost-benefit analysis, the Navy should use more realistic capability assumptions, and it should ensure that the most cost-effective alternative meets operational requirements before requesting procurement funds or committing to production. (NSIAD-94-44) AVIATION SECURITY: ADDITIONAL ACTIONS After the Pan Am flight 103 tragedy, the Federal Aviation Administration (FAA) strengthened security at U.S. domestic and international airports; many questions remain unanswered, however. For example, even though FAA and the Federal Bureau of Investigation examined 18 of 19 U.S. airports that have high traffic volumes and complex security programs, the agencies did not match the capabilities, the methods, or the intent of known terrorist groups with individual airport vulnerabilities, which is important to determine the appropriate level of security necessary and to develop effective contingency plans. (RCED-94-38) MILITARY SPACE PROGRAMS: OPPORTUNITIES TO REDUCE MISSILE WARNING AND COMMUNICATION SATELLITES' COSTS Testimony by the Director of Systems Development and Production Issues, Both the Defense Support Program (DSP) and the Milstar program, two Department of Defense space programs designed for the Cold War, need to be adapted to tactical warfare in regional conflicts. The Department's decision to end the DSP follow-on program provides an opportunity to fully consider the new tactical requirements and reduce program costs. Also, if the Department canceled some of Milstar's planned large-sized satellites and developed a lowercost system of smaller satellites, Milstar program costs could be reduced by billions of dollars. (T-NSIAD-94-108) SOCIAL SECURITY: DISABILITY BENEFITS FOR Testimony by the Associate Director for Income Security Issues, Jane L. Ross With the number of alcoholics and drug addicts receiving disability benefits from the Social Security Administration increasing rapidly, the agency must improve its monitoring of these recipients to ensure that benefits are not used to support addictions. About 250,000 addicts currently receive disability benefits at an annual cost of $1.4 billion, but the vast majority of them are not required to be in treatment. (T-HEHS-94-101) MANAGED HEALTH CARE: EFFECT ON Testimony by the Associate Director for National and Public Health Issues, Although certain "managed care" plans have the potential to deliver health care at lower cost, little empirical evidence exists showing that the use of these plans has contained employers' overall health care costs. The plans also limit employees' choice of physicians, which is considered a major drawback of these plans. To gain greater employee acceptance, employers are offering newer types of managed care plans with more flexibility but less cost-saving potential. (T-HEHS-94-91) |